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Cybex II Isokinetic Dynamometer (Lumex Corp. Ronkonkoma, NY) tests for the upper extremity strength of eight professional baseball players, together with radar gun measurements of their individual throwing speeds, were subjected to statistical analysis. Results of simple and multiple regression analysis showed a relationship between the strength of the elbow extension and wrist extension movements and throwing speed.
Five male subjects' throwing and pitching motions were analyzed by dynamic electromyography and high speed photography. Electrodes inserted into the deltoid and rotator cuff muscles attempted to define muscle activation patterns during the throwing and pitching cycle. The wind-up or preparation (Stage I) had no consistent pattern. Cocking (Stage II) had a sequential muscle activation pattern of first deltoid activity, followed by the S.I.T. muscles and finally by the subscapularis muscle. Acceleration (Stage III) had a lack of muscle activity, even though the arm was accelerating forward in space. Follow-through (Stage IV) was the most active stage with all the muscles firing intensely. The muscle patterns observed during the cycle were largely characteristic of attempts to decelerate the arm.
OBJECTIVE: The purpose of this report is to describe the imaging features in three cases of avulsion injury of the sublime tubercle of the ulna that occurred in throwing athletes. CONCLUSION: Avulsion fracture of the sublime tubercle of the ulna is a potential cause of chronic medial elbow pain in the throwing athlete. This entity is best evaluated with a combination of plain radiographs and coronal MR images, particularly gradient-echo images that show the continuity of the avulsed fragment with the ulnar collateral ligament.
OBJECTIVE: Conventional radiography, arthrography, CT arthrography, and MR arthrography--including use of the abduction and external rotation position--were compared, with arthroscopic correlation, to determine the spectrum of abnormalities encountered and the relative benefits of each imaging method in the evaluation of shoulder lesions occurring in 17 throwing athletes. SUBJECTS AND METHODS: Each of 36 athletes with shoulder pain aggravated by abduction and external rotation was examined in a single visit during which conventional radiography, arthrography, CT arthrography, and MR arthrography were performed. In 17 of these athletes, imaging findings were compared with those at arthroscopy. All images were independently evaluated by two groups of musculoskeletal radiologists. RESULTS: Structures found to be affected were, in decreasing order of frequency, the following: the posterosuperior labrum, supraspinatus tendon, infraspinatus tendon, humeral head, glenoid cavity and rim, acromioclavicular joint, anteroinferior capsulolabral complex, biceps tendon, and subscapularis tendon. MR arthrography without and with abduction and external rotation yielded the highest sensitivity and specificity for all lesions with the exceptions of bone sclerosis and enthesophytes (which were best seen with CT arthrography). MR arthrography with abduction and external rotation was most accurate for diagnosis of rotator cuff and anteroinferior capsulolabral complex tears. CONCLUSION: On the basis of these preliminary results, we believe that MR arthrography with abduction and external rotation should be part of the imaging evaluation of shoulder pain in throwing athletes, owing to the high sensitivity of this imaging technique.
80 adults (40 men and 40 women) aged 18 to 25 yr. and 80 boys aged 14 to 15 yr. observed a throwing action presented in point-light form at a frontoparallel viewpoint either as a video film or computer simulation of the actor. The display consisted of the relative motion of the wrist, elbow, and shoulder joints of the throwing arm. Subjects were asked to report what they observed. The action was recognised immediately by 68% of all subjects, and this value increased to 90% with one more viewing of the demonstration. Response was virtually the same for both types of display, and there were no differences between adults and children. The results were similar to those from other studies from which researchers have concluded that kinematic information alone is sufficient to permit perception of fundamental patterns of movement.
131 deaf boys and girls were evaluated on development of the overhand throw. Mature form in this skill was related to chronological age and to balance proficiency. Sex and hearing loss do not appear to affect level of development for throwing.
Light (0.02% BAC) and moderate (0.05% BAC) does of alcohol were administered to 10 dart throwers while effects were monitored on tasks related to dart throwing, i.e., rotary pursuit and hand steadiness. Balance and accuracy of throwing improved with the 0.02% BAC, but performance was impaired with 0.05% BAC. The higher BAC levels were linked with deteriorations on rotary pursuit and hand steadiness.
The effect of learning a throwing skill with the body in one position on performing the skill in a different position was investigated. 40 normal women, aged 20 to 34 years, were randomly assigned to experimental or control groups. Subjects threw darts from two positions, sitting on a Balans chair or reclined on a slanted table. Practice and transfer sessions each included 4 sets of 5 throws. Performance was significantly poorer after switching positions than when remaining in the same position. Performance after practice in an alternate position was significantly worse than performance after no practice. These findings suggest that practicing a skill in one position may not improve learners' ability to perform that skill in a different position.
The purpose of this analysis of data from a larger investigation was to assess effects of anthropometric factors on free throw shooting performance of 15 girls from Michigan and 18 from Puerto Rico. Subjects performed 60 free throws (10 trials x 3 ball sizes x 2 basket heights). Correlations were low, with two exceptions, .53 between shooting performance at the low basket and grip strength (as measured by hand grip dynamometer) for girls from Michigan, and .49 for hand width and performance at the low basket for girls from Michigan.
Throwing athletes may develop a multitude of problems in the glenohumeral joint and subacromial area. On occasions when rehabilitation is unsuccessful, diagnostic arthroscopy and arthroscopic management of these disorders may be indicated. The present study demonstrates several common injury patterns noted on arthroscopic examination of the throwing shoulder.
