scholarly journals Baseball Pitching Biomechanics Shortly After Ulnar Collateral Ligament Repair

2019 ◽  
Vol 7 (8) ◽  
pp. 232596711986619
Author(s):  
Glenn S. Fleisig ◽  
Alek Z. Diffendaffer ◽  
Monika Drogosz ◽  
E. Lyle Cain ◽  
Benton A. Emblom ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Ulnar Collateral Ligament ◽  
Optical Tracking ◽  
Control Group ◽  
Elbow Extension ◽  
Collateral Ligament ◽  
Joint Kinetics ◽  
Ball Velocity ◽  
History Of ◽  
Repair Group

Background: The probability of returning to competition for injured baseball pitchers is similar after ulnar collateral ligament (UCL) repair as after UCL reconstruction, but the time to return is significantly quicker after UCL repair. Previous research has found no differences in pitching biomechanics between pitchers with and without a history of UCL reconstruction, but pitching biomechanics after UCL repair has not been studied. Hypothesis: There will be significant differences in pitching biomechanics between pitchers returning to play after UCL repair and pitchers with no injury history. Study Design: Controlled laboratory study. Methods: A total of 33 pitchers were tested shortly after UCL repair (9.8 ± 2.6 months) and compared with a matched group of 33 uninjured pitchers. Each group comprised 14 college pitchers and 19 high school pitchers. Shoulder and elbow passive ranges of motion were measured. The biomechanics of 10 fastballs was then collected using a 12-camera automated motion capture system. Ball velocity was measured using a separate 3-camera optical tracking system. Data were compared between the UCL repair group and the control group using the Student t test (significance set at P < .05). Results: There were no differences in passive range of motion or fastball velocity between the 2 groups. There were no differences in joint kinetics during pitching, but 3 kinematic variables showed significant differences. Specifically, the UCL repair group produced less elbow extension (flexion: 27° ± 6° vs 24° ± 4°, respectively; P = .03), less elbow extension velocity (2442 ± 367 vs 2631 ± 292 deg/s, respectively; P = .02), and less shoulder internal rotation velocity (6273 ± 1093 vs 6771 ± 914 deg/s, respectively; P = .049 ) compared with the control group. Conclusion: Elbow extension, elbow velocity, and shoulder velocity differed between pitchers with a recent history of UCL repair and a matched control group, but it is unclear whether this has clinical significance, as there were no differences in ball velocity and passive range of motion. Furthermore, it is unknown whether these few differences in pitching biomechanics resolve with time. Clinical Relevance: Elbow and shoulder kinematics during pitching might not be completely regained within the first year after UCL repair, although passive range of motion and pitch velocity show no difference in comparison to other healthy pitchers.

Shoulder Range of Motion Deficits in Baseball Players With an Ulnar Collateral Ligament Tear

2012 ◽  
Vol 40 (11) ◽  
pp. 2597-2603 ◽  
Author(s):  
J. Craig Garrison ◽  
Mollie A. Cole ◽  
John E. Conway ◽  
Michael J. Macko ◽  
Charles Thigpen ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Ulnar Collateral Ligament ◽  
Control Group ◽  
Elbow Extension ◽  
Collateral Ligament ◽  
Baseball Players ◽  
Elbow Injury ◽  
Shoulder Range Of Motion ◽  
Shoulder Range

