Dr. Freehill is a board-certified, double fellowship-trained specialist in orthopaedic surgery with a sub-specialty certification in sports medicine. His concentration is in shoulder and elbow. Dr. Freehill is a team physician for the Stanford University athletics program and head physician for the Stanford University baseball team. Dr. Freehill also teaches in the Department of Orthopaedic Surgery at Stanford University School of Medicine.

Dr. Freehill?s practice focuses on all shoulder conditions. He treats rotator cuff tears, shoulder instability, shoulder arthritis, sports shoulder, arthopathy, complex shoulder pathology, and sports-related shoulder injury. In addition, he is also passionate about sports- related elbow injuries, with an emphasis on thrower?s elbow.

Professional and amateur athletes, as well as non-athletes, come to Dr. Freehill for expert care. His sports medicine training and specialization in shoulder replacement procedures enable him to treat patients across the lifespan. Depending on factors including the patient?s condition and occupation, he may recommend treatment ranging from non-operative solutions (such as physical therapy) to cutting-edge biologics procedures or complex surgery.

In addition to his positions within the Stanford University athletics program, Dr. Freehill serves as assistant team physician for the Oakland A?s. Previously, he was a team physician for the Detroit Tigers and the Winston-Salem Dash (affiliated with the Chicago White Sox); he assisted with the Baltimore Orioles. He has also served as Director of Sports Medicine for Wake Forest University Athletics.

As director of the imminent Stanford Performance and Pitching Lab, Dr. Freehill draws on his previous experience as a professional baseball player to help athletes of all skill levels. In the lab, he conducts cutting edge research on the biomechanics of overhead throwers in order to support advances in throwing performance. He has conducted a study on pitch counts in adolescent players funded by Major League Baseball. Dr. Freehill was also awarded a research grant from the National Institutes of Health to investigate stromal vascular fractionated mesenchymal cells and their potential for healing rotator cuff tendon tears.

Dr. Freehill has pioneered the use of some of the latest techniques and technology for leading-edge care. Among the advanced technologies he utilizes is a virtual reality (VR) system that enables him to perform a simulated shoulder arthroplasty procedure prior to entering the operating room with a patient. The system also enables him to predict and order customized implants if needed, which is believed to enable a more positive outcome for patients.

Peer-reviewed articles authored by Dr. Freehill explore rotator cuff injuries, shoulder arthroplasty, baseball-related injuries and performance interests, and more. His work has been featured in the American Journal of Sports Medicine, the Orthopedic Journal of Sports Medicine, Journal of Shoulder and Elbow Surgery, Arthroscopy, and elsewhere. He has written numerous book chapters and made over 200 presentations at conferences around the world.
Dr. Freehill?s honors include an Orthopaedic Residency Research Award while at Johns Hopkins University. He is also a Neer Award winner, denoting the highest research award selected annually by the American Shoulder and Elbow Society.

Currently, he serves on the Medical Publishing Board of Trustees for the American Orthopaedic Society for Sports Medicine. He is a member of the American Orthopaedic Association, and the Major League Baseball Team Physician Association. He is a committee member for the American Shoulder and Elbow Surgeons Society, International Congress of Arthroscopy and Sports Traumatology, the Arthroscopy Association of North America, and the American Academy of Orthopaedic Surgeons.

Clinical Focus

  • Orthopaedic Surgery

Academic Appointments

Professional Education

  • Board Certification: American Board of Orthopaedic Surgery, Sports Medicine (2017)
  • Board Certification: American Board of Orthopaedic Surgery, Orthopaedic Surgery (2014)
  • Fellowship: Massachusetts General Hospital Dept of Orthopaedic Surgery (2012) MA
  • Fellowship: Stanford University Orthopaedic Sports Medicine Fellowship (2011) CA
  • Residency: Johns Hopkins Univ Hospital Orthopaedic Surgery (2010) MD
  • Medical Education: Tulane University School of Medicine Registrar (2005) LA


All Publications

  • The Effect of Straight-Line Long-Toss Versus Ultra-Long-Toss Throwing on Passive Glenohumeral Range of Motion Recovery After Pitching SPORTS HEALTH-A MULTIDISCIPLINARY APPROACH Luo, T., Sciascia, A. D., Stone, A. V., Gwam, C. U., Grimes, C. A., Strahm, J. G., Mannava, S., Naugher, G., Waterman, B. R., Freehill, M. T. 2021: 1941738120980016


