ESPN - Sport Science
I recently watched an ESPN video entitled "Sport Science: Aroldis Chapman," in which the mechanics of the 105 mph pitcher were examined. Although the torque Chapman generates on his elbow and shoulder are extraordinary, his separation of lower and upper body are to me, astonishing. As pointed out by Tom Howes, the typical pitcher averages 50 degrees of separation between shoulder and hip turn. Chapman generates 65 degrees!
I note this because the exact point on the human body which feels the brunt of this force is the rectus aponeurotic plate. This is the point which attaches structures to the pubic bone. The two main muscles are the rectus abdominus, and the adductor longus. Other structures like the inguinal ligament, the conjoint tendon, and the pectineus muscle are also involved. Simply put, this one point of attachment bears the load of this extraordinary force. Unfortunately, when this structure is injured, it may not heal without appropriate rest and physical therapy. In some cases, it cannot heal, and requires surgery. I see a large contingent of ball players in my practice, many of them pitchers. After watching videos like these, I am not surprised.
NHL Ducks captain Ryan Getzlaf apparently played in the Western Conference finals with a sports hernia, as revealed on the NBC Sports website. Ultimately, he did not need surgery. It is important to realize that not all sports hernia diagnoses are ultimately a surgical problem. In the right setting, with a mild injury, a sports hernia, or more appropriately, athletic pubalgia, can be overcome with rest and a specialized physical therapy regimen. Only after these options have failed, or the MRI findings are severe, will surgery be required.
Advancing Technology in Surgery
As the age of minimally invasive surgery continues to progress, modalities for operating are becoming more and more sophisticated. Robotic surgery and Single port surgery are just two of the plethora of recent examples. In many ways, this phenomenon is driven by technological breakthrough. There are, however, other forces at work, not the least of which is the medical device industry. As with all advances, the advent of new technology has to be supported, but also evaluated to an exceedingly high degree. Just because a technology becomes available does not mean it is in the best interests of the patient or the society as a whole. To this end, General and Laparoscopic Surgeons is both learning and evaluating new technologies for its patients on a constant basis. Our recent attendance at both the American College of Surgeons (ACS), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) represents the continued devotion we have to patient care and the future.