SATURDAY, March 8 (HealthDay News) -- Sometimes it doesn't take three strikes to get out in baseball. A new study found that just one injury severe enough to require surgery kept more than half of those injured players from returning to the same or higher level of play.
And, for those players who've made it to the major or minor leagues in professional baseball, the news was even more dismal -- just 18 percent made it back to the same level or higher, according to the study.
"The demands of professional baseball are not insignificant. Not everybody gets back to 100 percent after an injury," said the study's lead author, Dr. Steven B. Cohen, assistant team physician for the Philadelphia Phillies baseball team and director of sports medicine research at the Rothman Institute in Philadelphia.
Dr. Gerard Varlotta, director of sports rehabilitation at New York University Medical Center's Rusk Institute of Rehabilitation Medicine/Hospital for Joint Diseases in New York City, added: "Many pitchers in the major league just aren't the same after a rotator [shoulder] injury."
He cited Dwight Gooden, a former New York Mets star, as an example. "He lost the velocity on his pitch," said Varlotta, adding, "We'll see how Pedro Martinez [a current Mets pitcher] does after his surgery. He may have difficulty getting back to the same level. It will be interesting to see if Martinez changes the ratio of fastballs and other pitches."
Sometimes, pitchers have to change the way they pitch after an injury. For example, a fastball pitcher may have to start throwing different types of pitches, such as curveballs, sliders or change-ups, Varlotta explained.
For the new study, Cohen and his colleagues analyzed injury data from one professional baseball club over a four-year period. During that time, 44 players sustained 50 shoulder or elbow injuries serious enough to require surgery. Six players, five of them pitchers, needed more than one surgery.
Twenty-six players had shoulder surgeries -- one of them had two shoulder surgeries. Eighteen of these players were pitchers. Four were in the major league, three were in AAA, four were in AA and 15 were in the A league. After surgery, just seven players returned to their pre-surgery level of play, and two advanced to a higher level. Five players returned to a lower level of play, one has not returned from his injury, and 11 retired from baseball. Only one player from the high professional level of AA or above returned to the same level of play.
There were 23 elbow surgeries performed on 21 players, and 20 of them were pitchers. Six were in the major league, three were in AAA, three in AA and nine in A league. Of the 12 players at a high professional level, just four returned to the same or higher level.
"Just 45 percent of injured players needing surgery returned to the same or higher level, and if you look specifically at pitchers, 43 percent returned to the same or higher level," Cohen said.
He said those with elbow injuries were more likely to return to the same level of play, with 52 percent in this study attaining their previous or an even higher level. For shoulder injuries, however, that number was just 35 percent.
Both Cohen and Varlotta said that stretching and strengthening exercises are key for preventing injuries in professional -- and recreational -- players.