While baseball is considered a non-contact sport, injuries and conditions related to America’s favorite pastime can yield equally traumatic consequences if not correctly diagnosed and treated. Aside from painful strains, sprains and bruises, the most common injuries that players experience are overuse of the rotator cuff in the shoulder and ulnar collateral ligament tears in the elbow.

Due to the game’s repetitive nature, it’s imperative that coaches and players alike keep in mind the importance of preventative measures such as pre-season physical exams, warming up and cooling down before practices and games, and staying hydrated. Additionally, the American Academy of Orthopaedic Surgeons recommends the following:

Players should be taught techniques for sliding and must practice, beginning with a sliding bag, before being allowed to slide during a game. They must also be taught and observe the “obstruction” rule, which prevents the fielding player from obstructing the runner’s path without possession of the ball.

To prevent foot and ankle injuries between the runner and fielder on first base, a “double bag” should be used, so both the runner and first baseman have their own base.

Follow established guidelines to limit the number and types of pitches thrown based on the player’s age. Pitch Smart, a Major League Baseball and USA Baseball initiative, provides guidelines to help avoid overuse.

Players should avoid pitching on consecutive days and multiple teams with overlapping seasons.

Equipment should fit properly and be worn correctly.

Wear a batting helmet with a protective face shield at the plate, in the “on deck” circle and while running bases.

Position-specific equipment should be used, such as a specialized mitt, helmet, face mask, throat guard, long-model chest protector, protective supporter and shin guards for players in the Catcher’s position.

Players should always wear cleats with a snug heel, roomy toe box, good traction, flexibility in the sole, and plenty of ankle support and coverage. It is also essential to break in a new pair of cleats before wearing them during a game and check to ensure they breathe properly to discourage bacteria and fungus growth.

Gender-specific equipment may be of value, including athletic supports for boys/men and padded bras for girls/women.

Inspect the playing field for uneven terrain, holes and divots, as well as glass and other debris.

Use a field with breakaway bases to minimize the risk of injury when sliding into bases. The traditional stationary base is a rigid obstacle for an athlete to encounter while sliding. In contrast, a breakaway base is snapped onto grommets attached to an anchored rubber mat, which holds it in place during regular play but will dislodge when slid into.

Assess weather conditions and be prepared to delay/cancel the game, especially in extremely hot weather or thunderstorms with lightning.

The American Orthopaedic Society for Sports Medicine’s tips indicates that many injuries can be treated with active rest from sports participation until primary symptoms subside. The AOSSM further outlines the following considerations:

Active rest should include activities to address flexibility, strength, balance and form to begin successfully playing again.

When applying ice to an injured area to decrease pain or swelling, use crushed ice in a bag for 20 minutes as often as every 2 hours.

If symptoms persist, and for any injury involving pain, swelling, dysfunction, loss of sensation, uncontrolled bleeding, or concussion-related symptoms, the player should visit a trained sports medicine physician for evaluation.

For those seeking treatment by Dr. Josh Hackel, players can expect a detailed exam during the initial consultation. For many patients, this includes using in-office musculoskeletal ultrasound images to assess the area of concern. As one of the first sports medicine physicians in the region to utilize ultrasound technology, Dr. Hackel is not only a sought-after clinician but an instructor as well. He teaches an annual course in partnership with the Andrews Research & Education Foundation for other physicians from around the country. If you have sustained a baseball-related injury or suffer from chronic shoulder pain, contact our office at 850.916.8783 or use our convenient online appointment form to schedule an initial consultation with our office.

While baseball is considered a non-contact sport, injuries and conditions can yield equally traumatic consequences if not correctly diagnosed and treated.

Baseball Injury Prevention

A recent story about orthopaedic surgeon Dr. Christopher O’Grady has been featured in more than 1,100 daily and weekly newspapers nationwide (Los Angeles Times, Houston Chronicle, Chicago Tribune and Orlando Sentinel) sharing his expertise in a new minimally invasive rotator cuff procedure that not only repairs injured shoulder tendons but can potentially help thicken and strengthen them. 


The Rotation Medical bioinductive implant, about the size of a postage stamp, is placed over the injured rotator cuff tendon through a small incision during a short, minimally invasive procedure. It stimulates the growth of new tissue as it dissolves over time. 

“The Rotation Medical implant repairs a tendon effectively and, in many cases, patients can recover more quickly than with traditional repair procedures,” says Dr. O’Grady, who practices in Gulf Breeze, Fla., and has been at the renowned Andrews Institute for Orthopaedics & Sports Medicine since it opened in 2007. “This is a tremendous advance in the treatment of rotator cuff disease.”

