Penn State Milton S. Hershey Medical Center, USA
Title: Hand Pain in a professional baseball player
Emuje Ophori obtained her Bachelor of Science degree from Montclair State University, graduating cum laude. She obtained her medical degree from UMDNJ-New Jersey Medical School based in Newark, NJ. She is currently chief resident of Family and Community Medicine in Penn State Milton S. Hershey Medical Center, and is applying for primary care sports medicine fellowship. She has covered numerous sporting events, and completed several rotations in sports medicine and orthopedic surgery. She is a member of the honor society Phi Sigma Pi.
A 29-year-old, right-hand-dominant, professional baseball player presented in the training room with a 1-day history of right hand pain within the palmar thenar eminence. He had hyperabducted his thumb and "jammed" it while he was batting. He was able to continue playing, but he continued to have a dull ache within his hand whenever he held and swung a bat. As the day went on, his hand began to have more pain. On exam, he had tenderness to palpation at the base of the second metacarpal, worse volarly than dorsally. He had mild pain on passive thumb abduction and active thumb adduction. Radiographs and magnetic resonance imaging (MRI) were ordered. MRI revealed feathery edema within the adductor policis muscle, with a few retracted fibers from the myotendinous junction within the oblique head. There were inflammatory changes surrounding the muscle from the level of origin of the muscle at the third metacarpal diaphysis to its myelotendinous junction. He was made to wear a neoprene thumb spica while batting. His symptoms slowly resolved after 2 weeks. Thenar pain can be a significant problem for a baseball player who relies on manual dexterity for gripping a bat, and throwing precisely and accurately. Adductor pollicislongus strains should perhaps be considered in any baseball or racquet sports player sustaining a hyperabduction force to the thumb.