Suprascapular neuropathy in a collegiate pitcher.
A healthy, 20-year-old, highly competitive collegiate baseball pitcher developed vague pain and soreness in the dominant posterior shoulder with live pitching. The symptoms intensified, and, after a particularly poor starting performance, the athlete presented for physical examination. Examination revealed visible atrophy of the infraspinatus muscle and decreased strength in external rotation and abduction. Magnetic Resonance Imaging was inconclusive. Electromyographic examination revealed decreased suprascapular nerve conduction to the infraspinatus muscle. Our diagnosis was entrapment neuropathy from traction on the suprascapular nerve at the spinoglenoid notch, causing delayed conduction to the infraspinatus muscle. We took a conservative approach of shoulder rehabilitation and activity modification, which resulted in the athlete returning to a highly competitive level without further problems, despite the remaining atrophy and muscle weakness. Examination of injuries to the shoulder complex, especially in athletes involved in repetitive overhead motions, should take suprascapular neuropathy into consideration.
Andrew N. Smith is Assistant Athletic Trainer at United States Military Academy, West Point, NY 10996.
A N
AN
Smith