    Repetitive throwing in baseball pitchers can lead to pathologic changes in shoulder anatomy, range of motion (notably glenohumeral internal rotation deficit), and subsequent injury; however, the ideal strengthening, recovery, and maintenance protocol of the throwing shoulder in baseball remains unclear. Two strategies for throwing shoulder recovery from pitching are straight-line long-toss (SLT) throwing and ultra-long-toss (ULT) throwing, although neither is preferentially supported by empirical data.ULT will be more effective in returning baseline internal rotation as compared with SLT in collegiate pitchers after a pitching session.Cohort study.Level 3.A total of 24 National Collegiate Athletic Association Division I baseball pitchers with mean age 20.0 ± 1.1 years were randomized to either the ULT group (n = 13; 9 right-hand dominant, 4 left-hand dominant) or SLT group (n = 11; 10 right-hand dominant, 1 left-hand dominant). Measurements (dominant and nondominant, 90° abducted external rotation [ER], internal rotation [IR], and total range of motion [TROM]) were taken at 5 time points across 3 days: before and immediately after a standardized bullpen session on day 1; before and immediately after a randomized standardized ULT or SLT session on day 2; and before practice on Day 3.ULT demonstrated significantly greater final ER compared with baseline (+10°; P = 0.05), but did not demonstrate significant IR changes. Similarly, SLT demonstrated significantly greater post-SLT ER (+12°; P = 0.02) and TROM (+12°;P = 0.01) compared with baseline, but no significant IR changes. Final ER measurements were similar between ULT (135° ± 14°) and SLT (138° ± 10°) (P = 0.59). There was also no statistically significant difference in final IR between ULT (51° ± 14°) and SLT (56° ± 8°) (P = 0.27).The routine use of postperformance, ULT throwing to recover from range of motion alterations, specifically IR loss, after a pitching session is not superior to standard, SLT throwing. Based on these findings, the choice of postpitching recovery throwing could be player specific based on experience and comfort.The most effective throwing regimens for enhancing performance and reducing residual impairment are unclear, and ideal recovery and maintenance protocols are frequently debated with little supporting data. Two strategies for throwing shoulder recovery from pitching are SLT and ULT throwing. These are employed to help maintain range of motion and limit IR loss in pitchers. The routine use of ULT throwing for recovery and to limit range of motion alterations after a pitching session is not superior to SLT throwing.

    View details for DOI 10.1177/1941738120980016

    View details for Web of Science ID 000620309900001

    View details for PubMedID 33539268

  • Superior Capsular Reconstruction: A Systematic Review of Surgical Techniques and Clinical Outcomes. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association Gao, I., Sochacki, K. R., Freehill, M. T., Sherman, S. L., Abrams, G. D. 2020


    PURPOSE: To evaluate surgical techniques and clinical outcomes for arthroscopic superior capsular reconstruction (SCR) for treatment of massive irreparable rotator cuff tears.METHODS: A systematic review was registered with PROSPERO and performed using PRISMA guidelines. PubMed, SCOPUS, and Cochrane databases were searched. Studies investigating SCR with reported surgical technique were included. Animal studies, cadaveric studies, review studies, and letters to the editor were excluded. Technical aspects of surgical technique for SCR were analyzed in each article, which included: graft type, glenoid fixation method, greater tuberosity fixation method, graft passage technique, suture management, margin convergence, concomitant procedures, and post-operative rehabilitation protocol. Clinical outcomes, when available, were also analyzed.RESULTS: Three hundred sixty-five articles were screened with 29 found that described surgical technique for SCR. According to the Modified Coleman Methodology Score, 24 articles were poor (scores <55), 4 were fair (scores between 55 and 69), and 1 was good (scores between 70 and 84) with an average score of 25.8 ± 20.9. The most commonly used technique for SCR utilized: acellular dermal allograft, two biocomposite suture anchors for glenoid fixation, transosseus equivalent double-row suture anchor fixation for greater tuberosity fixation with two biocomposite medial row anchors and two biocomposite lateral row anchors, double-pulley technique combined with an arthroscopic grasper and/or pull suture to pass the graft into the shoulder, performance of both anterior and posterior margin convergence, and native rotator cuff repair when possible. Only 8 of the studies reported clinical outcomes, and they showed that SCR provides significant improvement in patient-reported outcomes, significant improvement in shoulder ROM, variable graft failure rates, low complication rates, and variable reoperation rates. There were no studies comparing outcomes between the various surgical techniques.CONCLUSIONS: Many surgical techniques exist for arthroscopic SCR. However, no superior technique was demonstrated, as there were no studies comparing clinical outcomes among these various techniques.

