Getting Called Up To The Bigs.

Article by Clayton G. Lane, M.D.

As the team physician for the Baybears, one of the perks is that I also get invited to assist with Spring Training for the Arizona Diamondbacks in Tucson. While I have covered many athletic teams at all levels, it is always interesting to get another perspective on the medical care of athletes. I’ll take you though a typical day of Spring Training.

The athletes and trainers report to the clubhouse at 6:30AM. Breakfast is served and the athletes begin their preparation for the day. By 7:00AM the training room is hopping. Seven trainers juggle the needs of the athletes as they file in and out over the next hour. Some get myofascial release therapy (medical jargon for an aggressive massage), while others have trainer-assisted stretching or maintenance rotator cuff exercises. Still others need taping and other applications. The athletes and trainers must keep moving in order to be on the field in full uniform for group-stretching at 8:00AM.

The army of athletes consisting of what will become two minor league teams and one major league team is quite impressive. Once stretching is complete, the team splits up for position specific drills. Drills last most of the morning.

After lunch, there are four scrimmages; three minor league games on the practice fields and one major league game open to fans in the stadium. While I was in town it was the Rockies and the Angels.

After the games, the training room gets busy again with icing, more myofascial therapy and cuff maintenance. The adjacent weight-room gets busy as well. The strength trainers bounce around between athletes directing their exercise whether it be core strengthening, balance or cardio.

The energy level and tempo is very high throughout the day. This is of the innate competitive nature of professional athletes, but also because all are being evaluated at every moment. Particularly at the beginning of Spring, technically no one’s spot is secure whether they signed on for $6 million or $1000. So demonstrating a good work ethic as well as performing on the field is crucial. Even the trainers want to shine in front of the medical coordinator so that they might secure a spot in the Majors. I stayed with the trainers in the clubhouse until 9pm on Friday night, long after the players were gone, going over exam techniques and manipulations. I learned more from the trainers than they learned from me and was impressed with how eager they were to do this despite knowing they had to report at 6AM the next morning.

I look forward more to the Baybears’ season this year now that I know more about where they came from, how talented they are, and what they are driving for.

If you would like more information about Dr. Lane , the other Sports Medicine specialist, as well as the comprehensive and technologically advance care available at AOC, go to alortho.com.

Stinger

Dr. Clayton G. Lane, MD

One half of college football players will experience a stinger injury at some point during their career. Because, it sometimes results in temporary paralysis of the arm, it can be quite concerning for the athlete, coach and family members. In most cases however, there are no permanent limitations following the stinger (or Burner) syndrome episode.

All of the nerves that go to the arm come from a web of nerve roots exiting the spinal cord at neck level called the brachial plexus. This web of nerve roots coalesce into a nerve just like the roots of a tree into a tree trunk. Therefore, any injury to the brachial plexus results in variable nerve dysfunction in the arm dependent on which roots or cords are injured.

The stinger is almost exclusively a football injury because of the nature of the game. The brachial plexus runs to the arm just deep to the clavicle. Therefore, every time a player puts his shoulder into a tackle the plexus is at risk. The classic stinger injury occurs when the player takes a hard hit to the top of the shoulder while the head is turned to the opposite side. This places a stretch on the brachial plexus which can result in simple stretch, partial tearing or complete tearing of the nerves. The player typically experiences instantaneous burning pain in the arm. This pain may be associated with weakness of the arm that is apparent immediately or may present over the next few hours or days.

In most cases in which only a stretch has occurred, the athlete has resolution of pain and weakness within 15 minutes. The athlete should only be allowed to go back into the game if he has no pain and full strength on examination by a physician or trainer. In a small amount of cases recovery of full strength can take two weeks with partial tearing or up to a year with complete tearing of nerve tissue. With all stingers there is a recurrence rate up to 90%, so preventative measures should be taken.

High quality shoulder pads, ‘cowboy collars’ and shoulder strengthening have all been recommended as prevention strategies. If an athlete experiences recurrence despite these measures, a full evaluation by an orthopedist for cervical spine abnormalities should be performed. Also, any athlete experiencing symptoms of pain or weakness in both arms at the same time should be placed on spinal precautions for possible spinal cord injury, because stingers do not occur in both arms at the same time.

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