The ulnar collateral ligament responds to stress in professional pitchers.
Ulnar collateral ligament
baseball pitching
elbow instability
ligament biology
Journal
Journal of shoulder and elbow surgery
ISSN: 1532-6500
Titre abrégé: J Shoulder Elbow Surg
Pays: United States
ID NLM: 9206499
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
02
04
2020
revised:
15
06
2020
accepted:
22
06
2020
pubmed:
11
7
2020
medline:
29
6
2021
entrez:
11
7
2020
Statut:
ppublish
Résumé
Our purpose with this study was to determine the response of the ulnar collateral ligament (UCL) in professional pitchers after exposure to a season of pitching and to rest during an off-season. In a prospective study supported by Major League Baseball, all pitchers within a single professional baseball club were enrolled. An ultrasound of the ligament was then performed by a single fellowship-trained ultrasonographer at the beginning of the season (T1), the end of the season (T2), and the beginning of the following season (T3). We measured the UCL thickness and ulnotrochlear joint opening at 30° of flexion with and without stress. Two ultrasound images were saved. Inter- and intra-rater reliability were determined. A multivariable analysis was conducted. A total of185 total pitchers were included: 94 pitchers at T1, 83 at T2, and 118 at T3. These pitchers had 12 [7, 15] (median [interquartile range]) years of pitching experience and had a peak velocity of 95 [93, 97] miles/hour. Intra- and inter-rater reliability were excellent. The baseline UCL thickness was associated with peak velocity (P = .031) and prior UCL reconstruction (P = .024). After accounting for pitching experience, peak velocity, and prior UCL reconstruction, thickness increased during the season (P = .002) and decreased during the off-season (P = .001). After accounting for these same variables, valgus laxity at 30° increased during the season (P = .002) and decreased during the off-season (P = .029). The UCL responds to stress in professional pitchers by becoming thicker and more lax, and responds to rest by becoming thinner and less lax.
Sections du résumé
BACKGROUND
BACKGROUND
Our purpose with this study was to determine the response of the ulnar collateral ligament (UCL) in professional pitchers after exposure to a season of pitching and to rest during an off-season.
METHODS
METHODS
In a prospective study supported by Major League Baseball, all pitchers within a single professional baseball club were enrolled. An ultrasound of the ligament was then performed by a single fellowship-trained ultrasonographer at the beginning of the season (T1), the end of the season (T2), and the beginning of the following season (T3). We measured the UCL thickness and ulnotrochlear joint opening at 30° of flexion with and without stress. Two ultrasound images were saved. Inter- and intra-rater reliability were determined. A multivariable analysis was conducted.
RESULTS
RESULTS
A total of185 total pitchers were included: 94 pitchers at T1, 83 at T2, and 118 at T3. These pitchers had 12 [7, 15] (median [interquartile range]) years of pitching experience and had a peak velocity of 95 [93, 97] miles/hour. Intra- and inter-rater reliability were excellent. The baseline UCL thickness was associated with peak velocity (P = .031) and prior UCL reconstruction (P = .024). After accounting for pitching experience, peak velocity, and prior UCL reconstruction, thickness increased during the season (P = .002) and decreased during the off-season (P = .001). After accounting for these same variables, valgus laxity at 30° increased during the season (P = .002) and decreased during the off-season (P = .029).
CONCLUSION
CONCLUSIONS
The UCL responds to stress in professional pitchers by becoming thicker and more lax, and responds to rest by becoming thinner and less lax.
Identifiants
pubmed: 32650069
pii: S1058-2746(20)30544-9
doi: 10.1016/j.jse.2020.06.027
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
495-503Informations de copyright
Copyright © 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.