Training With Lighter Baseballs Increases Velocity Without Increasing the Injury Risk

Background: Pitch velocity has become an increasingly popular metric by which pitchers are graded and compared. Training programs that utilize weighted balls have been effective in increasing velocity but at the cost of an increased injury risk. No studies have evaluated training with lighter baseballs with regard to increasing pitch velocity and the injury risk. Purpose/Hypothesis: The purpose of this study was to determine whether a training program utilizing lighter baseballs could increase fastball velocity without increasing the injury risk to participants. We hypothesized that a training program with lighter baseballs would increase fastball velocity but not increase the injury risk. Study Design: Case series; Level of evidence, 4. Methods: All baseball pitchers who participated in a 15-week program at a single location, with the same coaches, and aimed to improve pitching mechanics and increase velocity were included. The training program was broken down into 3 phases, and each participant went through the same program. Lighter baseballs (3 and 4 oz) and standard baseballs (5 oz) were utilized as part of the training program. Weighted (heavier) balls were not used. Velocity was measured at 4 time points throughout the program with the pitcher throwing 5 fastballs using a standard 5-oz ball at maximum velocity (sessions 3, 10, 17, and 25). Injuries for all players were recorded throughout the entire program. Results: A total of 44 male pitchers aged 10 to 17 years (mean age, 14.7 ± 1.8 years) completed the training program and were available for analysis. No pitcher sustained a shoulder or elbow injury during the course of the training program. Fastball velocity increased by a mean of 4.8 mph (95% CI, 4.0-5.6 mph) ( P < .001). Overall, 43 of 44 players (98%) had an increase in fastball velocity over the course of the program. Conclusion: A 15-week pitching training program with lighter baseballs significantly improved pitching velocity without causing any injuries, specifically to the shoulder or elbow. Lighter baseballs should be considered as an alternative to weighted baseballs when attempting to increase a pitcher’s velocity.

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Training with Lighter Baseballs Increases Velocity Without Increasing Injury Risk

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00341 ◽

2020 ◽

Vol 8 (7_suppl6) ◽

pp. 2325967120S0034

Author(s):

Peter Chalmers ◽

Rocco Bassora ◽

Chris Inzerillo ◽

Andrew Beharrie ◽

Anthony Romeo ◽

...

Keyword(s):

Training Program ◽

Confidence Intervals ◽

Injury Risk ◽

Training Programs ◽

Complete Data ◽

Velocity Data ◽

Injury Rates ◽

Time Points ◽

Baseball Pitcher ◽

The Cost

Objectives: Pitch velocity has become an increasingly popular metric by which pitchers are graded and compared. Training programs that utilize weighted balls have been effective in increasing velocity but at the cost of increased injury risk. The purpose of this study was to determine if a baseball pitcher-training program utilizing lighter baseballs could increase fastball velocity without increasing injury risk. The author’s hypothesized that the training program with lighter baseballs would increase fastball velocity without causing injuries during the training program to the participants Methods: All baseball pitchers who participated in a 15-week pitching mechanic and velocity training program were included. Training program was broken down into three phases, and each participant went through the same program. Lighter balls (4oz and 3oz) and standard baseballs (5oz) were utilized as part of the training program. Weighted (heavier) balls were not used. Velocity was measured at four time points throughout the program. Injury rates for all players were recorded throughout the entire program. Results: 48 male pitchers aged 10-17 (average age: 14.7 +/- 1.8) years started the program and 44 had complete data and were included in the analysis. No pitcher sustained a baseball-related injury while participating in the training program (one player broke his ankle playing basketball, one player moved, one did not have baseline velocity data, and one experienced biceps soreness after participating in back to back showcases against recommendations). Fastball velocity increased by an average of 4.8mph (95% confidence intervals 4.1 - 5.5mph). Overall 43/44 players (98%) had an increase in fastball velocity over the course of the program. Conclusions: A 15-week baseball pitcher-training program with lighter baseballs significantly improved pitching velocity without significantly increasing injuries. Lighter baseballs should be considered instead of weighted baseballs when attempting to increase a pitcher’s velocity.

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Olecranon Apophyseal Nonunion in Adolescent Judo Players: A Report of Two Cases

Case Reports in Orthopedics ◽

10.1155/2018/8256074 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Kohei Yamaura ◽

Yutaka Mifune ◽

Atsuyuki Inui ◽

Hanako Nishimoto ◽

Yasuhiro Ueda ◽

...