    View details for DOI 10.1016/j.arthro.2020.09.016

    View details for PubMedID 33227320

  • Quantifying Throw Counts and Intensities Throughout a Season in Youth Baseball Players: A Pilot Study. Journal of biomechanical engineering Rose, M., McCollum, K. A., Freehill, M. T., Cain, S. 2020


    Overuse injuries in youth baseball players due to throwing are at an all-time high. Traditional methods of tracking player throwing load only count in-game pitches and therefore leave many throws unaccounted for. Miniature wearable inertial sensors can be used to capture motion data outside of the lab in a field setting. The objective of this study was to develop a protocol and algorithms to detect throws and classify throw intensity in youth baseball athletes using a single, upper arm-mounted inertial sensor. Eleven participants from a youth baseball team were recruited to participate in the study. Each participant was given an inertial measurement unit and was instructed to wear the sensor during any baseball activity for the duration of a summer season of baseball. A throw identification algorithm was developed using data from a controlled data collection trial. In this report, we present the throw identification algorithm used to identify over 17,000 throws during the 2-month duration of the study. Data from a second controlled experiment was used to build a support vector machine model to classify throw intensity. Using this classification algorithm, throws from all participants were classified as being "low," "medium," or "high" intensity. The results demonstrate that there is value in using sensors to count every throw an athlete makes when assessing throwing load, not just in-game pitches.

    View details for DOI 10.1115/1.4049025

    View details for PubMedID 33156351

  • Optimizing the Double-Row Construct: An Untied Medial Row Demonstrates Equivalent Mean Contact Pressures in a Rotator Cuff Model ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE Stone, A., Luo, T., Sharma, A., Danelson, K. A., De Gregorio, M., Freehill, M. T. 2020; 8 (4): 2325967120914932


    The merits of a double-row rotator cuff repair (RCR) construct are well-established for restoration of the footprint and lateral-row security. The theoretical benefit of leaving the medial row untied is to prevent damage to the rotator cuff by tissue strangulation, and the benefit of suture tape is a more even distribution of force across the repair site. These benefits, to our knowledge, have not been evaluated in the laboratory.Leaving the medial row untied and using a suture bridge technique with suture tape will offer more even pressure distribution across the repair site without compromising total contact force.Controlled laboratory study.A laboratory model of RCR was created using biomechanical research-grade composite humeri and human dermal allografts. The pressure distribution in a double-row suture bridge repair construct was analyzed using the following testing matrix: double-loaded suture anchors with the medial row tied (n = 15) versus untied (n = 15) compared with double-loaded suture tape and anchors with the medial row tied (n = 15) versus untied (n = 15). A digital pressure sensor was used to measure pressure over time after tensioning of the repair site. A multivariate analysis of variance was used for statistical analysis with post hoc testing.The total contact force did not significantly differ between constructs. The contact force between double-loaded suture anchors and double-loaded suture tape and anchors was similar when tied (P = .15) and untied (P = .44). An untied medial row resulted in similar contact forces in both the double-loaded suture anchor (P = .16) and double-loaded suture tape and anchor (P = .25) constructs. Qualitative increases in focal contact pressure were seen when the medial row was tied.An untied medial row did not significantly affect the total contact force with double-loaded suture anchors and with double-loaded suture tape and anchors. Tying the medial row qualitatively increased crimping at the construct's periphery, which may contribute to tissue strangulation and hinder clinical healing. Qualitative improvements in force distribution were seen with double-loaded suture tape and anchors.Both tied and untied medial rows demonstrated similar pressures across the repair construct.

    View details for DOI 10.1177/2325967120914932

    View details for Web of Science ID 000535799900001

    View details for PubMedID 32426405

    View details for PubMedCentralID PMC7218996

  • Thrower's Exostosis of the Shoulder: A Systematic Review With a Novel Classification. Orthopaedic journal of sports medicine Freehill, M. T., Mannava, S. n., Higgins, L. D., Lädermann, A. n., Stone, A. V. 2020; 8 (7): 2325967120932101


