Is Workload Associated with Latissimus Dorsi and Teres Major Tears in Professional Baseball Pitchers? An Analysis of Days of Rest, Innings Pitched and Batters Faced

Background: Latissimus dorsi and teres major (LD/TM) tears are becoming an increasing common cause of injury and disability amongst professional baseball pitchers. Purpose: To determine the rate of return to sport (RTS) and performance upon RTS in professional baseball pitchers following LD/TM tears treated both operatively and non-operatively, and to see if there is a difference in RTS rate and performance between players who sustained a LD/TM tear and matched controls within each treatment group. Hypothesis: There is a high rate of RTS in professional baseball pitchers following LD/TM tears with no significant difference in rate of RTS or performance, specifically related to the primary outcome performance variables of earned run average (ERA), WHIP ((walks +hits)/innings pitched), fielding independent pitching (FIP), and wins above replacement (WAR)) between cases and controls for both operative and non-operative treatment. Methods: All professional baseball pitchers who sustained a LD/TM tear between 2011-2016 were included. Demographic and performance data (pre and post injury) for each player was recorded. Performance metrics were then compared between cases and matched controls within both operatively non-operative treatment. Results: Overall 120 pitchers sustained a LD/TM tear; 42 (35%) were playing at the major league level at the time of injury. The majority of players (107 (89.2%)) were treated non-operatively. The average time to return to the same level of competition for pitchers treated non-operatively was 170.7 +/- 169.7 days while for those treated operatively was 536.6 +/- 300.4 days. Of the players treated with surgery, the mean time from injury to surgery was 97.5+/-115.5 days (range 12-453 days). The RTS rate among players treated non-operatively and operatively was identical at 75%. Players treated non-operatively had no change in ERA, FIP, or WAR following injury but had a higher WHIP after injury (p=0.039). Players treated operatively had no change in any measured performance metrics following surgery. No difference existed between cases and controls in the primary performance variables Conclusion: LD/TM tears occur more frequently than previously reported. The majority of LD/TM tears in professional baseball pitchers are treated non-operatively. RTS rate for professional baseball pitchers following LD/TM tears treated operatively or non-operatively is 75%. No significant difference in performance was seen in these pitchers following tear/surgery compared to matched controls.

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Performance and Return to Sport After Latissimus Dorsi and Teres Major Tears Among Professional Baseball Pitchers

The American Journal of Sports Medicine ◽

10.1177/0363546519829086 ◽

2019 ◽

Vol 47 (5) ◽

pp. 1090-1095 ◽

Cited By ~ 4

Author(s):

Brandon J. Erickson ◽

Peter N. Chalmers ◽

John D’Angelo ◽

Kevin Ma ◽

Anthony A. Romeo

Keyword(s):

Latissimus Dorsi ◽

Performance Metrics ◽

Return To Sport ◽

Nonoperative Treatment ◽

Professional Baseball ◽

Significant Difference ◽

Major League ◽

Teres Major ◽

Baseball Pitchers ◽

And Performance

Background: Latissimus dorsi and teres major (LD/TM) tears are becoming an increasingly common cause of injury and disability among professional baseball pitchers. Purpose/Hypothesis: To determine performance and return to sport (RTS) among professional baseball pitchers after LD/TM tears treated operatively and nonoperatively and to compare the RTS rate and performance between pitchers who sustained an LD/TM tear and matched controls. The authors hypothesized a high RTS rate among professional baseball pitchers after LD/TM tears, with no significant difference in RTS rate or performance between cases and controls for operative and nonoperative treatment—specifically, in the primary performance outcome variables of WHIP ([walks + hits] / innings pitched), fielding independent pitching, and wins above replacement. Study Design: Cohort study; Level of evidence, 3. Methods: All professional baseball pitchers who sustained an LD/TM tear between 2011 and 2016 were identified with the Health and Injury Tracking System database of Major League Baseball. Demographic and performance data (before and after injury) were recorded for each player. Performance metrics were then compared between cases and matched controls by operative and nonoperative treatment. Results: Overall, 120 pitchers had a documented LD/TM tear; 42 (35%) were major league players. Most players (n = 107, 89.2%) were treated nonoperatively. Time to return to the same level of competition was 170 ± 169 days (mean ± SD) for pitchers treated nonoperatively and 406 ± 146 days for those treated operatively. The RTS rate among players treated nonoperatively and operatively was identical at 75%. Players treated nonoperatively had no change in fielding independent pitching or wins above replacement after injury but had a higher (ie, worse) WHIP after injury ( P = .039); they also performed significantly worse in several secondary performance metrics, including number of games played per year ( P < .001). Players treated operatively had no change in any measured performance metrics after surgery. No difference existed between cases and controls in the primary performance variables. Conclusion: The majority of LD/TM tears are treated nonoperatively. The RTS rate is 75% for professional baseball pitchers after LD/TM tears treated operatively or nonoperatively. Players treated nonoperatively saw a decline in several performance metrics, while players treated operatively had no significant difference in performance after surgery.

