Background:The purpose of this study was to assess major and minor league baseball players’ return to professional baseball at a preinjury level or higher after surgery of the shoulder or elbow.Hypothesis:The majority of athletes will be able to return to their preinjury level after surgery.Study Design:Case series.Methods:Over a 4-season period, prospective injury and surgery records were reviewed for one professional baseball club. Forty-four players underwent 51 procedures (28 shoulder and 23 elbow) by multiple experienced surgeons; 7 players underwent more than 1 procedure.Results:Twenty-eight shoulder surgeries were performed on 27 players: 19 pitchers and 8 position players. The majority of the procedures were labral repairs (n = 21). Nine players returned to their preoperative level; 2 advanced to a higher level; 5 returned to a lower level; and 11 retired from professional baseball. Only 2 of the 12 players at the high professional level (Major League Baseball, triple-A, double-A) returned to the same level. Twenty-three elbow surgeries were performed on 21 players (20 pitchers). The majority of the procedures were ulnar collateral ligament reconstructions (n = 12). Seven players returned to their preoperative level; 4 advanced to a higher level; 4 returned to a lower level; and 6 retired from professional baseball. Of the 12 players at the high professional level, 3 returned to the same or higher level.Conclusion:Following surgery, 21 of 44 players (48%) returned to the same or higher level of professional baseball. For those players performing at a high professional level, 5 of 22 (23%) returned to the same or higher level. Return to the same or higher level was more likely with elbow surgery than with shoulder surgery.Clinical Relevance:Elite throwing athletes may not return to the same level at a high rate following shoulder or elbow surgery.

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We identified a significant modification of RR for mortality due to air pollution by age, which is enhanced under specific weather types. Efforts should be targeted at minimizing pollutant exposure to the elderly and/or all age groups with respect to weather type in question.

Background: Because of the large forces and high frequency of throwing, the upper extremity experiences repetitive stresses that lead to acute and chronic adaptations. While the importance of pennation angle and muscle thickness as predictors of muscle force production has been shown in other populations and other joints, there has been little research done that examines these variables in the shoulders of baseball players. Purpose: (1) To examine the chronic effect pitching has on the rotator cuff muscle architecture (pennation angle and muscle thickness) in healthy professional baseball pitchers, and (2) to examine the correlation between muscle architecture and clinical measures of strength and range of motion (ROM). Study Design: Cross-sectional study; Level of evidence, 3. Methods: Twenty-eight healthy professional pitchers were recruited during the 2019 spring training. Internal rotation (IR) and external rotation (ER) strength were measured with a handheld dynamometer and IR and ER ROM were measured with an inclinometer. A diagnostic ultrasound machine was utilized to capture images of humeral retroversion, as well as the pennation angle and muscle thickness of the infraspinatus and teres minor muscles. ImageJ software was used to quantify the pennation angle and muscle thickness. Results: There were no significant differences between the dominant and nondominant arms for ER or IR strength. Also, no pennation angle and muscle thickness differences were found between the dominant and nondominant arms. A weak positive relationship between infraspinatus muscle thickness (superficial and total) and ER strength ( P = .016, R = 0.287 and P = .009, R = 0.316) and a moderate negative relationship between soft tissue glenohumeral internal rotation deficit (GIRD) and the bilateral difference of the teres minor deep pennation angle ( R = −0.477, P = .008) were observed. No other significant relationships were noted. Conclusion: Our results are contrary to current literature as we expected to see a stronger dominant arm, with a larger pennation angle and greater muscle thickness. Interestingly, we found that ER strength was positively related to only the thickness of the infraspinatus muscle, and that soft tissue GIRD was positively related to only the side-to-side adaptation of the pennation angle within the deep portion of the teres minor. This suggests that when posterior shoulder tightness occurs, specifically the architecture of the teres minor muscle is involved. However, the organization to which these players belonged has a very extensive training protocol throughout the year that emphasizes bilateral training during a large majority of the exercises. Therefore, the results may not be generalizable to all professional players.

Context Baseball is played around the world, including in North America and Latin America. The repetitive and stressful act of throwing can lead to adaptations such as increased humeral retroversion (HR) in the throwing arm. This adaptation is often considered beneficial as it allows more glenohumeral external rotation during the cocking phase of pitching without soft tissue stretching. Therefore, it is speculated that throwing should be started at a young age to capitalize on this adaptation. Interestingly, athletes in different geographic regions of the world often begin organized baseball at different ages. However, range of motion (ROM), HR, and the starting age of baseball have never been examined based on geographic region. Objective To determine if ROM, HR, and the starting age of baseball players differed between professional baseball pitchers from North America and Latin America. Design Cross-sectional study. Setting Clinical setting. Patients or Other Participants Thirty professional pitchers (North American = 19, Latin American = 11) with no current injury or surgery in the previous 6 months. Main Outcome Measure(s) Both ROM and HR were measured in the dominant and nondominant shoulder of each participant. The starting age for baseball was self-reported. Results The Latin American group had more dominant-arm HR (8.7°; P = .034), more nondominant-arm external rotation (5.3°; P = .049), and a trend toward more nondominant-arm HR (6.5°; P = .058), yet they started playing baseball at a later age (by 3.7 years; P = .021) compared with the North American group. Conclusions Latin American players had greater HR but started playing baseball at an older age. These findings contradict current thinking that HR would be more pronounced if baseball was started at a younger age. Additional research is required to better understand HR and the genetic, environmental, and nutritional factors that contribute to its development.