    A variety of thrower's exostoses are grouped under the term Bennett lesion, which makes understanding diagnosis and treatment difficult.To identify all types of reported thrower's and overhead athlete's exostoses and categorize them into a classification system to allow a morphology-based classification.Systematic review; Level of evidence, 4.A systematic review of all articles pertaining to Bennett lesions and thrower's exostosis was performed. The classification and treatments were evaluated to describe the types, proposed causes, diagnosis, and treatment options.A total of 27 studies were included in the systematic review. The anatomic locations referenced in the study demonstrated posteroinferior, posterior, and posterosuperior glenoid lesions. Aggregate radiographic data demonstrated 158 of 306 patients (52%) with a thrower's exostosis of any type and location. Of these 158 patients with a radiographic lesion, 119 (75%) patients were symptomatic. The locations were posteroinferior in 110 patients (70%), directly posterior in 2 patients (1.3%), posterosuperior in 44 patients (28%), and unknown in 2 patients (1.3%). Avulsed lesions were present in 9 (5.7%) posteroinferior lesions, 0 direct posterior lesions, and 2 (1.3%) posterosuperior lesions. Treatment plans included both nonoperative and operative strategies, but operative intervention was more commonly reported for detached lesions. After operative intervention, only 61% of reported athletes returned to preinjury performance.Based on a comprehensive review of the literature, we identified several anatomic locations for a thrower's exostosis beyond the classic Bennett lesion. We categorized the reported exostoses into a new classification system for description of location and type (subperiosteal or free fragment) of the thrower's exostosis, which may be used to study future treatments. Current treatment strategies recommend that surgical treatment of thrower's exostosis is considered only after exhausting nonoperative management because reported return to sport is variable after surgery. The effectiveness of excision or repair for both subperiosteal and detached lesions has not been established.

    View details for DOI 10.1177/2325967120932101

    View details for PubMedID 32704507

    View details for PubMedCentralID PMC7361505

  • Osseous Healing With Nonrigid Suture Fixation in the Arthroscopic Latarjet Procedure. Orthopaedic journal of sports medicine Weick, J. W., Kalia, V. n., Pacheco, E. n., Jacobson, J. A., Freehill, M. T. 2020; 8 (11): 2325967120964489


    The Latarjet procedure is a popular means to surgically address anterior glenohumeral joint instability. Although the Latarjet procedure is becoming increasingly common, challenges persist and include postoperative complications secondary to use of the conventional 2 bicortical fixation screws. Recently, a novel surgical technique using a guided surgical approach for graft positioning with nonrigid fixation via a suture suspensory system has been described.To evaluate healing rates and stability of the grafts in patients who underwent this new Latarjet technique.Case series; Level of evidence, 4.We retrospectively gathered anonymized computed tomography (CT) data sets from a total of 107 patients who underwent nonrigid suture fixation using a cortical button fixation for anterior glenohumeral instability. Of the 107 patients, 45 had CT scans performed at 2 different time periods. The CT scans of each patient were compared by 2 fellowship-trained musculoskeletal radiologists. Data recorded included age, sex, date of scan, initial graft position on the glenoid, presence and degree of graft migration relative to the equator on follow-up scan, and percentage of osseous healing (as assessed by osseous bridging) on the follow-up scan. Descriptive statistics were calculated to evaluate the average migration and average percentage of healing at both time points.Our population (n = 45) consisted of 38 men (84.4%) and 7 women (15.6%). The mean age was 27.1 ± 1.1 years. The mean time between initial CT scan (2 weeks postoperatively) and follow-up CT scan was 26 ± 2 weeks. On follow-up scan, reviewer 1 found 75.6% of patients had greater than 75% healing, and reviewer 2 found 70.2% of patients had greater than 75% healing. The center of the graft was measured at or below the equator on follow-up examination in 43 of 45 (95.6%) patients by reviewer 1 and 44 of 45 (97.8%) patients by reviewer 2.Based on these findings, nonrigid suture fixation using a cortical button device offers an effective alternative to traditional screw fixation for the Latarjet procedure with a high level of osseous healing and minimal graft migration.

    View details for DOI 10.1177/2325967120964489

    View details for PubMedID 33244477

    View details for PubMedCentralID PMC7678400

  • Outcomes Evaluation of the Athletic Elbow SPORTS MEDICINE AND ARTHROSCOPY REVIEW Freehill, M. T., Mannava, S., Safran, M. R. 2014; 22 (3): E25-E32


