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Effects of varying recovery periods on muscle enzymes, soreness, and performance in baseball pitchers.

In this study we examined the effects of varied recovery time on serum creatine kinase (CK), serum lactate dehydrogenase (LDH), muscle soreness, and pitch velocity in baseball pitchers. Ten males who had pitching experience participated in the study. After an 18-day training period, subjects pitched three simulated games. Game A and Game B were separated by four days of rest, while Game B and Game C were separated by two days of rest. CK, LDH, and muscle soreness were evaluated at the following times: before and immediately after exercise, and six, 24, 48, and 72 hours after exercise. Muscle performance was evaluated by measuring pitch velocity during the games. The CK level was elevated after each game (Game A - 249 U/l; Game B - 243 U/l; and Game C - 240 U/l); then it dropped toward baseline (p</=0.01). CK post-exercise values were not different among games A, B, and C. LDH displayed a response similar to CK; however, there was a reduction over the span of the games (p</=0.05). Muscle soreness was significantly elevated immediately after exercise (p</=0.01) compared to all other measurement times. Pitch velocity was not different among games A, B, and C. Results indicate that muscle damage, as evidenced by CK release, occurs in response to baseball pitching. However CK values, muscle soreness, and pitch velocity are not significantly affected by changes in the amount of recovery time typically scheduled between games.

Journal Article↗

Atraumatic subclavian vein thrombosis in a collegiate baseball player: a case report.

OBJECTIVE: To introduce the case of a collegiate baseball player who suffered an atraumatic subclavian vein thrombosis. This case presents an opportunity to discuss the diagnosis and treatment of a 22-year-old male with a thrombosis of his right subclavian vein. BACKGROUND: Upper extremity deep venous thrombosis is an uncommon vascular problem, occurring primarily in young, healthy, active people. Although the history and symptoms are often unremarkable, the condition can lead to complications if not correctly recognized and appropriately treated. In this case, the athlete reported tightness in his right biceps muscle and upper back after sleeping on his shoulder. The patient denied substance abuse or illegal anabolic steroid use, and these possibilities were ruled out as factors in the diagnosis and treatment. DIFFERENTIAL DIAGNOSIS: Shoulder tendinitis, thoracic outlet syndrome, primary upper extremity thrombosis of the right subclavian vein. TREATMENT: After diagnosis, the patient was placed on blood thinners to dissolve the clot and referred to a vascular surgeon. The patient underwent a balloon angioplasty and later had the first rib removed. A second clot formed, and a stent was placed in the vein after the clot was removed by medication and another angioplasty procedure. He developed a pulmonary embolism during the stent procedure and was sent postoperatively to the intensive care unit, where he underwent therapeutic anticoagulation. After 10 weeks of therapy, the patient stopped all anticoagulant medication and returned to school to play baseball. UNIQUENESS: We present the atraumatic pathogenesis of a subclavian venous thrombosis in a young, active, and otherwise healthy college athlete with unremarkable predisposing factors. Within 24 hours after rib resection, the subclavian vein rethrombosed. The patient was thought to have experienced a small pulmonary embolus. CONCLUSIONS: Individuals who participate in athletics can develop atraumatic upper extremity deep venous thrombosis. Therefore, it is important that team physicians and certified athletic trainers be prepared to recognize the signs and symptoms of this condition to institute prompt, appropriate treatment.

Journal Article↗

Myocardial contusion caused by a baseball.

Myocardial contusion is a rare type of sports injury. We report a case of myocardial contusion caused by a baseball. In this patient, arrhythmias were induced by an exercise test 1 week after injury. That patients with myocardial contusion but without arrhythmias at rest need to be treated carefully is emphasized.

Adolescent↗

MR imaging of shoulder injuries in professional baseball players.

Magnetic resonance (MR) imaging was used to evaluate the shoulders of 10 symptomatic professional baseball players and one asymptomatic player, with surgical correlation in six cases and arthrographic correlation in two cases. Seven small rotator cuff tears measuring 0.5-1 cm were identified on MR images, with arthrographic and surgical confirmation of these findings in two patients and surgical confirmation only in three patients. Cortical irregularity and/or subchondral cyst formation at the posterior aspect of the greater tuberosity near the insertion site of the infraspinatus tendon was found in five of the seven players with rotator cuff tears. Similar findings were noted in the asymptomatic volunteer and in one of the three players without cuff tear, who also had irregular thickening of the posterior capsule. These findings are believed to represent chronic avulsive changes resulting from the deceleration stresses of the follow-through motion.

Adult↗

Dynamic sonography with valgus stress to assess elbow ulnar collateral ligament injury in baseball pitchers.

