Date of Presentation

5-4-2023 12:00 AM

College

School of Osteopathic Medicine

Poster Abstract

Background: The ulnar collateral ligament (UCL) is put under high levels of stress through the overhead throwing motion typical of professional baseball pitchers. In response to repetitive stress the UCL undergoes adaptive changes including thickening of the ligament and increased joint laxity under valgus stress. Studies examining the adaptive changes in the elbows of professional pitchers over multiple seasons are limited. Investigations such as this one offer insight into the changes in the UCL of professional pitchers over multiple years of professional play as well as the risk for injuries that may be associated with these changes.

Purpose/Hypothesis: The purpose of this study was to compare stress ultrasound findings between warm and cold climate pitchers and to assess for significant differences that may predispose players from either climate to future injury.

Study Design: Retrospective Cohort Study Methods: Dynamic stress ultrasounds (SUS) of professional baseball pitchers were taken over an 18 year period. Player demographics were collected to determine climate of origin. SUS measurements of the same player taken 3 years apart were examined to determine changes in relative UCL thickness and laxity between the dominant and nondominant arms. The term ‘relative’ refers to (dominant – non-dominant), laxity (joint space distance under stress - joint space distance at rest). SUS were also examined at time of measurements for pathologic findings.

Results: Players from colder and warmer climates did not differ from one another in the progression of relative UCL thickness (0.72 mm vs 0.55 mm, P = .748) of relative laxity (-0.01 mm vs 0.03 mm, P = .904). Both groups did not differ in rates of pathology development including calcifications (P = .412), hypoechoic foci (P = .084), osteophyte (P = .892).

Conclusion: Adaptive changes of the UCL in professional baseball pitchers originating from colder and warmer climates did not significantly differ from one another. Although there is potential for those from warmer climates to throw year-round the effect may not be enough to cause noticeable changes over a 3 year period. Future studies should expand on this investigation with examination of injuries of players from different climates to determine if any correlation exists with UCL changes in an expanded cohort.

Keywords

Ulnar Collateral Ligament, Baseball, Professional Athletes, Pitcher, Joint Instability

Disciplines

Medicine and Health Sciences | Musculoskeletal Diseases | Musculoskeletal System | Orthopedics | Pathological Conditions, Signs and Symptoms | Sports Medicine

Document Type

Poster

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May 4th, 12:00 AM

Adaptive Changes of the Ulnar Collateral Ligament of Professional Baseball from Different Climates Over Multiple Seasons: An 18-Year Study

Background: The ulnar collateral ligament (UCL) is put under high levels of stress through the overhead throwing motion typical of professional baseball pitchers. In response to repetitive stress the UCL undergoes adaptive changes including thickening of the ligament and increased joint laxity under valgus stress. Studies examining the adaptive changes in the elbows of professional pitchers over multiple seasons are limited. Investigations such as this one offer insight into the changes in the UCL of professional pitchers over multiple years of professional play as well as the risk for injuries that may be associated with these changes.

Purpose/Hypothesis: The purpose of this study was to compare stress ultrasound findings between warm and cold climate pitchers and to assess for significant differences that may predispose players from either climate to future injury.

Study Design: Retrospective Cohort Study Methods: Dynamic stress ultrasounds (SUS) of professional baseball pitchers were taken over an 18 year period. Player demographics were collected to determine climate of origin. SUS measurements of the same player taken 3 years apart were examined to determine changes in relative UCL thickness and laxity between the dominant and nondominant arms. The term ‘relative’ refers to (dominant – non-dominant), laxity (joint space distance under stress - joint space distance at rest). SUS were also examined at time of measurements for pathologic findings.

Results: Players from colder and warmer climates did not differ from one another in the progression of relative UCL thickness (0.72 mm vs 0.55 mm, P = .748) of relative laxity (-0.01 mm vs 0.03 mm, P = .904). Both groups did not differ in rates of pathology development including calcifications (P = .412), hypoechoic foci (P = .084), osteophyte (P = .892).

Conclusion: Adaptive changes of the UCL in professional baseball pitchers originating from colder and warmer climates did not significantly differ from one another. Although there is potential for those from warmer climates to throw year-round the effect may not be enough to cause noticeable changes over a 3 year period. Future studies should expand on this investigation with examination of injuries of players from different climates to determine if any correlation exists with UCL changes in an expanded cohort.

 

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