Background: Shoulder range of motion (ROM) deficits are associated with elbow injury in baseball players. Purpose: To compare the ROM characteristics of baseball players with a diagnosed ulnar collateral ligament (UCL) tear with those of a group of age-, activity-, and position-matched healthy controls. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Sixty male competitive high school and collegiate baseball players participated. Thirty athletes (age [mean ± standard deviation], 18.20 ± 1.56 years) with a diagnosed UCL tear were compared with 30 (age, 18.57 ± 0.86 years) age-, activity-, and position-matched players without a UCL injury. Of the 60 participants, there were 44 pitchers, 4 catchers, 5 infielders, and 7 outfielders. Participants were measured for shoulder internal rotation (IR), external rotation (ER), and horizontal adduction (HA) at 90° of shoulder elevation. Participants were also measured for elbow extension in a seated position. Group comparisons were made between participants with and without a UCL injury using independent t tests with an α level set at P < .05. All measurements were taken bilaterally, and the differences (involved to uninvolved) were used to calculate means for all variables, including glenohumeral internal rotation deficit (GIRD), total rotational motion (TRM), HA, and elbow extension. Results: Baseball players with a UCL tear (UCLInj) exhibited significantly greater deficits in TRM compared with the control group of healthy baseball players (NUCLInj) (UCLInj = −6.67° ± 11.82°, NUCLInj = 0.93° ± 9.91°; P = .009). No group differences were present for GIRD (UCLInj = −12.53° ± 5.98°, NUCLInj = −13.63° ± 5.90°; P = .476), HA (UCLInj = −3.00° ± 5.01°, NUCLInj = −3.23° ± 5.15°; P = .860), or elbow extension (UCLInj = −2.63° ± 7.86°, NUCLInj = −1.17° ± 2.76°; P = .339). Pitchers with a UCL tear had significantly greater deficits in TRM (UCLInjPitch = −6.96° ± 11.20°, NUCLInjPitch = 1.29° ± 8.33°; P = .0087) and dominant shoulder ER (UCLInjPitch = 112.04° ± 14.35°, NUCLInjPitch = 121.85° ± 9.46°; P = .011) than pitchers without a UCL tear. Conclusion: A deficit in TRM is associated with a UCL tear in baseball players. Although GIRD may be prevalent in throwers, it may not be associated with a UCL injury. When examining ROM in baseball players, it is important to assess both TRM and GIRD.

scholarly journals Reasons for Retirement Following Ulnar Collateral Ligament Reconstruction Among Major League Baseball Pitchers

2017 ◽  
Vol 5 (12) ◽  
pp. 232596711774502 ◽  
Author(s):  
Brandon J. Erickson ◽  
Junyoung Ahn ◽  
Peter N. Chalmers ◽  
Christopher S. Ahmad ◽  
Bernard R. Bach ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Major League Baseball ◽  
Ulnar Collateral Ligament ◽  
Control Group ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Elbow Injury ◽  
Major League ◽  
History Of ◽  
Ulnar Collateral Ligament Reconstruction

Background: Ulnar collateral ligament reconstruction (UCLR) has become an increasingly common procedure among Major League Baseball (MLB) pitchers. The long-term effects of this procedure on the career of an MLB pitcher are largely unknown. Purpose/Hypothesis: The purpose of this study was to determine why and when MLB pitchers who underwent UCLR during their careers retired from baseball as compared with controls. We hypothesized that pitchers who underwent UCLR are no more likely than control pitchers to retire from elbow or shoulder problems. Study Design: Cross-sectional study; Level of evidence, 3. Methods: All MLB pitchers who underwent UCLR were identified through publicly available data. A cohort of pitchers who did not undergo UCLR were matched to pitchers with a history of UCLR, based on sex, age, draft year, and draft round. Of those who were no longer pitching in the MLB, the reason for retirement was determined. Reason for retirement and length of career following UCLR (surgical group) and index year (control group) were determined and compared through prior studies via the MLB HITS database, MLB team websites, and publicly available internet-based injury reports. Results: Overall, 153 MLB pitchers who underwent UCLR between 1974 and 2015 are currently retired. Mean ± SD time to retirement was 4.4 ± 4.7 years (range, 0-26 years) after the index year in the control group and 4.4 ± 3.5 years (range, 0-15 years) after surgery in the UCLR group ( P = .388). Patients who were status post-UCLR were significantly more likely to be released during the season (34 of 144, 23.6%) than were players who were not status post-UCLR (14 of 144, 9.7%) ( P = .002). Shoulder injury as a reason for retirement was more common in the control group than the UCLR group ( P = .011). Elbow injury as a reason for retirement was not more common in either group ( P = .379). Leg injury as a reason for retirement was more common in the control group ( P = .013). Performance as a reason for retirement was more common in the UCLR group than the control group ( P < .001). Conclusion: MLB pitchers who have undergone UCLR are no more likely to retire from shoulder or elbow injuries than are those who have not undergone UCLR. MLB career length was similar between pitchers with and without a history of UCLR.

