NFL quarterback, NHL goalie, MLB starting pitcher, and NBA point guard are generally considered the most important positions in the major U.S. sports. A position that is arguably as important is the major league closer. The closer is responsible for whether a team wins close games. A majority of major league games are decided by only 2 runs or less. It is easy to see the importance of a quality closer. Unfortunately for the San Diego Padres, closer Joaquin Benoit has been sidelined off and on by ongoing shoulder pain. He has missed a number of games over the course of the season due to the shoulder pain. Benoit has described a pain fluctuates. That he will feel good for a couple of days but then the inflammation will return. The cause of this pain has not been diagnosed but there are some acute shoulder tears that may be attributing to Benoit’s discomfort.

A SLAP tear is a tear in the top part of the labrum. The labrum is a strong, fibrous tissue that stabilizes the shoulder joint. The labrum acts to deepen the shoulder socket and allows a stronger fit between the upper arm bone, the shoulder blade, and the collarbone. A SLAP tear occurs in both the top-front and top-back portion of the labrum and is often caused by repetitive shoulder motion such as constantly hurling MLB sized curve balls and sliders. When a SLAP tear is present, the patient may experience shoulder pain, decreased strength, decreased range of motion, and unusual and uncomfortable feelings that the shoulder is catching, locking, grinding, or popping out of it’s joint. For major league pitchers there will also likely be a decreased in their pitch velocity.

A partial thickness rotator cuff tear is an incomplete tear of the rotator cuff. The rotator cuff connects the upper arm to the shoulder blade and is essential for shoulder strength and lifting of the arm. A partial tear in the rotator cuff would include damage to the soft tissue of the rotator cuff but would not be severed and would not be disconnected from the upper arm or shoulder blade. When the rotator cuff is torn, a patient will likely experience shoulder pain, shoulder weakness, difficulty lifting and rotating arm, and a crackling sensation in the shoulder. For major league pitchers lifting and rotating the arm is an essential part of the pitching motion. A partial thickness rotator cuff tear can cause tremendous amount of pain and a decrease in pitcher productivity.

For these acute injuries the suggested initial treatment is rest, anti-inflammatory medications, and physical therapy to restore the strength, flexibility, and range of motion. If non-surgical treatment is not sufficient and problems persist or worsen then the next step would be to review surgical options. At this point Joaquin Benoit is experiencing discomfort bad enough to miss some games, but team doctors do not believe that surgery is needed just yet. Time will tell whether he can overcome this nagging shoulder injury or if he will need to have the shoulder repaired via surgery. Call to schedule your appointment with our top notch sports medicine specialists at Orthopedic Surgery San Diego.