Keyword(s):

Internal Fixation ◽

Bone Grafting ◽

Case Series ◽

Radiographic Evidence ◽

Level Of Evidence ◽

Old Patients ◽

Elbow Injury ◽

Autologous Bone Grafting ◽

Judo Athletes ◽

Autologous Bone

Olecranon apophyseal nonunion is an elbow injury from overuse that affects adolescent athletes such as baseball pitchers who participate in overhead throwing sports. However, such injury is rare in collision sports. Here, we report two patients with this condition who are Judo athletes. The purpose of this report was to describe three elbows with olecranon apophyseal nonunion in two adolescent patients participating in Judo. This is a case series; the level of evidence is 4. Two 15-year-old patients were evaluated. One suffered from unilateral and the other from bilateral chronic posterior elbow pain. They were diagnosed with olecranon apophyseal nonunion, which was treated using internal fixation and bone grafting. Radiographic evidence of the apophyseal union was observed four months postsurgery. Two elbows were treated with tension band wiring, then they underwent hardware removal six months postsurgery. Both patients returned to their previous levels of activities six months postsurgery. Internal fixation using autologous bone grafting was a useful treatment for these Judo athletes with olecranon apophyseal nonunion.

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Posterolateral Elbow Impingement in Professional Boxers

The American Journal of Sports Medicine ◽

10.1177/0363546507308937 ◽

2007 ◽

Vol 36 (2) ◽

pp. 328-332 ◽

Cited By ~ 17

Author(s):

Kars P. Valkering ◽

Henk van der Hoeven ◽

Bas C. M. Pijnenburg

Keyword(s):

Fibrous Tissue ◽

Case Series ◽

Normal Function ◽

Ligament Injury ◽

Arthroscopic Debridement ◽

Extension Deficit ◽

Level Of Evidence ◽

Elbow Injury ◽

Special Surgery ◽

Hospital For Special Surgery

Background Elbow injury is common in boxing, but it has not been reported in the literature. The onset is often a hyperextension trauma caused by a missed hit. Clinically the boxers complain of pain, stiffness, and an extension deficit. Purpose To evaluate the pathogenesis, diagnostic approach, and arthroscopic treatment of elbow injury in boxers, and to compare these with other sports-related elbow injuries. Study Design Case series; Level of evidence, 4. Methods Between 2003 and 2005, a group of 5 professional boxers received a diagnosis of posterior elbow impingement. An arthroscopic debridement was performed. All patients were evaluated preoperatively and 1 year postoperatively with the Hospital for Special Surgery Elbow Assessment Scale. Results An arthroscopic partial resection of the posterior olecranon tip was performed, and osteophytes and fibrous tissue were removed in this area. Loose bodies were removed from the elbow in 3 patients. They were present in the posterior compartment in 2 patients and the anterior compartment in 1. The Hospital for Special Surgery score showed satisfactory to good improvement after 1 year in all 5 cases. They all showed a normal function at follow-up and had a full return to their sports activities. In contrast with the valgus extension overload syndrome, our patients did not show any signs of concomitant ulnar collateral ligament injury. Conclusion Posterolateral elbow impingement in boxers is caused by hyperextension trauma. Concomitant medial elbow instability was not present. Standard arthroscopic debridement showed good results.

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Peace Corps Training for Africa

African Studies Review ◽

10.1017/s0002020600039251 ◽

1965 ◽

Vol 8 (02) ◽

pp. 24-38 ◽

Cited By ~ 1

Author(s):

David W. Brokensha

Keyword(s):

Training Program ◽

Present Article ◽

Training Programs ◽

Peace Corps ◽

Educational Background ◽

African Countries ◽

Service Period ◽

Major Factors ◽

The Cost ◽

The Relationship

Most of the Fellows of the African Studies Association have participated in at least one Peace Corps training program, so that they have an interest in, and opinions on, this subject. The present article summarizes the major factors of training programs, outlines the main characteristics of the projects in Africa and of the volunteers, and then considers some aspects of the relationship between the Peace Corps and the universities. Finally, there is a detailed summary of all Peace Corps training programs for Africa, from the first one in June 1961 through the summer of 1965. Forty-four different universities, colleges, or other organizations have produced 132 programs for 19 different African countries, and some 6,000 volunteers have successfully completed the training and gone to serve with the Peace Corps in Africa (the usual service period spent in Africa is two years). The first step in the establishment of a training program is a discussion between an interested university and the Training Division of the Peace Corps, followed by a series of negotiations which culminate in a formal contract. The contract specifies the duration of the program, the number and educational background of trainees, the faculty who will participate, the details of phases of training, and the country and project for which the trainees are being prepared. An important part of the contract is the budget, the cost generally being a little more than $200 per trainee per week.