Sonography is a valuable method for imaging superficial tendons and ligaments. The ability to obtain comparison images easily with dynamic stress allows assessment of ligament and tendon integrity. We studied the medial elbow joints of two baseball pitchers using MR imaging and dynamic sonography. Both sonography and MR imaging identified the ulnar collateral ligament tears. Dynamic sonography uniquely demonstrated the medial joint instability.

Adolescent↗

Flexor carpi radialis tendinitis caused by malunited trapezial ridge fracture in a professional baseball player.

Flexor carpi radialis tendinitis is an uncommon cause of pain experienced over the flexor aspect of the wrist. It may be a primary condition caused by overuse syndrome, or it may be a secondary condition associated with osteoarthritis of the carpometacarpal joint of the thumb, osteoarthritis of the scaphotrapezial joint, scaphoid fracture, or scaphoid cyst. We present a case report of flexor carpi radialis tendinitis caused by a malunited trapezial ridge fracture, in a professional baseball player who was treated successfully by excision of the malunited trapezial ridge fragment.

Adult↗

Histopathology of smokeless tobacco lesions in professional baseball players. Associations with different types of tobacco.

We examined 142 biopsy specimens of smokeless tobacco-associated oral mucosal lesions from 133 professional baseball players. Four types of epithelial change were observed in the specimens: hyperparakeratosis, hyperorthokeratosis, pale surface staining, and basal cell hyperplasia. These types of epithelial change were associated with the type of smokeless tobacco used (snuff or chewing tobacco) but not with the duration (years) or amount (hours per day) of use. The thickness of hyperkeratosis in a specimen correlated directly with the amount of smokeless tobacco use. The use of snuff was more frequently associated with development of oral mucosal lesions than was the use of chewing tobacco, and snuff appeared to cause a greater variety and severity of epithelial change than did chewing tobacco.

Adult↗

Facioscapulohumeral muscular dystrophy presenting as shoulder pain in a baseball player.

Facioscapulohumeral muscular dystrophy is a commonly occurring myopathy that affects the facial and periscapular musculature. We describe a case in a high school throwing athlete that presented as shoulder pain with throwing a baseball. The patient has begun an intensive physical therapy training program that targets his weak scapular stabilizers as well as altering his throwing mechanics. His symptoms have improved, and he is able to continue competing in throwing sports at a high level.

Adolescent↗

Describing baseball pitch movement with right-hand rules.

The right-hand rules show the direction of the spin-induced deflection of baseball pitches: thus, they explain the movement of the fastball, curveball, slider and screwball. The direction of deflection is described by a pair of right-hand rules commonly used in science and engineering. Our new model for the magnitude of the lateral spin-induced deflection of the ball considers the orientation of the axis of rotation of the ball relative to the direction in which the ball is moving. This paper also describes how models based on somatic metaphors might provide variability in a pitcher's repertoire.

Baseball↗

A functional modulation for timing a movement: a coordinative structure in baseball hitting.

In baseball hitting, a powerful bat-swing needs to be produced by utilizing ground reaction force (GRF) and it should also be temporally coordinated relative to the flight of the pitch. The temporal organization of hitting movements associated with these task requirements was investigated by analyzing GRF during hitting slow and fast pitches. The timing of stepping with a front foot and shifting weight forward was modulated relative to the pitch's speed. The temporal relation between successive motion phases was compensatory and timing variability progressively reduced up to ball-bat contact. These results demonstrated the coordinative structure of the hitting movement for timing the bat-swing relative to the pitch's flight.

Adult↗

Physeal changes and range-of-motion differences in the dominant shoulders of skeletally immature baseball players.

The purpose of this study was to document range-of-motion differences and radiographic changes in the dominant shoulder of skeletally immature throwers and to determine how pain associated with throwing may relate to these changes. Seventy-nine male youth baseball players (aged 8-15 years) completed a questionnaire, a shoulder examination, and a series of radiographs to determine physeal changes and humeral retroversion. Radiographs were reviewed and interpreted by a blinded musculoskeletal radiologist. Measurement of proximal humeral physeal width revealed a significant increase on the dominant side for the entire group, in subjects with a history of symptoms during the current season, and in subjects who had never had symptoms. Visual radiographic changes were commonly found in subjects with a history of pain (16/26 [62%]) as well as in those subjects without symptoms (29/53 [55%]). Subjects had increased external rotation of the dominant arm as compared with the nondominant arm, and this pattern increased in magnitude as the throwers aged. Range-of-motion and radiographic asymmetry of the shoulders is common, is often asymptomatic, and may represent adaptive changes in this population.

Adolescent↗

Baseball and beer: an analysis of alcohol consumption patterns among male spectators at major-league sporting events.