scholarly journals A Biomechanical Evaluation of a 2-Suture Anchor Repair Technique for Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Injuries

Hand ◽  
2017 ◽  
Vol 13 (5) ◽  
pp. 581-585 ◽  
Author(s):  
Joseph A. Gil ◽  
Alison Chambers ◽  
Kalpit N. Shah ◽  
Joseph J. Crisco ◽  
Christopher Got ◽  
...  
Keyword(s):  
Suture Anchor ◽  
Proximal Phalanx ◽  
Ulnar Collateral Ligament ◽  
Maximum Load ◽  
Biomechanical Analysis ◽  
Control Group ◽  
Collateral Ligament ◽  
Repair Technique ◽  
The Mean ◽  
Repair Group

Background: A complete thumb ulnar collateral ligament (UCL) repaired with 1-suture anchor has been demonstrated to be significantly weaker compared with the intact UCL. The objective of this study is to test the biomechanical strength of a 2-anchor thumb UCL repair. Methods: Nine paired fresh-frozen hands were used for this biomechanical analysis. One thumb from each pair was randomized to the control group and one to the repair group. In the control group, the UCL was loaded to failure in tension. In the repair group, the UCL was dissected off of the proximal phalanx, subsequently repaired with a 2-anchor technique, and then tested to failure. Results: The mean yield load was 342 N (95% confidence interval [CI], 215-470 N) in the control group and 68 N (95% CI, 45-91 N) in the repair group. The mean maximum load at failure was 379 N (95% CI, 246-513 N) in the control group and 84 N (95% CI, 62-105 N) in the repair group. The mean stiffness was 72 N/m (95% CI, 48-96 N/m) in the control group and 17 N/m (95% CI, 13-21 N) in the repair group. The mean displacement at failure was 7.8 mm (95% CI, 7-9 mm) in the control group and 7.8 mm (95% CI, 7-9 mm) in the repair group. Conclusions: The 2-anchor repair technique we tested does not acutely reestablish the strength of the insertion of the native insertion of the UCL with this technique.

scholarly journals Is Workload Associated with Ulnar Collateral Ligament Tears in Professional Baseball Players? An Analysis of Days of Rest, Innings Pitched and Batters Faced (126)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0026
Author(s):  
Peter Chalmers ◽  
Kathryn Mcelheny ◽  
John Dangelo ◽  
Kevin Ma ◽  
Dana Rowe ◽  
...  
Keyword(s):  
Major League Baseball ◽  
Tracking System ◽  
Ulnar Collateral Ligament ◽  
Fold Increase ◽  
Professional Baseball ◽  
Control Group ◽  
Collateral Ligament ◽  
Baseball Players ◽  
Elbow Injuries ◽  
Paired Analysis

