In brief: This case report looks at the treatment and rehabilitation of a Major League Baseball pitcher with myofascial pain syndrome and acute recurrent somatic dysfunction. Throughout the baseball season the patient had a dull aching pain in the neck and upper back that worsened as he tired, and his performance and playing time declined severely. Through a comprehensive rehabilitation and reconditioning program that included strengthening his weaker shoulder and arm, increasing the flexibility of the overdeveloped pitching arm, correcting the somatic dysfunction, and gradually releasing the myofascial trigger areas, the pitcher was able to return to his profession.