The effect of repetitive baseball pitching on medial elbow joint space gapping associated with 2 elbow valgus stressors in high school baseball players

Hattori, Hiroshi; Akasaka, Kiyokazu; Otsudo, Takahiro; Hall, Toby; Amemiya, Katsuya; Mori, Yoshihisa

doi:10.1016/j.jse.2017.10.031

Cited by 27 publications

(37 citation statements)

References 30 publications

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“…Repetitive pitching more than 60 times causes an increase in medial elbow joint space gapping. In addition, the medial elbow joint space gapping after 100 pitches increased by 25% compared to gapping before pitching . Elbow valgus is resisted primarily by the UCL (54%) and the bony articulation (33%), with the anterior bundle of the UCL providing most of the restraint .…”

Section: Discussionmentioning

confidence: 99%

“…Until now, various injury prevention programs have been carried out to try to prevent elbow injury in baseball players. These include studies of pitching form using a three-dimensional motion analysis system, [29][30][31][32] studies of the relationship between physical functions and injuries, 22,33 basic studies on the elbow joint by evaluation such as using ultrasound scanning or radiographs, [10][11][12][13][14][15][16][17][18] and encouraging a limitation of the number of pitches in a game. 20,34 However, although these prevention projects have been carried out, it is reported that the number of UCL reconstruction surgeries in recent years has increased, 35 suggesting that these preventative measures are not effective or are not being used effectively.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the medial elbow joint space gapping after 100 pitches increased by 25% compared to gapping before pitching. 17 Elbow valgus is resisted primarily by the UCL (54%) and the bony articulation (33%), 6 with the anterior bundle of the UCL providing most of the restraint. [5][6][7] Furthermore, the anterior bundle of the UCL has been reported to fail at a strain of 23.6% AE 0.9%.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have demonstrated asymmetrical changes of medial elbow joint space gapping for a prolonged period as a result of habitual or repetitive baseball pitching . Even after pitching only 60 balls, there is an immediate increase in medial elbow joint space gapping, likely due to a phenomenon called cyclic creep . It is suggested that repetitive pitching causes a burden on the medial elbow joint, and may lead to overuse injury.…”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12][13][14][15][16] Even after pitching only 60 balls, there is an immediate increase in medial elbow joint space gapping, likely due to a phenomenon called cyclic creep. 17 It is suggested that repetitive pitching causes a burden on the medial elbow joint, and may lead to overuse injury.…”

Section: Introductionmentioning

confidence: 99%

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Use of an Elbow Brace During Repetitive Pitching Does Not Cause an Increased Mechanical Burden on the Throwing Arm

Hattori

Akasaka

Otsudo

et al. 2019

PM&R

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Background Repetitive pitching induces an increase in medial elbow joint space gapping and may consequently lead to local tissue stress and injury. Use of an elbow brace may prevent this from occurring by preventing an increase of medial elbow joint space gapping. However, an elbow brace adds weight to the limb and may increase the burden on the throwing arm. Objective To investigate whether use of an elbow brace during repetitive pitching reduces shoulder and arm range of motion and grip strength. Design Prospective crossover study. Setting University campus. Participants Twenty‐five healthy high school baseball players. Methods Each participant pitched 100 times under two conditions: without an elbow brace (control) and wearing an elbow brace. Main Outcome Measurements Shoulder and elbow range of motion (ROM) before pitching and after every block of 20 pitches. Grip strength before pitching and after 100 pitches. Results There was no significant main effect and interaction for ROM between the two conditions and between pitching sets. In both conditions, grip strength after 100 pitches was significantly lower than that before pitching (P < .05). When the two conditions were compared, there was no significant difference before pitching or after 100 pitches. Conclusions Use of elbow brace does not alter shoulder and elbow ROM or decrease grip strength after repetitive pitching up to 100 times compared with a no brace condition. An elbow brace can be used during repetitive pitching without causing an increased mechanical burden on the throwing arm. Level of Evidence II

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Use of an Elbow Brace During Repetitive Pitching Does Not Cause an Increased Mechanical Burden on the Throwing Arm

Hattori

Akasaka

Otsudo

et al. 2019

PM&R

Self Cite

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The Role of Ultrasound in the Evaluation of Elbow Medial Ulnar Collateral Ligament Injuries in Throwing Athletes

Sutterer

Boettcher

Payne

et al. 2022

Curr Rev Musculoskelet Med

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Purpose of Review Although ultrasound (US) imaging is commonly used to evaluate the elbow medial ulnar collateral ligament (mUCL) in throwing athletes, significant technical heterogeneity exists in the published literature and in practice. This has resulted in variable and often ambiguous US diagnostic criteria for mUCL injury. This review summarizes the literature on sonographic evaluation of the mUCL and outlines recommendations for consistent descriptive terminology, as well as future clinical and research applications. Recent Findings Both acute and chronic throwing loads in overhead athletes cause the mUCL to become thicker and more lax on stress testing, and these changes tend to revert after a period of prolonged rest. Stress US (SUS) can aid in the diagnosis of mUCL tears and may help identify athletes at risk of mUCL injury. Variability exists in terminology, elbow flexion angle, amount of stress applied, and technique of stress testing. Recent studies have suggested an injured elbow stress delta (SD—change in ulnohumeral joint (UHJ) space with valgus stress) of 2.4 mm and a stress delta difference (SDD—side-side difference in SD) of 1 mm each denote abnormal UHJ laxity due to mUCL injury. Summary US imaging is a powerful and widely accessible tool in the evaluation elbow mUCL injuries. Sonologists should consider how their US techniques compare with published methods and use caution when applying diagnostic criteria outside of those circumstances. Currently, an SD of 2.4 mm and an SDD of 1 mm provide the best diagnostic accuracy for mUCL tears requiring surgery. Finally, preliminary work suggests that shear wave elastography may be helpful in evaluating the biomechanical properties of the mUCL, but additional research is needed.

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Elbow Torque Is Reduced in Asymptomatic College Pitchers With Elbow Laxity: A Dynamic Ultrasound Study

Khalil

The effect of repetitive baseball pitching on medial elbow joint space gapping associated with 2 elbow valgus stressors in high school baseball players

Cited by 27 publications

References 30 publications

Use of an Elbow Brace During Repetitive Pitching Does Not Cause an Increased Mechanical Burden on the Throwing Arm

Use of an Elbow Brace During Repetitive Pitching Does Not Cause an Increased Mechanical Burden on the Throwing Arm

The Role of Ultrasound in the Evaluation of Elbow Medial Ulnar Collateral Ligament Injuries in Throwing Athletes

Elbow Torque Is Reduced in Asymptomatic College Pitchers With Elbow Laxity: A Dynamic Ultrasound Study

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