Objectives: To determine if workload; as measured by number of days rest between outings, innings pitched, batters faced, and being a starting pitcher; associates with risk for sustaining a subsequent UCL tear in professional baseball players. Methods: All professional baseball pitchers who sustained a UCL tear between 2011-2017 were identified using the major league baseball (MLB) Health and Injury Tracking System (HITS). A separate player usage was used to determine workload . We then compared these variables between player-games 2, 6, 12, and >12 weeks prior to a documented UCL tear and player games from a non-UCL tear control group. In a paired analysis, we compared the acute workload (2, 6, 12 weeks) prior to injury and the injured player’s workload >12 weeks prior to injury. Results: There were 2,204 elbow injuries within MLB, 369 of which were unique UCL tears in pitchers. In all time periods, player-games with more days rest, more innings pitched, and more batters faced associated with a subsequent UCL tear. Players who pitched 4 of more innings per outing had a 1.78-fold increase in percent of players with a subsequent UCL tear as compared to players with one inning pitched. Being a starting pitcher carried a relative risk of 1.51 (p<0.001) of subsequent UCL injury. In a paired analysis there were significantly more innings pitched and batters faced in the player-games 2 weeks prior to UCL injury than in the player-games >12 weeks prior to UCL injury (p=0.028 and p=0.017). Conclusions: Being a starting pitcher, pitching more innings per game, and facing more batters per game increased the risk of a UCL tear. An increase in workload in the 2 weeks prior to injury over that player’s baseline also significantly increased the risk for injury.

scholarly journals The impact of distance and the crow hop on medial elbow stress during an interval throwing program

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0034
Author(s):  
Austin Cross ◽  
Grace Smith ◽  
Caleb Gulledge ◽  
Dylan Koolmees ◽  
Vasilios Moutzouros ◽  
...  
Keyword(s):  
High School ◽  
Ligament Reconstruction ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
Baseball Players ◽  
Standard Interval ◽  
Rehabilitation Programs ◽  
Ball Velocity ◽  
The Impact ◽  
Ulnar Collateral Ligament Reconstruction

Objectives: Rehabilitation programs following ulnar collateral ligament reconstruction include an interval throwing program in order to gradually increase stress and prevent excessive elbow valgus loads. These programs often instruct players to use the crow hop, even at short distances, in order to reduce stress on the reconstructed ligament. The purpose of the study was to evaluate the impact of the crow hop on medial elbow stress at various distances of an interval throwing program. Methods: High school and college-aged baseball players were recruited for this study. Players threw at distances of 30, 45, 60, 90, 120, 150, and 180 feet. At each distance, participants made 3 throws while using a crow hop and 3 throws without using a crow hop with the instruction to throw on an arc. A wearable device recorded elbow torque, arm slot, arm speed, and shoulder rotation. Ball velocity was measured using radar gun. Results: A total of 20 players participated in this study. Overall elbow torque at each distance was 12.9, 20.5, 26.3, 31.9, 34.7, 36.1, and 37.1 Nm, respectively. There was no difference in elbow stress for throws with a crow hop compared to throws without a crow hop at any distance of throwing (p > 0.05). There was no difference in elbow torque for throws at 150 feet compared to 120 feet (p = 0.10) or 150 feet compared to 180 feet (p = 0.83); however, there were significant increases in elbow torque between every other throwing distance (p < 0.05). Conclusions: Medial elbow torque significantly increases at greater throwing distances of a standard interval throwing program, although the effect becomes less pronounced at longer distances as players maximize effort. The crow hop does not affect medial elbow torque at any distance of throwing.

scholarly journals Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament: Early Outcomes of Suture Anchor Repair with Suture Tape Augmentation

2020 ◽  
Author(s):  
Shaan S. Patel ◽  
Michael Hachadorian ◽  
Amber Gordon ◽  
Jason Nydick ◽  
Michael Garcia
Keyword(s):  
Range Of Motion ◽  
Suture Anchor ◽  
Ulnar Collateral Ligament ◽  
Dash Score ◽  
Suture Anchors ◽  
Collateral Ligament ◽  
Joint Flexion ◽  
Suture Anchor Repair ◽  
Suture Tape