The newspaper articles featuring Dr. O’Grady, one of 300 surgeons nationwide trained to use the Rotation Medical device, appeared in publications including the Los Angeles Times, Houston Chronicle, Chicago Tribune and Orlando Sentinel. The articles also chronicled one of Dr. O’Grady’s patients, Starr Boykin, a professional fisherwoman, who has been treated successfully with the device. 

Boykin underwent four rotator cuff surgeries on her left arm with other surgeons. After continued pain, she needed a solution and turned to Dr. O’Grady. 

Dr. O’Grady recommended the Rotation Medical implant.

How Does the Rotation Medical Implant Work? 

The rotator cuff is made of a group of tendons and muscles that surround the shoulder joint and keep the head of the upper arm bone, the humerus, firmly within the shoulder socket. When tendons tear, the shoulder is no longer stable and movement becomes painful.

The Rotation Medical device dissolves slowly after it is implanted and heals the tendon by inducing the growth of new tissue. This results in thicker tendons and repairs tissue defects.

For patients, the Rotation Medical implant can offer significant benefits including:

Potential to prevent or slow the progression of tendon degeneration. 

Within six months of the surgery, Boykin was competing in fishing tournaments again and paddling in her kayak.  

“I can do all these wonderful things, and I am so grateful for the Rotation Medical patch because it has given me my life back.”

Dr. O'Grady shares his expertise in a new minimally invasive rotator cuff procedure that can potentially help thicken and strengthen them.

Dr. O’Grady Innovative Surgery

The American Medical Society for Sports Medicine defines rotator cuff tears as partial or full tears of one or a number of the four muscles that help move the shoulder and keep the end of the long bone of the arm within the shallow socket of the shoulder (the “rotator cuff”). Rotator cuff tears are more common in your dominant arm. The most common symptoms of a rotator cuff tear include:

Pain at rest and at night, mainly if lying on the affected shoulder

Pain when lifting and lowering your arm or with specific movements

Weakness when lifting or rotating your arm

Crepitus or crackling sensation when moving your shoulder in certain positions

There are two main causes of rotator cuff tears – acute injury and degeneration. Acute tears can occur when you fall down on your outstretched arm or lift something too heavy with a jerking motion. This type of tear can happen with other shoulder injuries, such as a broken collarbone or dislocated shoulder. Degenerative or chronic tears are typically the result of a wearing down of the tendon that occurs slowly over time, which naturally occurs as we age. If you have a degenerative tear in one shoulder, there is a greater likelihood of a rotator cuff tear in the opposite shoulder — even if you have no pain in that shoulder. Several factors contribute to degenerative rotator cuff tears, including repetitive stress, lack of blood supply and bone spurs.

Repeating the same shoulder motions, again and again, can stress your rotator cuff muscles and tendons. Repetitive movements while playing sports like baseball, tennis, rowing and weightlifting are examples of sports activities that can put you at risk for overuse tears. Many jobs and routine chores can also cause overuse tears. The blood supply in our rotator cuff tendons lessens with age and impairs our body’s natural ability to repair tendon damage, which can ultimately lead to a tendon tear. As we age, bone spurs (bone overgrowth) can also develop on the underside of the acromion bone. When we lift our arms, the spurs rub on the rotator cuff tendon that, over time, will weaken the tendon and make it more likely to tear.

Rotator cuff tears are segmented into two types, partial and full-thickness tears. Partial tears are also referred to as incomplete tears. They damage the tendon but do not completely sever it. In contrast, full-thickness tears are considered complete tears because they separate all the tendon from the bone. Essentially with a full-thickness tear, there is basically a hole in the tendon. Tears that happen suddenly, such as from a fall, usually cause intense pain. There may be a snapping sensation and immediate weakness in your upper arm.

However, tears that develop slowly due to overuse can also cause significant pain and arm weakness. You may experience pain in the shoulder when you lift your arm or feel pain that moves down your arm. This pain may be mild and only present when lifting your arm over your head at first and be relieved by taking an over-the-counter (OTC) medication, such as aspirin or ibuprofen. Over time, the pain may become more noticeable when you lie on your side to sleep. The pain and weakness in the shoulder may make routine activities such as combing your hair or reaching behind your back more difficult. Eventually, OTC medication may stop providing pain relief. It is also essential for patients to understand that having a rotator cuff tear that is not painful can be common. These tears, however, may still result in arm weakness and other symptoms.

Diagnosis & Treatment of Rotator Cuff Tears

Rotator cuff tears are initially suspected based upon clinical examination by a trained physician, with findings such as painful or limited motion in partial tears or weakness and muscle atrophy (shrinking) in complete tears. We use diagnostic studies such as MRI (magnetic resonance imaging) and innovative diagnostic options such as musculoskeletal ultrasound to visualize the soft tissues around the shoulder, including the rotator cuff, and confirm the diagnosis.