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Effect of Eccentric Exercise Program for Early Tibialis Posterior Tendinopathy

Foot & Ankle International ◽

10.3113/fai.2009.0877 ◽

2009 ◽

Vol 30 (9) ◽

pp. 877-885 ◽

Cited By ~ 38

Author(s):

Kornelia Kulig ◽

Eric S. Lederhaus ◽

Steve Reischl ◽

Shruti Arya ◽

Greg Bashford

Keyword(s):

Rating Scale ◽

Early Stage ◽

Case Series ◽

Exercise Program ◽

Global Rating Scale ◽

Tibialis Posterior ◽

Global Rating ◽

Level Of Evidence ◽

Time Points ◽

Significant Difference

Background: Morphology and vascularization of painful tibialis posterior (TP) tendons before and after an intervention targeting the degenerated tendon were examined. Functional status and pain level were also assessed. Materials and Methods: A10-week twice daily, progressive eccentric tendon loading, calf stretching program with orthoses was implemented with ten, early stage TP tendinopathy subjects. TP tendons were imaged by grayscale and Doppler ultrasound at INITIAL and POST evaluations to assess the tendon's morphology and signs of neovascularization. The Foot Functional Index (FFI), Physical Activity Scale (PAS), 5-Minute Walk Test, and single heel raise (SHR) test were completed at INITIAL and POST evaluations. The Global Rating Scale (GRS) was completed at 6 months followup. One-way ANOVA was used to compare the FFI at INITIAL, POST, and 6-MONTH time points. Paired t-tests were used to compare means between the remaining variables. The level of significance was p = 0.05. Results: There was a significant difference in FFI total, pain, and disability at the three time-points. Post-hoc paired t-tests revealed that the FFI scores were lower for the total score and pain and disability subcategories when comparing from INITIAL to POST and INITIAL to 6-MONTH evaluations ( p < 0.05 for all). The number of SHR increased significantly on the involved side from INITIAL to POST evaluation ( p = 0.041). The GRS demonstrated minimum clinically important differences for improvements in symptoms at 6-MONTH. Tendon morphology and vascularization remained abnormal following the intervention. Conclusion: A 10-week tendon specific eccentric program resulted in improvements in symptoms and function without changes in tendon morphology or neovascularization. Level of Evidence: IV, Case Series

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Two-Year Follow-up Study on Clinical and Radiological Outcomes of Polyurethane Meniscal Scaffolds

The American Journal of Sports Medicine ◽

10.1177/0363546512463344 ◽

2012 ◽

Vol 41 (1) ◽

pp. 64-72 ◽

Cited By ~ 44

Author(s):

Tineke De Coninck ◽

Wouter Huysse ◽

Laurent Willemot ◽

René Verdonk ◽

Koenraad Verstraete ◽

...

Keyword(s):

Clinical Outcome ◽

Negative Correlation ◽

Radial Displacement ◽

Case Series ◽

International Knee Documentation Committee ◽

Magnetic Resonance Images ◽

Level Of Evidence ◽

Strong Negative Correlation ◽

Time Points ◽

Outcome Scores

Background: Little is known about radial displacement (RD) of polyurethane (PU) scaffolds, intended for partial meniscus defect substitution; no data are available on whether rim thickness influences RD and whether RD correlates with clinical outcome scores. Hypotheses: The meniscus is not extruded preoperatively, but RD occurs after scaffold implantation. A thicker rim will limit RD, and there is no correlation between RD and clinical outcome. Study Design: Case series; Level of evidence, 4. Methods: Twenty-six patients were implanted with a PU scaffold (8 lateral, 18 medial). Radial displacement (mm) was evaluated on magnetic resonance images preoperatively and at 3 months, 1 year, and 2 years postoperatively. At each time point, it was determined whether a correlation existed between the rim and RD. Clinical outcome was determined using a visual analog scale (VAS) for pain as well as the Lysholm knee scoring scale, Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) score. Results: Radial displacement of lateral scaffolds was not significantly different ( P = .178) either preoperatively (mean ± SD, 3.42 ± 0.99 mm) or at 3 months (4.82 ± 0.59 mm), 1 year (4.55 ± 0.87 mm), or 2 years postoperatively (4.10 ± 0.93 mm). No correlation was observed between the rim and lateral RD at all time points. Medial scaffold RD increased significantly ( P < .001) from preoperative values (2.17 ± 0.84 mm) to those at 3 months (4.25 ± 0.89 mm), 1 year (4.43 ± 1.01 mm), and 2 years postoperatively (4.41 ± 0.96 mm). A strong negative correlation between medial RD and the rim was observed at all time points. There was no significant correlation between clinical outcome scores and RD, either preoperatively or postoperatively. Conclusion: This study demonstrated that limited medial meniscal RD was present preoperatively but increased by 2 mm after scaffold implantation. Lateral RD was also present preoperatively but did not increase after scaffold implantation. Importantly, a strong negative correlation was found between the rim and postoperative medial RD; a thicker rim limited RD. However, in the lateral compartment, rim thickness did not correlate with RD because RD was already strongly present preoperatively. Finally, no correlations were observed between scaffold RD and clinical outcome scores, either preoperatively or postoperatively.