Vascular pathology in the upper extremity of a throwing athlete comprises a spectrum of serious disorders apt to threaten the patient's career and the viability of the involved parts. Such pathology includes digital vessel thrombosis, proximal thrombosis with distal embolization, vessel aneurysm, and vessel compression, such as in thoracic outlet syndrome and quadrilateral space syndrome. This article provides a description of vascular disorders prone to result from sports activities and a review of published data relevant to throwing athletes. Recognition of vascular compromise as a cause for dead arm syndrome or painful digital dysfunction among athletes is essential to prevent the grave consequences of progressive ischemia.
Over 25 million children participate in school-sponsored sports, and an additional 20 million participate in extracurricular organized sports. Over the past decade, increased intensity of training, more pressure for success, new opportunities for structured play, and more organized advanced leagues and traveling teams have led to a corresponding increase in overuse injuries in the skeletally immature athlete. Perhaps the classic sports model for overuse injuries of the upper extremity is baseball. Throwing sports contribute to an increased incidence of elbow and shoulder injuries that might be related to intensity of training, throwing mechanics, and poor conditioning, including core strength. Specific areas of concern regarding overuse injuries in young athletes include such diagnoses as little leaguer's shoulder, little leaguer's elbow, osteochondritis dissecans of the elbow, tennis elbow, and distal radial epiphysitis. Ultimately, overuse injuries, and particularly physeal injuries, should be suspected in any young athlete who has pain in the upper extremity. Comparative bilateral radiographs are the rule in workup.
Medial collateral ligament (MCL) injuries of the elbow in throwing athletes are part of a spectrum of valgus extension overload injuries. Clinicians should consider reconstruction of the injured MCL in those patients who are unable to return to sports activities or work after an interval of rest and rehabilitation. Surgical treatment of this disorder has continued to evolve from the original technique developed by Jobe and associates. The authors' surgical technique involves reconstruction of the MCL using a single ulnar tunnel and single humeral tunnel that is performed through a muscle-splitting approach that usually obviates the need for ulnar nerve transposition. Knowledge of the biology and biomechanics of MCL function is important in the diagnosis and treatment of MCL injuries of the elbow in the throwing athlete.
The efficacy of arthroscopy of the shoulder has been demonstrated as both a diagnostic and an operative tool. The throwing athlete has benefited greatly from this procedure. Intra-articular pathology resulting from throwing motion overuse can be visualized and treated, with relatively little morbidity and a rapid rehabilitation phase.
Fifteen male athletes who were skilled in throwing and who had chronic anterior instability of the shoulder (Group 1) were evaluated by dynamic intramuscular electromyography while pitching a baseball. Indwelling wire electrodes recorded the levels of activity in the biceps, middle deltoid, supraspinatus, infraspinatus, pectoralis major, subscapularis, latissimus dorsi, and serratus anterior throughout the entire pitching sequence. These signals were synchronized electronically with records of the pitch that were made using high-speed photography. The pitch was divided into five phases: wind-up, early cocking, late cocking, acceleration, and follow-through. The results were compared with previous identical studies of twelve healthy, uninjured male athletes who were skilled in throwing (Group 2). Activity increased mildly in the biceps and supraspinatus in Group 1 as compared with Group 2. Similar patterns of activity were demonstrated in the deltoid. In Group 1 the infraspinatus had increased activity during early cocking and follow-through but had decreased activity during late cocking. The pectoralis major, subscapularis, latissimus dorsi, and serratus anterior in Group 1 all were shown to have markedly decreased activity. The study revealed a difference between Groups 1 and 2 in all of the muscles of the shoulder that were tested with the exception of the deltoid. The mildly increased activity levels of the biceps and supraspinatus that were found in Group 1 may compensate for anterior laxity. The marked reduction in activity in the pectoralis major, subscapularis, and latissimus dorsi added to the anterior instability by decreasing the normal internal-rotation force that is needed during the phases of late cocking and acceleration.(ABSTRACT TRUNCATED AT 250 WORDS)
The throwing athlete is a unique patient. High demands on the shoulder, combined with poor tolerance for slight changes in performance, make this a particularly difficult group of patients to treat successfully. In addition, there is overlap between multiple pathologic conditions in the shoulder, including rotator cuff tendinopathy, shoulder instability, SLAP lesions, acromioclavicular arthrosis, and scapulothoracic problems. These disorders rarely occur in isolation in the throwing athlete. Arthroscopy of the shoulder may be invaluable as a diagnostic tool to confirm clinical and radiographic abnormalities, to identify associated intra-articular and extra-articular pathologic conditions, and to treat a variety of these lesions without the attendant morbidity of open surgical repair and reconstruction.
Forty-two team orthopedists representing all 28 major league baseball teams were surveyed to ascertain their definitive treatment for a hypothetical starting rotation pitcher who had sustained a grade III acromioclavicular (AC) separation to his throwing arm 1 week before the season. Twenty-nine (69%) of the physicians would treat the injury nonoperatively, while 13 (31%) would operate immediately. Twenty-five (60%) of the orthopedists had actually treated a pitcher or position baseball player with a grade III AC separation in the throwing arm, the 25 treating a total of 32 patients. Twenty (63%) of these injuries were treated nonoperatively, and 12 (37%) were treated operatively. The physicians reported that 16 (80%) of the patients treated nonoperatively regained normal function and achieved complete relief of pain, while 18 (90%) had normal range of motion after treatment; of those treated operatively, 11 (92%) regained normal function, achieved complete relief of pain, and had normal range of motion after surgery.
During a period of intensive practice, 2 petanque players developed freezing of shoulder flexion impeding boule throwing. This movement disorder was consistent with the diagnosis of task-specific focal dystonia. Polymyography showed that freezing was associated with bursts of low amplitude. In the absence of motor or sensory deficits, a motor apraxia could be considered.