Early diagnosis and treatment of a rotator cuff tear may prevent your symptoms from worsening, get you back into your everyday routine much quicker and help improve overall treatment results. If you have a rotator cuff tear and keep using it despite increasing pain, you may cause further damage as a rotator cuff tear can get larger over time.

There are several treatment options for a rotator cuff tear, and the best option is different for every person. Dr. Hackel offers various nonsurgical treatment options, including a plan for activity modification or physical therapy to restore movement, strengthen your shoulder, improve flexibility and range of motion to support your shoulder, and relieve pain and prevent further injury. If rest, medications, and physical therapy do not relieve your pain, we also offer innovative therapeutic procedures such as Stem Cell Injections and Platelet-Rich Plasma (PRP) Therapy that provide a non-invasive approach to healing.

In partnership with the Andrews Research & Education Foundation, Dr. Hackel is also currently serving as the Principal Investigator on a clinical study using regenerative cells for patients with partial-thickness rotator cuff tears. The study uses regenerative cells from your fat tissue that are isolated, concentrated and injected into your tendon tear. The trial will evaluate the safety and effectiveness of using these cells to treat injuries compared to a steroid injection. Visit our Partial Thickness Rotator Cuff Tear Study blog post to learn more about the process, eligibility, benefits and risks of participating in the study.

Dr. Hackel is dedicated to providing his patients with state-of-the-art procedures to address their pain and help them heal. If you have sustained an injury or are suffering from chronic pain due to a rotator cuff injury or are interested in learning more about participating in the clinical study, contact our office at 850.916.8783 or use our convenient online appointment form to schedule an initial consultation with our office.

Learn more about rotator cuff tears, including causes, types, diagnosis and treatment options available from Dr. Josh Hackel in Gulf Breeze, FL.

Rotator Cuff Injuries & Treatment

In partnership with the Andrews Research & Education Foundation, I am serving as the Principal Investigator on a clinical study involving the use of regenerative cells in patients who have partial-thickness rotator cuff tears. These are tears in the tendon that contribute to shoulder pain, dysfunction, and occupational disability. The use of regenerative stem cells is investigational. In this study, regenerative cells from your fat tissue will be isolated, concentrated, and injected into your tendon tear.

The trial will evaluate the safety and effectiveness of using these cells to treat patients’ injuries compared to a steroid injection. The study is sponsored by lnGeneron, Inc., a cell therapy company developing regenerative medicine therapies for musculoskeletal diseases. Please continue reading to learn more about the study. If you have additional questions or are interested in being a potential candidate for the trial, please call 850-916-8584.

Regenerative cells are a mixture of stem and progenitor cells as well as different immune cells (i.e., white blood cells). These cells can be found in a person’s body fat and harvested through liposuction and processing procedure. Earlier studies suggest that these cells can be used to stimulate repair and regeneration of damaged tissue.

After signing a consent form, you will undergo radiology and lab testing to confirm your diagnosis and ensure it’s safe for you to participate in the study. Once you pass the screening tests, you will be randomly enrolled in either the treatment or control group.

You won’t know which group you are enrolled in. This is to make sure your answers to any questions during your follow up visits are not influenced by the type of treatment you were given. Your chance of being placed in the treatment group is approximately 66%. Participants in both groups will receive a liposuction procedure of approximately half a cup of fat tissue (about 100 milliliters) taken from their abdomen, trunk, or thigh using a standard liposuction technique.

The fat tissue of a person in the treatment group will be processed using an enzyme, which isolates and concentrates regenerative cells located in the tissue. Those cells are then injected into the site of the injury. Patients in the control group will undergo a liposuction procedure and receive a standard steroid injection. Independent of the group you are enrolled in, you’ll be able to return home after the injection is complete. All procedures will take place on the same day and take approximately six hours total.

Following the procedure day, you’ll have six follow-up visits with the physician who performed the procedure – at 2 weeks, 6 weeks, 12 weeks, 24 weeks, 36 weeks, and 48 weeks after the procedure. These visits will include a physical exam, questions about your health history and medications, surveys, lab testing (at the 2 week and 48 week visits) and radiographic exams (at the 24 and 48 week visits).

Male and female patients between 30 and 75 years old who both demonstrate clinical symptoms of a partial-thickness rotator cuff tear and who are diagnosed with partial-thickness rotator cuff tears by an MRI are eligible to participate in the trial. The study team will review with you a detailed list of criteria that’s necessary to be included in the study and discuss your eligibility.

What are the potential benefits of participation?

Benefits to your participation are not guaranteed, but you could potentially see improved function and decreased pain in your injured rotator cuff, which could improve your overall quality of life.

There are potential risks for participation in this study. For example, the liposuction procedure may result in temporary bruising or soreness. A full list of risks will be reviewed with you by the study team.

