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Effort thrombosis in the elite throwing athlete
Gregory S DiFelice1, George A Paletta, Barry B Phillips
1Department of Orthopaedic Surgery, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, Missouri 63110, USA.
The American Journal of Sports Medicine
|September 20, 2002
Summary
Elite baseball players can develop upper extremity venous thrombosis, or effort thrombosis, due to extreme throwing stress. Early diagnosis and treatment lead to a full return to play with no lasting effects.
Area of Science:
- Sports Medicine
- Vascular Surgery
- Orthopedics
Background:
- Upper extremity vascular injuries are rare in elite throwing athletes.
- Elite baseball pitchers face extreme upper extremity stress, increasing risk for injuries like effort thrombosis.
Purpose of the Study:
- To review clinical symptoms and physical findings of effort thrombosis in elite baseball players.
- To examine associated conditions like hypercoagulable states and pulmonary embolism.
Main Methods:
- Retrospective case series review.
- Analysis of medical records from a Major League Baseball organization and a Division I college (1987-1997).
Main Results:
- Four cases of effort thrombosis in elite baseball players were identified.
- Diagnosis confirmed via contrast venography.
- Successful treatment included urokinase thrombolysis, first rib resection, and anticoagulation.
- All players returned to their previous competitive level without long-term sequelae.
Conclusions:
- Prompt recognition, diagnosis, and treatment are crucial for effort thrombosis in elite baseball players.
- Optimal management offers an excellent prognosis for athletes to return to play.