    The high-level athletic population poses difficulty when evaluating outcomes in orthopedic surgery, given generally good overall health and high function at baseline. Subtle differences in performance following injury or orthopedic surgery are hard to detect in high-performance athletes using standard outcome metrics; however, attaining these subtle improvements after injury or surgery are key to an athletes' livelihood. Outcome measures serve as the cornerstone for critical evaluation of clinical outcomes following orthopedic surgery or injury. In the age of "evidence-based medicine" and "pay-for-performance" accountability for surgical intervention, understanding clinically relevant outcome measures is essential for careful review of the published literature, as well as one's own critical review of surgical performance. The purpose of this manuscript is to evaluate clinical outcome measures in the context of the athletic elbow. An emphasis will be placed on evaluation of the 5 most clinically relevant outcome measures for sports-related elbow outcomes: (1) American Shoulder and Elbow Committee; (2) Mayo Elbow Performance Index; (3) Andrews-Timmerman [and its precursor the (4) Andrews-Carson]; and (5) Kerlan-Jobe Orthopaedic Clinic overhead athlete score. A final outcome measure that will be analyzed is "return to play" statistics, which has been published in various studies of athletes' recovery from elbow surgery, as well as, the outcomes metric known as the "Conway-Jobe scale." Although there is no perfect outcomes score for the athletic elbow, the Kerlan-Jobe Orthopaedic Clinic score is the only outcomes tool developed and validated for outcomes for elbow injuries in the overhead athlete, as compared with the Andrew-Timmerman and Conway-Jobe metrics, which were not validated outcome measures for the elbow in this patient population. Despite the Disabilities of Arm, Shoulder, Hand (DASH) (and DASH-Sport module) being validated in the general population, this upper extremity scale is not specific for elbow function.

    View details for Web of Science ID 000340731700004

    View details for PubMedID 25077753

  • Biomechanical evaluation of a coracoclavicular and acromioclacicular ligament reconstruction technique utilizing a single continuous intramedullary free tendon graft. Journal of shoulder and elbow surgery Abrams, G. D., McGarry, M. H., Jain, N. S., Freehill, M. T., Shin, S., Cheung, E. V., Lee, T. Q., Safran, M. R. 2013; 22 (7): 979-985


    Reconstruction of only the coracoclavicular (CC) ligaments may restore superior-inferior (S-I) but not anterior-posterior (A-P) stability of the acromioclavicular (AC) joint. Concomitant reconstruction of both the AC and CC ligaments may more reliably restore intact biomechanical characteristics of the AC joint.Ten matched pairs of shoulders were utilized. Five specimens underwent CC ligament reconstruction while an equal number underwent combined AC and CC ligament reconstruction utilizing an intramedullary tendon graft. Each of the reconstructions was compared with the intact contralateral control. Translational and load to failure characteristics were compared between groups.No difference was found in S-I translation between intact specimens and CC-only reconstructions (P = .20) nor between intact specimens and AC/CC reconstructions (P = .33) at 10 Newton (N) loads. Significant differences were noted in A-P translation between intact specimens and CC-only reconstructions (P < .001) but no difference in A-P translation between intact specimens and AC/CC reconstructions (P = .34).The A-P and S-I translational biomechanical characteristics of the AC joint were restored using the new technique described. Reconstruction of the CC ligaments only (versus AC/CC combined) led to significantly increased translational motion in the A-P plane as compared to intact control specimens.

    View details for DOI 10.1016/j.jse.2012.09.013

    View details for PubMedID 23313367

  • Diagnosis and Management of Ulnar Collateral Ligament Injuries in Throwers CURRENT SPORTS MEDICINE REPORTS Freehill, M. T., Safran, M. R. 2011; 10 (5): 271-278


    Although ulnar collateral ligament (UCL) injuries are reported most commonly in baseball players (especially in pitchers), these also have been observed in other throwing sports including water polo, javelin throw, tennis, and volleyball. This article reviews the functional anatomy and biomechanics of the UCL with associated pathophysiology of UCL injuries of the elbow of the athlete participating in overhead throwing. Evaluation, including pertinent principles in history, physical examination, and imaging modalities, is discussed, along with the management options.

    View details for DOI 10.1249/JSR.0b013e31822d4000

    View details for Web of Science ID 000294685000005

    View details for PubMedID 23531973

  • The Labrum of the Hip: Diagnosis and Rationale for Surgical Correction CLINICS IN SPORTS MEDICINE Freehill, M. T., Safran, M. R. 2011; 30 (2): 293-?


    The treatment of labral pathologic condition of the hip has become a topic of increasing interest. In patients undergoing hip arthroscopy, tears of the acetabular labrum are the most commonly found pathologic condition and most common cause of mechanical symptoms. Although a labral tear may occur with a single traumatic event, often another underlying cause may be already present, predisposing the individual to injury. This article discusses the structure and function of the acetabular labrum, the diagnosis of labral injury through physical examination and imaging modalities, and the current treatment options, including labrectomy, labral repair, and reconstruction.

    View details for DOI 10.1016/j.csm.2010.12.002

    View details for Web of Science ID 000289811500007

    View details for PubMedID 21419957

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