Partial Thickness Rotator Cuff Tear Study

Fortunately, when properly diagnosed and treated the vast majority of shoulder problems are treated successfully without surgery.  This is especially true of rotator cuff problems. However, in many cases, it is important to have an orthopaedic surgeon evaluate the problem in order to make sure something more serious is not the cause of the shoulder pain.

When shoulder pain is short-lived, an individual’s family doctor may be able to address the problem; however, if an individual experiences a long period of pain or loss of motion following an injury, he or she may have a torn rotator cuff. In a case such as this, a shoulder specialist should be consulted because some rotator cuff surgeries are time sensitive. Dr. Chris O’Grady is an Orthopaedic doctor who specializes in diagnosing and treating injuries to the shoulder, including rotator cuff tears. He has been providing expert care to athletes of all ages in and around Gulf Breeze, Fla., for years.

Make it difficult to move the shoulder without pain

Lead to disturbed sleep, especially if the individual lies on the affected shoulder

An individual’s primary care physician may choose to observe his or her condition for a certain length of time without providing medical treatment. this practice is referred to as watchful waiting. The length of time a physician chooses to employ watchful waiting can range from several days to weeks, or even months.

Although watchful waiting may be suitable in certain instances, watchful waiting is not suitable when:

The shoulder pain is different and/or more severe than previous shoulder pain

The pain or stiffness is not improving or worsening

An individual experiencing any of the aforementioned symptoms should contact an Orthopaedic surgeon and schedule an appointment. Even if a primary care physician makes a diagnosis, Dr. O’Grady can review the medical records to determine which nonsurgical and/or surgical treatments will serve the patient best.

Furthermore, for those with a significant shoulder injury, he or she should seek assistance from a physician as soon as possible.

Why Should Individuals with a Shoulder Injury See an Orthopaedic Surgeon?

Only a physician can diagnose an injury to the rotator cuff. Orthopaedic surgeons specialize in pain, diseases, and injuries related to the musculoskeletal system, which is why they play a significant role in diagnosing, treating, preventing and rehabilitating conditions related to the musculoskeletal system, including the shoulder.

If you have had a fall or other injury resulting in shoulder pain, schedule an appointment with an Orthopaedic surgeon. An Orthopaedic surgeon can diagnose most problems with x-rays and a good physical exam.  They may also confirm the suspected diagnosis with a diagnostic study, such as an MRI (magnetic resonance imaging). The earlier a proper diagnosis is attained, the quicker treatment, pain relief, and recovery can begin.

Rotator cuff disease can occur due to a substantial shoulder injury, progressive degeneration and/or wear, and tear of the tendon.

Occupational and sports-related risk factors associated with damage to the rotator cuff include:

Regularly lifting heavy objects (construction worker, weight-lifter)

Repeatedly performing overhead activities (basketball player, construction worker, painter)

Performing the same activity over and over (factory worker, baseball pitcher, tennis player, archer, painter)

Bone spur development in the bones around the shoulder. These bone spurs can irritate and/or damage the tendon

Individuals over 40 years of age are at an increased risk for rotator cuff tears

Rotator cuff injuries may be genetic as these injuries tend to occur more commonly in some families

Without proper treatment, rotator cuff disease can lead to continued weakness and/or stiffness. Furthermore, a progressive degeneration of the shoulder joint may result.

When to Schedule an Appointment with an Orthopaedic Surgeon

An individual should schedule an appointment with an experienced Orthopaedic surgeon if he or she has:

Pain in the joints, tendons and /or muscles that lasts for more than a couple days

Difficulty performing daily activities due to a specific part of the body (carrying groceries, raising arms above the head, etc.)

Bruising and/or swelling at the location of the injury, or around the injured joint

Any other unusual symptoms in the area of the injury

Prompt Treatment Can Prevent Further Damage and Quicker Recovery

Without early intervention, the issue may become even more severe and lead to a chronic condition that includes loss of strength and a reduced range of motion. During an initial consultation with Dr. O’Grady, he will isolate the problem, determine the potential cause and discuss treatment options. In addition, he may provide a potential time frame for recovery.

If you have a shoulder injury or you are experiencing pain in your shoulder, schedule an appointment with Dr. Chris O'Grady today. The sooner you receive a diagnosis, the quicker recovery can begin.

Fortunately, when properly diagnosed and treated the vast majority of shoulder problems are treated successfully without surgery.

Blog Posts for Rotator Cuff

Baseball Injury Prevention

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Dr. O’Grady Innovative Surgery

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Rotator Cuff Injuries & Treatment

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Partial Thickness Rotator Cuff Tear Study

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Rotator Cuff Injury: When to see an Orthopaedic Surgeon

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