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Injury-Related Fears During the Return-to-Sport Phase of ACL Reconstruction Rehabilitation

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120909385 ◽

2020 ◽

Vol 8 (3) ◽

pp. 232596712090938

Author(s):

Adam Meierbachtol ◽

Michael Obermeier ◽

William Yungtum ◽

John Bottoms ◽

Eric Paur ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Training Program ◽

Sport Participation ◽

Cruciate Ligament ◽

Case Series ◽

Return To Sport ◽

Level Of Evidence ◽

Sport Training ◽

Anterior Cruciate ◽

The Individual

Background: Fear of reinjury is common after anterior cruciate ligament reconstruction (ACLR) and often deters a return to preinjury sport participation. A better understanding of injury-related fear is needed to inform rehabilitation strategies. Purpose/Hypothesis: The purpose of this study was to (1) identify individual fear-evoking tasks or situations, (2) compare the intensity and amount of change relative to other injury-related fears (reinjury, knee giving way, and knee pain) after completion of a return-to-sport training program, and (3) determine whether standardized questionnaires can identify the intensity of fear for the individual fear-evoking task or situation and for fear of reinjury. The hypothesis was that the task or situation that evokes fear would vary across patients and the intensity of that fear would be higher and show less change after return-to-sport training compared with other injury-related fears. Study Design: Case series; Level of evidence, 4. Methods: Participants included 33 patients (15 males; mean age, 18 years) with ACLR who enrolled in a group-format return-to-sport training program. Questionnaires completed before and after return-to-sport training included items to specify fear-evoking tasks or situations, items to rate the intensity of various injury-related fears, the Anterior Cruciate Ligament Return to Sport after Injury scale (ACL-RSI), and the Tampa Scale for Kinesiophobia (TSK-11). Results: The most common fear-evoking task or situation was cutting, followed by contact, jumping, and other. Intensity of fear-evoking task or situation was higher than other injury-related fears, but all fears decreased in intensity after training. The ACL-RSI score better identified the intensity of fear for the individual fear-evoking task or situation and for fear of reinjury than did the TSK-11 score. Conclusion: Activities that evoke fear vary across patients, but fear of cutting is common. The intensity of common fears after ACLR decreased after advanced group training, and large effect sizes were seen for nearly all examined fears. Fear of reinjury and intensity of individually feared tasks may be better reflected in the ACL-RSI score than the TSK-11 score.

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Single Pulley Double-strand Anchor Suture Fixation of the Coronoid Process in Terrible Triad of the Elbow Injury

10.21203/rs.3.rs-155381/v1 ◽

2021 ◽

Author(s):

Yih-Wen Tarng ◽

Kai-Cheng Lin

Keyword(s):

Suture Anchor ◽

Case Series ◽

Suture Technique ◽

Coronoid Process ◽

Fixation Method ◽

Type I ◽

Terrible Triad ◽

Level Of Evidence ◽

Elbow Injury ◽

Anchor Suture

Abstract Background: Terrible triad of the elbow injury is difﬁcult to manage, and the role of the coronoid process in instability is very important. We describe a simple, modified suture technique to fix a coronoid process fragment using suture anchor fixation.Methods: Eight patients (3 female and 5 male) with coronoid process injuries with the fragment involving <50% of the total height (Reagan-Morrey type I/II) in terrible triad of elbow injury were included. Patients were treated operatively via a lateral Kocher’s approach, and coronoid process fractures were repaired with a single pulley double-strand suture technique. Structures were addressed in a sequential fashion—the coronoid process, radial head, lateral ulnar collateral ligament.Results: All patients were treated with the single pulley double-strand anchor suture technique and the coronoid process fragment was found to be in good contact with the original avulsion site using the method. The final Mayo Elbow Performance Score was excellent (> 90) in 6 patients and good (between 85 and 89) in 2 patients.Conclusions: The single pulley double-strand suture tie method using a suture anchor is a less invasive and simpler fixation method for the repair of coronoid process fractures in patients with terrible triad of the elbow injuries, and results in good outcomes. Level of evidence: Level IV; Case Series; Treatment Study

