Baseball Players Diagnosed With Ulnar Collateral Ligament Tears Demonstrate Decreased Balance Compared to Healthy Controls

Abstract

Study Design Cross-sectional. Objectives To compare lower extremity balance and shoulder range of motion in baseball players with ulnar collateral ligament (UCL) tears to a healthy cohort. Background Throwing is a complex motion that requires balance and coordination to effectively transfer energy through the kinetic chain. In theory, poorer balance could negatively affect throwing mechanics and lead to injury. Methods Thirty baseball players (mean ± SD age, 18.5 ± 1.9 years) with a diagnosis of a UCL tear of their throwing arm were compared to 30 players (age, 19.0 ± 1.1 years) without a UCL tear. All participants were competing at either the high school or collegiate level and reported an average ± SD of 13.5 ± 1.7 years of playing experience. The Y Balance Test composite scores were calculated for the stance and lead lower extremities of all players. Shoulder range of motion was used to calculate glenohumeral internal rotation deficit and side-to-side differences in total rotational motion. Group comparisons were made between participants with and without UCL tears using independent t tests. Results Baseball players with UCL tears scored significantly lower on the Y Balance Test for both the stance (P<.001) and lead (P<.001) lower extremities compared to the noninjured cohort. No between-group differences were noted in glenohumeral internal rotation deficit (P = .453), whereas the mean ± SD side-to-side difference in total rotational motion was −6.0° ± 9.6° for the injured group, compared to −0.4° ± 9.6° for the control group (P = .028). Conclusion Participants with a UCL tear demonstrated decreased performance for their stance and lead lower extremities during the Y Balance Test. These data are consistent with a clinical hypothesis of a potential association between impaired balance and UCL tears in high school and collegiate baseball players. The lower total rotational motion of the dominant shoulder in participants with UCL tears needs to be considered in the interpretation of those results. J Orthop Sports Phys Ther 2013;43(10):752–758. Epub 9 September 2013. doi:10.2519/jospt.2013.4680

Coexistence of Trunk or Lower Extremity Pain with Elbow and/or Shoulder Pain among Young Overhead Athletes: A Cross-Sectional Study

“…Several studies have reported that dysfunction in the trunk or lower extremities has a significant association with elbow and shoulder injuries in adult overhead athletes (Scher et al 2010;Feigenbaum et al 2013;Garrison et al 2013;Chaudhari et al 2014;Pontillo et al 2014;Radwan et al 2014). Some studies have demonstrated that poor core stability should be considered as a potential risk factor for elbow and shoulder injuries (Garrison et al 2013;Chaudhari et al 2014;Pontillo et al 2014;Radwan et al 2014).…”

“…Some studies have demonstrated that poor core stability should be considered as a potential risk factor for elbow and shoulder injuries (Garrison et al 2013;Chaudhari et al 2014;Pontillo et al 2014;Radwan et al 2014). Other studies have shown an association between hip range of motion, as well as foot posture, with elbow and shoulder injuries.…”

A Proposal for Functional Screening of the Throwing Kinetic Chain in Baseball Pitchers to Assess Shoulder and Elbow Injury Risk

“…6,11,25 Historically, GIRD was thought to be a primary contributing factor to both shoulder and elbow injuries in overhead throwing athletes due to the concomitant hyperexternal rotation associated with the loss of internal rotation. GIRD has been attributed to tightness in the posterior glenohumeral joint capsule, myofascial restrictions, laxity of anterior glenohumeral joint capsule, and osseous changes that result in humeral retroversion.…”

“…Literature suggests that year-round training and competition increases the likelihood of a youth baseball pitcher suffering a shoulder or elbow injury. 10,11 The number of pitches thrown, the type of pitches thrown, and the overall physical fitness of the youth baseball pitcher can increase the risk for shoulder and elbow injuries. 10,12,15 Fifteen percent of college-level pitchers consider injuries sustained playing youth baseball have limited current performance.…”

“…Specifically in overhead throwing, an impaired ability to control the position of the trunk and legs can alter the position of the arm and potentially lead to injury of the shoulder and elbow. 3,4,11,16,[18][19][20][21][22][23][24] In order to properly screen, train, and rehabilitate a throwing athlete, an approach that examines balance, core stability, and lower extremity mobility and stability is necessary. 16,19,22 …”