STUDY OBJECTIVE: Examination of alcohol consumption patterns of male spectators at two major-league baseball stadiums. METHODS: A prospective observational study was conducted at two stadiums over the course of three games at each venue. We approached 1,084 male spectators of drinking age in a consecutive fashion at two junctures: at the entrance gate and during the fifth inning inside the stadium's concourse. Of those approached, 747 (68.9%) participated. After verbal consent, participants completed a questionnaire and blew into a breath analyzer. The results were blinded and later analyzed. RESULTS: Forty-one percent of all participants tested positive for alcohol. The highest consumption occurred in the 20- to 35-year-old age group. In this age group, 50.8% had consumed some alcohol, and 10.8% had a blood alcohol level of .08% (intoxicated) or higher. Almost 5% of all participants tested during the fifth inning collection were intoxicated and claimed to be driving. CONCLUSION: Of the spectators tested, those in the 20- to 35-year-old age group were most likely to have consumed alcohol and to be legally intoxicated. A disturbing number of spectators who had blood alcohol levels of .08% or higher late in the game claimed to be driving home.

Adult↗

Overuse injuries of the upper extremity in baseball.

The shoulder and elbow are prone to many overuse injuries in baseball. Injury to the muscles or ligaments leads to pain and loss of effectiveness in competition. Although many of these disorders respond to conservative management, surgery is sometimes necessary to provide pain relief and restore function. Unfortunately, overuse injuries that require surgery still are career-threatening injuries. Correct diagnosis and treatment increase the probability of a throwing athlete returning to competition.

Arm Injuries↗

Methylphenidate and baseball playing in ADHD children: who's on first?

The effects of 0.3 and 0.6 mg/kg methylphenidate were analyzed in a double-blind, placebo-controlled, cross-over study in which 17 boys (ages 7.8-9.9 years) with attention deficit hyperactivity disorder (ADHD) played in baseball games. Drug effects were evaluated on children's attention during the game, as indicated by their on-task behavior on the field and their ability to answer questions about the status of the game at all times. Judgment during batting, batting skill during the game, and performance on skill drills prior to the game were also assessed as a function of medication. Results revealed that methylphenidate had a beneficial effect on attending during the game.

Attention Deficit Disorder with Hyperactivity↗

Naive beliefs in baseball: systematic distortion in perceived time of apex for fly balls.

When fielders catch fly balls they use geometric properties to optically maintain control over the ball. The strategy provides ongoing guidance without indicating precise positional information concerning where the ball is located in space. Here, the authors show that observers have striking misconceptions about what the motion of projectiles should look like from various perspectives and that they estimate when the physical apex of a fly ball occurs to be far later than actual, irrespective of baseball experience. Their estimations are consistent with the highest point they are looking at as the ball approaches, not with the physical apex. These findings introduce a new and robust effect in intuitive perception in which people confuse their perceptual perspective with the physical situation that they mentally represent.

Baseball↗

A skin cancer education initiative at a professional baseball game and results of a skin cancer survey.

BACKGROUND: It is important to develop an understanding of what the public knows about skin cancer and what sun safety precautions they are taking. Research on the evaluation of skin cancer education targeting adults is minimal. AIM: To assess the knowledge and behavior related to skin cancer and sun exposure, and to determine if an informal interaction between dermatologists and the public could promote skin cancer awareness and precautions. METHODS: In May 2000, a dermatologist-staffed educational booth was set up at an Indianapolis Indians baseball game. Attendees were educated through discussions and handouts. Attendees completed a self-administered questionnaire prior to this interaction and a mailed follow-up questionnaire in August 2000. RESULTS: One hundred and thirty-six attendees participated in May, and 60 completed the second questionnaire in August. The May results revealed that 92% believed that sun exposure caused skin cancer; 37% used sunscreens "sometimes" and 29%"never." There was a significant decrease in the number of hours spent outdoors per week during the summer of 2000 compared to 1999. CONCLUSIONS: Frequent and unprotected sun exposure occurs despite awareness of the adverse effects. Although the number of subjects in our study was small, informal education at public events has the potential to influence behavior.

Adolescent↗

Neurologic injuries in baseball players.

In baseball pitchers, injuries to the throwing arm are common due to the extreme stresses placed on the elbow and shoulder joints. These result in peripheral nerve syndromes including ulnar neuropathy at the elbow and suprascapular neuropathy at the shoulder. Recurrent trauma to the axillary artery causing aneurysm and thrombus formation may lead to distal ischemia and stroke. Careful evaluation is required to identify musculoskeletal, neurologic, and vascular causes of upper extremity symptoms in the throwing athlete.

Adult↗