Tag Archives: Vicente Padilla

Vicente Padilla: Radial Nerve Injury

This is a rare occasion.

Yes, its true I’m going to talk about a Dodger, but only because I find his injury so interesting and something worth talking about. Padilla is a right handed pitcher that has been a starter / long reliever in the majors for over ten years. He has bounced around several teams in that time and also had a battle with injuries over his twelve year career.

His most recent bout of injury has intrigued me. In April of last year (I know this because I’m an uber nerd that keeps track of this kind of stuff), Padilla started complaining of forearm tightness and soreness in his pitching arm. Not an uncommon complaint of pitchers, however the tightness was enough that the Dodgers had to place Padilla on the DL and he was diagnosed with radial nerve irritation. He came back, but struggled with tightness and weakness the entire year, and only started 16 games for the Dodgers (good news for the Giants though… and Aaron Rowand)

This radial nerve irritation kept him sidelined into spring training this year, and in February he had a surgical release of the nerve. By April, he came back to replace the struggling Jonathan Broxton (he’s going to be a whole different blog….) as the dodgers closer, pitched a few games, and then was placed BACK on the DL again MAY 14th  with more “radial nerve irritation.”

The radial nerve passing through the Supinator muscle (Ss being the superficial and Sd being the deep heads of the muscle).

Just to give you a quick anatomy break down, the radial nerve runs through the deep muscles of the forearm, and splits right at the elbow into a deep branch (PIN) and superficial branch (SR). This is the most common site of nerve entrapment because the nerve has to run directly through the Supinator muscle. When the supinator gets inflamed, or overused with repetitive movements, it can compress on the deep branch of the radial nerve and cause severe pain and weakness in the forearm.

I guess the next question would then be; why or how does the Supinator muscle get inflammed? Well, supination of the forearm is the motion that brings your palm up towards you (like you are asking for soup is how I remember it), whereas pronation makes your palm face down. This is important because when pitchers throw a breaking ball (slider, curve, cutter…) his hand is supinated when the ball is released. The opposite would be true for a change up, where the ball would be released with the hand pronated. So he could have caused irritation in that supinator muscle by over throwing breaking balls. Possible. However, a lot of pitchers throw a lot of breaking balls and yet this is not a common injury. The other cause for a muscle getting overused, is the weakness of other muscles, causing one particular muscle to do the work, which is probably more likely his case.

The common treatment for pitchers is for a surgeon to make a small incision, find the place where the nerve has been getting entrapped, and simply make more room for that nerve so it isn’t being compressed. This is what they did with Padilla in February. Now, his nerve has been compressed for some time now (at least since last April), so its no surprise that even after surgery he continues to have problems with it, and had to go back on the DL. However, if he doesn’t address the cause of why this happened to begin with, he will continue to aggravate it no matter how much room they give that nerve.

Hope that makes sense.

By the way…..congrats to FC BARCELONA on the Champions League Title. Someday I will marry David Villa…just saying.