Dead arm (people)

Dead arm syndrome starts with repetitive motion and forces on the posterior capsule of the shoulder. The posterior capsule is a band of fibrous tissue that interconnects with tendons of the rotator cuff of the shoulder. Four muscles and their tendons make up the rotator cuff. They cover the outside of the shoulder to hold, protect and move the joint.

Overuse can lead to a build up of tissue around the posterior capsule called hypertrophy. The next step is tightness of the posterior capsule called posterior capsular contracture. This type of problem reduces the amount the shoulder can rotate inwardly -- a motion needed by pitchers to throw the ball forward before releasing it.

Over time, with enough force, the player may develop a tear in the labrum. The labrum is a rim of cartilage around the shoulder socket to help hold the head of the humerus (upper arm) in the joint. This condition is called a superior labrum anterior posterior (SLAP) lesion. The final outcome in all these steps is the dead arm phenomenon.

The shoulder is unstable and dislocation may come next. Dead arm syndrome won't go away on its own with rest -- it must be treated. If there's a SLAP lesion, then surgery is needed to repair the problem. If the injury is caught before a SLAP tear, then physical therapy with stretching and exercise can restore it and return the player to the field.

References

• Rowe, C.R. and Zarins, B. (1981) "Recurrent transient subluxation of the shoulder" Journal of Bone and Joint Surgery (American) 63: pp. 863-72.
• Leffert, R.D. and Gumley, G. (1987) "The relationship between dead arm syndrome and thoracic outlet syndrome" Clinical orthopaedics and related research 223: pp. 20-31. Abstract
• Blevins, F.T. (1997) "Rotator cuff pathology in athletes" Sports Medicine (Auckland, N.Z.) 24(3): pp. 205-20. Abstract
• Ticker, J.B.; Beim, G.M. and Warner, J.J. (2000) "Recognition and treatment of refractory posterior capsular contracture of the shoulder" Arthroscopy 16(1): pp.27-34. Abstract
• Bach, H. Gregory and Goldberg, Benjamin A. (May 2006) "Posterior Capsular Contracture of the Shoulder" Journal of the American Academy of Orthopaedic Surgeons 14(5): pp. 265-277. Abstract