Background: Previous pilot research has investigated differences in elbow valgus torque between the “tall and fall” (TF) and “drop and drive” (DD) pitching styles. Whether one of these pitching styles is associated with a greater rate of ulnar collateral ligament reconstruction (UCLR) is currently unknown. Purpose: To determine the proportion of Major League Baseball (MLB) pitchers using the TF and DD pitching styles who underwent UCLR over a 10-year period. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The demographic characteristics of pitchers who underwent UCLR between 2007 and 2017 were obtained via the open-source database MLB Player Analysis Tommy John Surgery List. Other information, such as previous UCLR and pitching videos and graphics, was obtained from other open-source databases. A comprehensive, 2-dimensional, kinesiology-based multicomponent definition of each pitching style was formulated and used to categorize the included pitchers into the TF and DD groups. Statistical comparisons and contrasts were made using chi-square and Pearson correlation tests. Results: Included were 223 MLB pitchers (mean ± SD age, 27.5 ± 3.6 years; body mass index [BMI], 27.6 ± 2.2; throwing velocity, 92.9 ± 2.6 mph [149.5 ± 4.2 km/h]) who underwent UCLR between 2007 and 2017. Of these pitchers, 162 were categorized as TF pitchers (72.6%) and 61 as DD pitchers (27.4%). Pitching velocity for injured pitchers was significantly correlated to BMI ( P < .001). We found no significant associations of pitching style with year of UCLR ( P = .941), BMI ( P = .549), age ( P = .647), handedness ( P = .501), or average pitch velocity ( P = .921). Conclusion: The study findings demonstrated that a higher proportion of UCL-injured MLB pitchers (72.6%) used the TF pitching style. Further research is needed to explore the potential association between pitching style and UCL injury.

Background: There is growing concern among sports medicine professionals regarding the increasing prevalence of ulnar collateral ligament (UCL) surgery in baseball players. At this time, it is unclear whether collegiate head baseball coaches possess adequate knowledge of UCL injuries. Purpose/Hypothesis: The purpose of this study was to assess the knowledge and perceptions of UCL injury among National Collegiate Athletic Association (NCAA) head baseball coaches. It was hypothesized that NCAA head baseball coaches would demonstrate misconceptions and knowledge disparities regarding UCL injury. Study Design: Cross-sectional study. Methods: An online 35-question survey was designed to assess NCAA head baseball coaches’ knowledge of UCL injury. The survey included questions related to participant characteristics, UCL injury, biometric performance and pitching variables, throwing fatigue, surgical variables/performance outcomes, and collegiate athlete recruitment. A total of 788 NCAA head baseball coaches were asked to participate. Responses were analyzed and reported using descriptive statistics where appropriate. Statistical comparisons and contrasts were made using chi-square and Fisher exact tests. Results: A total of 103 NCAA head baseball coaches participated in the survey, representing a 13.1% response rate. Only 31% of respondents could correctly identify all UCL injury symptoms, and 93% recommended <8 weeks off from overhead throwing during the off-season. Previous elbow injury observation was associated with UCL symptom identification (χ2 = 10.614; P = .005). Regular access to an athletic trainer ( P = .015) and regular access to a strength and conditioning coach ( P = .004) were both associated with NCAA division status, with Division I programs having the most access. Neither sports medicine physician ( P = .656) nor athletic trainer ( P = .611) access was associated with the geographic location of the baseball program; however, strength and conditioning coach access was associated with geographic location (χ2 = 6.696; P = .010). Conclusion: This study demonstrates that limited UCL injury knowledge and various misconceptions exist among NCAA baseball head coaches. The majority of responding coaches recommended an amount of time off from overhead throwing during the off-season that may be inadequate and were unable to identify all symptoms associated with UCL injury, representing the most concerning findings of the present study.