Abstract Introduction The purpose of this study was to evaluate the early outcomes of thumb metacarpophalangeal (MCP) joint ulnar collateral ligament (UCL) repair using suture anchors with suture tape augmentation. Materials and Methods Six patients underwent thumb UCL repair or reconstruction with suture tape augmentation and six patients underwent thumb UCL repair with intraosseous suture anchors between January 2013 and January 2018. The main outcome measures were range of motion, strength, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and complications. Results At final follow-up for patients who had suture tape augmentation, the average thumb MCP joint and interphalangeal (IP) joint flexion were 65 and 73 degrees, respectively. The average DASH score was 4.3. At final follow-up for patients who had intraosseous suture anchor repair, the average thumb MCP joint and IP joint flexion were 50 and 60 degrees, respectively. The average DASH score was 38. There were no complications or secondary procedures in either group. Conclusion The use of suture anchor repair with suture tape augmentation for thumb UCL injuries is a treatment option that allows for early range of motion with satisfactory early outcomes that are comparable to intraosseous suture anchor repair. Level of Evidence This is a level IV, case series article.

Biomechanical Performance of Baseball Pitchers With a History of Ulnar Collateral Ligament Reconstruction

2015 ◽  
Vol 43 (5) ◽  
pp. 1045-1050 ◽  
Author(s):  
Glenn S. Fleisig ◽  
Charles E. Leddon ◽  
Walter A. Laughlin ◽  
Michael G. Ciccotti ◽  
Bert R. Mandelbaum ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
History Of ◽  
Baseball Pitchers ◽  
Ulnar Collateral Ligament Reconstruction

scholarly journals Performance Analytics and Pitch Metrics as Predictors of Ulnar Collateral Ligament Injury in Major League Baseball Pitchers (128)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0027
Author(s):  
Matthew Fury ◽  
Donna Scarborough ◽  
Luke Oh ◽  
Joshua Wright-Chisem ◽  
Jacob Fury ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Injury Risk ◽  
Major League Baseball ◽  
Ulnar Collateral Ligament ◽  
Ligament Injury ◽  
Control Group ◽  
Collateral Ligament ◽  
Significant Difference ◽  
Major League

Objectives: Ulnar collateral ligament (UCL) injury is a significant concern in elite throwers, and it is associated with prolonged time away from competition in Major League Baseball (MLB) pitchers. Identifying athletes at higher risk of injury, with the subsequent goal of injury prevention, may positively impact pitcher health while mitigating the significant economic impact of this injury on professional organizations. As technology continues to advance, more granular assessments of performance are becoming possible. In 2015, Major League Baseball introduced StatCast, a spatiotemporal data tracking system that uses a standardized camera system and radar technology, to optically track player and ball movement to measure and quantify game events. This technology allows for further investigation of the science of pitching and provides new frontiers for injury research. Understanding UCL injuries in MLB pitchers may also provide insight into youth pitching injuries. To date, there is a paucity of evidence regarding risk factors of UCL injury in MLB pitchers. Methods: All MLB pitchers who underwent primary UCLR between 2015 and 2019 were identified from publicly available reports. This date range was selected to capture the seasons in which Statcast data was available. Advanced analytics and pitch metrics from the injury season—including velocity, spin rates, and pitch movement from MLB StatCast data—were collected as well as the seasonal data of an uninjured control group. Binomial logistic regression analysis was performed to determine risk factors for UCL injury. Results: Seventy-six MLB pitchers undergoing primary UCL reconstruction were included, and a control group of 95 uninjured pitchers was identified. There was no significant difference in age, height, weight, or BMI between the two cohorts. A logistic regression model was created using the following variables: 4-seam fastball velocity, 4-seam fastball spin rate, slider spin rate, curveball spin rate, strikeout percentage, and wins above replacement (WAR). The model explained 18.4% of the variance and predicted 70.4% of UCL injuries. Increasing WAR was associated with increasing likelihood of subsequent UCL injury (odds ratio [OR] 2.34; 95% CI, 1.08–5.07; p = 0.031). Conclusions: When controlling for fastball velocity and pitch spin rates, MLB pitchers who are more valuable, as indicated by WAR, may be at an elevated risk of UCL injury. While velocity is a known risk factor for UCL injury, this model indicates that other factors, including performance or pitch metrics, may influence single-season injury risk and warrant future investigation in multi-year studies.

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