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Proximally displaced medial humeral epicondyle fracture in pediatric patients: A clinical case series

10.21203/rs.3.rs-32733/v1 ◽

2020 ◽

Author(s):

Lujie Xu ◽

Wensong Ye ◽

Haibing Li ◽

Jingfang Xu ◽

Weiwei Zhu ◽

...

Keyword(s):

Demographic Data ◽

Clinical Signs ◽

Case Series ◽

Medial Epicondyle ◽

Considerable Proportion ◽

Retrospective Case ◽

Level Of Evidence ◽

Fracture Fragment ◽

Elbow Injury ◽

Injury Causes

Abstract Background Medial epicondyle fracture comprises a considerable proportion of pediatric elbow injury. The fracture fragment is typically pulled distally by the muscle and the ligament. This study aims to suggest proper recognition of a subset of the fracture that differs from its usual presentation. Methods A retrospective case study was conducted during 2011–2016. Of those cases, a subset was identified as proximally displaced (atypical) ones. Distinctive radiologic images, as well as the injury causes, demographic data, clinical signs, treatment ways, and final follow-ups regarding these atypical ones, were presented and discussed. The fracture mechanism was carefully inferred from former theories and the operative findings, and a tentative management strategy was suggested. Results Seven out of 112 cases were distinguished as the atypical, which represents 6.25% of the whole sample. Injury causes were all direct or combined direct/indirect force injuries instead of indirect force mostly seen in the typical. Five were operated while two nonoperatively treated. Operated cases revealed stripping of medial epicondyle from its surrounding periosteum/muscle origin or even cartilage. The fracture fragment was either pulled by proximal periosteum or even proximally dissociated. The outcomes of those atypical were mostly acceptable despite some minor defects. Conclusion The proximally displaced cases do constitute a portion of medial humeral epicondyle fracture in children. As well as its skeletal manifestation, awareness of its injury mechanism and soft tissue damage is required. Precise restoration of its anatomical structure might be vital for its treatment. Further scientific work is needed regarding its mechanism and management. Level of evidence: Level 4.

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70. Supporting IMG integration into residency trainings

Clinical & Investigative Medicine ◽

10.25011/cim.v30i4.2831 ◽

2007 ◽

Vol 30 (4) ◽

pp. 67

Author(s):

S. Glover Takahashi ◽

M. Alameddine ◽

D. Martin ◽

S. Verma ◽

S. Edwards

Keyword(s):

Training Program ◽

Residency Training ◽

Training Programs ◽

Comprehensive Evaluation ◽

International Medical ◽

Full Time ◽

Design Development ◽

Course Content ◽

Medical Trainees ◽

Personal Wellness

This paper is describes the design, development, implementation and evaluation of a preparatory training program for international medical trainees. The program was offered for one week full time shortly before they begin their residency training programs. First the paper reports on the survey and focus groups that guided the learning objectives and the course content. Next the paper describes the curriculum development phase and reports on the topical themes, session goals and objectives and learning materials. Three main themes emerged when developing the program: understanding the educational, health and practice systems in Canada; development of communication skills; and supporting personal success in residency training including self assessment, reflection and personal wellness. Sample lesson plans and handouts from each of the theme areas are illustrated. The comprehensive evaluation of the sessions and the overall program is then also described. The paper then summarizes the identified key issues and challenges in the design and implementation of a preparatory training program for international medical trainees before they begin their residency training programs. Allan GM, Manca D, Szafran O, Korownyk C. Workforce issues in general surgery. Am Surg. 2007 Feb; 73(2):100-8. Dauphinee, WD. The circle game: understanding physician migration patterns within Canada. Acad Med. 2006 (Dec); 81(12 Suppl):S49-54. Spike NA. International medical graduates: the Australian perspective. Academic Medicine. 2006 (Sept); 81(9):842-6.

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