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- Title
Ulnar Collateral Ligament and Elbow Adaptations in High School Baseball Pitchers.
- Authors
Marshall, Nathan E.; Keller, Robert A.; Van Holsbeeck, Marnix; Moutzouros, Vasilios
- Abstract
<bold>Background: </bold>Baseball pitchers have adaptive changes in the soft tissues of the throwing elbow.<bold>Hypothesis: </bold>High school baseball pitchers would show adaptive changes in the ulnar collateral ligament (UCL), such as calcifications and hypoechoic foci, thickening, and increased ulnohumeral joint laxity, on dynamic ultrasound (DUS).<bold>Study Design: </bold>Cross-sectional study.<bold>Level Of Evidence: </bold>Level 3.<bold>Methods: </bold>Twenty-two asymptomatic high school pitchers, designated as their primary position by their coach, underwent DUS and physical examination of the throwing and nonthrowing elbows prior to the start of the season. UCL substance consistency and thickness, ulnohumeral joint space widening, and soft tissue elbow structures were evaluated.<bold>Results: </bold>The mean age of the cohort was 16.9 years. Calcifications of the UCL were similar, being present in 7 of 22 (32%) throwing elbows versus 8 of 22 (36%) nonthrowing elbows (P = 0.11). UCL hypoechoic foci also were similar between elbows: 2 of 22 (9%) throwing elbows versus 0 of 22 nonthrowing elbows (P = 0.11). UCL thickness was also found to be similar in both elbows (throwing arm, 6.54 mm vs nonthrowing, 6.71 mm; P = 0.48). Ulnohumeral joint laxity unloaded (throwing arm, 3.13 mm vs nonthrowing, 3.17 mm; P = 0.835) and loaded (throwing arm, 3.87 mm vs nonthrowing arm, 4.11 mm; P = 0.30) was similar between elbows. Throwing elbows showed posteromedial olecranon spurring in 36%, effusions in 27%, and synovitis in 9%.<bold>Conclusion: </bold>High school pitchers show limited adaptive changes in the elbow, including UCL calcifications, hypoechoic foci, posteromedial olecranon spurring, and effusions. However, these changes are similar to those seen in the nonthrowing elbow, and these younger athletes lack findings seen in professional and collegiate pitchers such as UCL thickening and increased ulnohumeral joint space laxity.<bold>Clinical Relevance: </bold>Preseason ultrasound examination of the high school pitching elbow lacks the adaptive changes to the elbow as seen in professional pitchers. These changes likely occur later in a pitcher's career.
- Subjects
ULNAR collateral ligament; PHYSIOLOGICAL adaptation; ELBOW physiology; PITCHERS (Baseball); CALCIFICATION; ULTRASONIC imaging; ARM physiology; SHOULDER physiology; BASEBALL; ELBOW; JOINT hypermobility; RANGE of motion of joints; ROTATIONAL motion; COLLATERAL ligament; CROSS-sectional method; CALCINOSIS; PHYSIOLOGY
- Publication
Sports Health: A Multidisciplinary Approach, 2015, Vol 7, Issue 6, p484
- ISSN
1941-7381
- Publication type
journal article
- DOI
10.1177/1941738115604577