BACKGROUND: The incidence of UCL injuries has increased considerably and is well documented in male-focused literature. Although women are not immune to UCL injuries, limited work has explored potential sex-specific differences in UCL mechanism of injury, clinical presentation, care pathway, or return to play. The purpose of the present study was to evaluate patterns of elbow UCL injury in male and female athletes via MRI review.METHODS: Retrospective chart review of diagnosed elbow UCL injuries at a single sports medicine institution from January 2015- January 2022 was performed. Inclusion criteria were as follows: (1) patients 15-35 years of age, (2) diagnosis of an elbow UCL injury, (3) athlete, (4) MRI of elbow at the time of injury, (5) patient documentation records with demographic information. Male and female groups were compared for differences in injury patterns and the presence of concurrent injuries. A secondary analysis assessed demographic differences between the two cohorts. To determine if there were statistically significant differences between males and females, t-tests or Mann-Whitney U tests were used for numerical variables based on distribution, while chi-square or Fisher’s exact tests were used for categorical variables. RESULTS: Of 1,068 patients diagnosed with a UCL injury during the study window, 168 patients met inclusion criteria (113 (67%) males and 55 (33%) females). The average age in both groups was 17.9 ± 2 years. No statistically significant differences were observed with regard to handedness, injury year, or injury month. When comparing injury-related clinical factors between male and female patients, statistically significant differences were discovered for injury onset, UCL grade, and tear location (all p<0.001). Males had a higher rate of bony edema (63% vs. 26%; p<0.001). No significant differences were found with other associated injuries.   CONCLUSION: This present study demonstrates that sex-specific differences exist in UCL injury patterns – including onset of UCL injury, grade, and tear location. We also found that MRI findings, symptom duration, and management strategies differed between male and female athletes. Female athletes more commonly presented with chronic UCL injuries, many of which displayed no significant findings on MRI imaging. The results of this study suggest that sex-specific differences in UCL injury occurrence and presentation exist. Further research is needed to better inform the care and treatment of UCL injuries in both male and female athletes.

was a significant difference (p < 0.001) between MASlab (16.33 ± 2.25 km/h) and MASfield (15.70 ± 2.41 km/h) with a mean bias of -0.63 km/h (Figure 1A). A significant correlation was found between the tests (r = 0.94, p < 0.001) (Figure 1B). Maximum heart rate was lower (p < 0.001) in the MASfield (182 ± 10 bpm) as compared to the MASlab (186 ± 7 bpm), and the respective differences between the heart rates and running speeds correlated (r = -0.538, p = 0.004). CONCLUSION Polar running performance test seems to be an applicable method for determining MAS with a sufficient accuracy in field conditions. Nevertheless, reliable test results will require standardization of the external factors and maximal effort control.

Background: Previous research has documented the proportion of “tall and fall” (TF) and “drop and drive” (DD) pitching styles among Major League Baseball (MLB) pitchers who underwent ulnar collateral ligament reconstruction (UCLR). The proportion of these 2 styles among all MLB pitchers remains unknown. Purpose: To determine the proportion of the TF and DD pitching styles in all rostered MLB pitchers during a single season as well as the proportion of TF and DD pitchers who sustained an upper extremity (UE) injury and those who underwent UCLR. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Pitcher demographic characteristics from the 2019 MLB season and pitching information were obtained via open-access sources. Two-dimensional video analysis was used to categorize the included pitchers into TF and DD groups. Statistical comparisons and contrasts were made using 2-tailed t tests, chi-square tests, and Pearson correlation analyses as appropriate. Results: Of the 660 MLB rostered pitchers in 2019 (age, 27.39 ± 3.51 years; body mass index, 26.34 ± 2.47 kg/m2; fastball velocity, 150.49 ± 3.99 kph [93.51 ± 2.48 mph]), 412 (62.4%) pitchers used the TF style and 248 (37.6%) pitchers used the DD style. Significantly more UE injuries were seen in the TF group compared with the DD group (112 vs 38 injuries, respectively; P < .001). Twelve pitchers underwent UCLR (TF, 10; DD, 2), representing a 1.8% UCLR rate among all pitchers. This was a second surgery for 2 pitchers, both of whom used the TF pitching style. Significantly more pitchers in the TF group than the DD group had undergone UCLR before 2019 (135 vs 56 pitchers, respectively; P = .005). Conclusion: The results of the present study demonstrated a higher prevalence of both UE injury and prior UCLR in TF pitchers. Further research is needed to explore the potential association between pitching style and UE injury.