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Teres major injuries in two professional baseball pitchers

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2009.01.025 ◽

2009 ◽

Vol 18 (6) ◽

pp. e1-e5 ◽

Cited By ~ 9

Author(s):

J. Martin Leland ◽

Michael G. Ciccotti ◽

Steven B. Cohen ◽

Adam C. Zoga ◽

Robert J. Frederick

Keyword(s):

Professional Baseball ◽

Teres Major ◽

Baseball Pitchers

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Correlation of Range of Motion and Glenohumeral Translation in Professional Baseball Pitchers

Yearbook of Sports Medicine ◽

10.1016/s0162-0908(08)70297-6 ◽

2006 ◽

Vol 2006 ◽

pp. 61-62

Author(s):

R.C. Cantu

Keyword(s):

Range Of Motion ◽

Professional Baseball ◽

Baseball Pitchers

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Lumbopelvic Control and the Development of Upper Extremity Injury in Professional Baseball Pitchers

The American Journal of Sports Medicine ◽

10.1177/0363546520988122 ◽

2021 ◽

pp. 036354652098812

Author(s):

Kevin Laudner ◽

Regan Wong ◽

Daniel Evans ◽

Keith Meister

Keyword(s):

Upper Extremity ◽

Lower Limbs ◽

Group Differences ◽

Professional Baseball ◽

Extremity Injury ◽

Level Of Evidence ◽

Balance Task ◽

Upper Extremity Injury ◽

Baseball Pitchers ◽

Extremity Injuries

Background: The baseball-throwing motion requires a sequential order of motions and forces initiating in the lower limbs and transferring through the trunk and ultimately to the upper extremity. Any disruption in this sequence can increase the forces placed on subsequent segments. No research has examined if baseball pitchers with less lumbopelvic control are more likely to develop upper extremity injury than pitchers with more control. Purpose: To determine if baseball pitchers who sustain a chronic upper extremity injury have less lumbopelvic control before their injury compared with a group of pitchers who do not sustain an injury. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 49 asymptomatic, professional baseball pitchers from a single Major League Baseball organization participated. Lumbopelvic control was measured using an iPod-based digital level secured to a Velcro belt around each player’s waist to measure anteroposterior (AP) and mediolateral (ML) deviations (degrees) during single-leg balance with movement and static bridge maneuvers. During a competitive season, 22 of these pitchers developed upper extremity injuries, while the remaining 27 sustained no injuries. Separate 2-tailed t-tests were run to determine if there were significant differences in lumbopelvic control between groups ( P < .05). Results: There were no significant between-group differences for the stride leg (nondominant) during the bridge test in either the AP ( P = .79) or the ML ( P = .42) directions, or either direction during the drive leg bridge test ( P > .68). However, the injured group had significantly less lumbopelvic control than the noninjured group during stride leg balance in both the AP ( P = .03) and the ML ( P = .001) directions and for drive leg balance in both the AP ( P = .01) and the ML ( P = .04) directions. Conclusion: These results demonstrate that baseball pitchers with diminished lumbopelvic control, particularly during stride leg and drive leg single-leg balance with movement, had more upper extremity injuries than those with more control. Clinicians should consider evaluating lumbopelvic control in injury prevention protocols and provide appropriate exercises for restoring lumbopelvic control before returning athletes to competition after injury. Specific attention should be given to testing and exercises that mimic a single-limb balance task.

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The Relationship between Scapular Upward Rotation and Shoulder Internal and External Rotation Isokinetic Strength in Professional Baseball Pitchers

Healthcare ◽

10.3390/healthcare9060759 ◽

2021 ◽

Vol 9 (6) ◽

pp. 759

Author(s):

Byung Gon Kim ◽

Seung Kil Lim ◽

Sunga Kong

Keyword(s):

External Rotation ◽

Professional Baseball ◽

Isokinetic Strength ◽

Strength Ratio ◽

Shoulder Injury ◽

Isokinetic Dynamometer ◽

Normal Range ◽

History Of ◽

Baseball Pitchers ◽

The Relationship

This study aims to assess the relationship between scapular upward rotation (SUR) across varying humeral-elevation angles (HEAs) and shoulder isokinetic strength and ratio in professional baseball pitchers. The subjects were professional baseball pitchers (n = 16) without a history of shoulder injury in the last six months. The subject’s SUR angles were measured with the humerus elevated at HEAs of 0° (at rest), 60°, 90°, and 120° to the scapular plane. Shoulder isokinetic strength was evaluated for shoulder internal rotation (IR) and external rotation (ER) strength (PT%BW and TW%BW), and the ER/IR strength ratios were determined at 60, 120 and 180°/s using an isokinetic dynamometer. The SUR angle at an HEA of 0° was positively correlated with IR strength at 120°/s (r = 0.535) and 180°/s (r = 0.522). The SUR angle at an HEA of 60° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.505) and 120°/s (r = −0.500). The SUR angle at an HEA of 90° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.574; r = −0.554) and 120°/s (r = −0.521; r = −0.589) as well as with ER strength at 180°/s (r = −0.591, r = −0.556). The SUR angle at an HEA of 120° was negatively correlated with ER strength at 60°/s (r = −0.558), 120°/s (r = −0.504; r = −0.524), and 180°/s (r = −0.543) and the ER/IR strength ratio at 60°/s (r = −0.517). In this study, we found that the ratio of isokinetic strength between ER and IR became closer to the normal range on increasing the SUR angle. In particular, an HEA of 90°, which resembles the pitching motion, showed a clear relationship between SUR, shoulder ER, and the ratio of ER/IR isokinetic strength in professional baseball pitchers.

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