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PubMedDate not supplied

Prevalence, patterns, and correlates of spit tobacco use in a college athlete population.

We surveyed varsity athletes (N = 1,328) in 16 California colleges about their patterns of spit (smokeless) tobacco (ST) use, related habits, reasons for use, and preferred methods for quitting. Prevalence of use was analyzed by sport and demographic characteristics, and patterns of use in players using snuff exclusively, using chewing tobacco exclusively, and those using both were compared. Odds ratios and 95% confidence intervals were calculated, adjusting for ethnic group. Prevalence was highest in Whites (44%) and Native Americans (48%) and lowest in African Americans (11%), and higher in varsity baseball (52%) than varsity football players (26%), in players attending rural colleges, and among those who ever smoked cigarettes or used alcohol. Forty-one percent of ST users initiated regular use during their high school years. Athletes who used snuff exclusively used it more intensively and for more years than those who used chewing tobacco exclusively. Snuff users indicated a greater perceived need for ST, but also were more ready to quit. These data suggest ST programs with prevention and cessation components are appropriate for high school as well as college athletes. Such interventions should focus on baseball players, distinguish snuff from chewing tobacco users in planning quit strategies, integrate intervention programs for cigarette smoking and alcohol consumption, provide training in refusal skills, and attempt to change social norms in support of ST use by integrating popular peers and significant others (e.g., wives/girlfriends) to endorse nonuse of ST.

Adolescent↗
PubMed1995

Arthroscopic debridement of glenoid labral tears in athletes.

UNLABELLED: This is a retrospective study of 46 patients who underwent arthroscopic glenoid labral debridement from June 1988 to June 1990. All patients complained of pain in the involved shoulder and all were active in sports involving overhead use of the shoulder, including 30 baseball players (16 professional, 14 collegiate/high school). The average age was 22 years (range 16 to 45) and the average follow-up was 2.7 years (range 18 to 50 months). At operation, 35 patients had posterior glenoid lesions, 9 had anterior-superior lesions, and 2 had anterior-inferior lesions. The posterior lesions were further divided into those that involved a horizontal flap tear (n = 19), and those that involved fraying (n = 16). Overall, at an average of 31 months follow-up. 54% (25 of 46) of patients had good to excellent results. Professional baseball players had a statistically significant enhanced outcome with 75% (12 of 16) good-excellent compared with the remaining nonprofessional group, with 43% (13 of 30) good-excellent results. Outcome did not correlate with shoulder laxity, labral lesion location, mechanism of injury, or the presence of a rotator cuff lesion. CONCLUSIONS: Arthroscopic debridement of glenoid labral lesions does not yield consistent long-term results. Aggressive, supervised physical therapy in highly motivated individuals may be the most important factors in influencing outcome in patients having arthroscopic labral debridement in the absence of overt shoulder instability.

Adult↗
PubMed2004

Maxillofacial fractures sustained during sports played with a ball.

OBJECTIVE: The aim of this study was to investigate the incidence and type of maxillofacial fractures caused by various sports played with a ball to better understand the nature of these fractures. Study design Retrospective study was carried out using records from 100 patients treated between 1986-2002. Age and sex, etiology, and site of the fracture, yearly and monthly distribution of the fractures, and treatment modality were analyzed. RESULTS: The fractures mostly resulted from baseball (44%), followed by rugby (28%) and soccer (18%). The highest incidence was in the 10- to 19-year age-group with male propensity. The most common cause of the fractures was impact against another player (43%). The majority of the patients suffered from mandibular fractures (56%), followed by midface (31%) and alveolar fractures (12%). Mandibular angle, zygoma, and zygomatic arch fractures were prominent for rugby fractures. A yearly comparison of the fracture incidence showed a gradual decrease over the 16-year period. Fractures had a peak incidence in autumn. 55% of the patients were treated surgically. Surgical intervention was mostly needed for patients sustaining fractures during soccer (72.2%). CONCLUSIONS: Among ball-related sports, baseball is responsible for most of the maxillofacial fractures, but, although the incidence is not that high, soccer-related fractures may be more severe due to the nature of this sport.

Adolescent↗
PubMed2001

Impact directly over the cardiac silhouette is necessary to produce ventricular fibrillation in an experimental model of commotio cordis.

OBJECTIVES: In an experimental model of sudden death from chest wall impact (commotio cordis), we sought to define the chest wall areas important in the initiation of ventricular fibrillation (VF). BACKGROUND: Sudden death can result from an innocent chest blow by a baseball or other projectile. Observations in humans suggest that these lethal blows occur over the precordium. However, the precise location of impact relative to the risk of sudden death is unknown. METHODS: Fifteen swine received 178 chest impacts with a regulation baseball delivered at 30 mph at three sites over the cardiac silhouette (i.e., directly over the center, base or apex of the left ventricle [LV]) and four noncardiac sites on the left and right chest wall. Chest blows were gated to the vulnerable portion of the cardiac cycle for the induction of VF. RESULTS: Only chest impacts directly over the heart triggered VF (12 of 78: 15% vs. 0 of 100 for noncardiac sites: p < 0.0001). Blows over the center of the heart (7 of 23; 30%) were more likely to initiate VF than impacts at other precordial sites (5 of 55; 9%, p = 0.02). Peak LV pressures generated instantaneously by the chest impact were directly related to the risk of VF (p < 0.0006). CONCLUSIONS: For nonpenetrating, low-energy chest blows to cause sudden death, impact must occur directly over the heart. Initiation of VF may be mediated by an abrupt and substantial increase in intracardiac pressure. Prevention of sudden death from chest blows during sports requires that protective equipment be designed to cover all portions of the chest wall that overlie the heart, even during body movements and positional changes that may occur with athletic activities.

Animals↗
PubMed2003

Upper and lower limits of vulnerability to sudden arrhythmic death with chest-wall impact (commotio cordis).

OBJECTIVES: In an animal model of commotio cordis, sudden death with chest-wall impact, we sought to systematically evaluate the importance of impact velocity in the generation of ventricular fibrillation (VF) with baseball chest-wall impact. BACKGROUND: Sudden cardiac death can occur with chest-wall blows in recreational and competitive sports (commotio cordis). Analyses of clinical events suggest that the energy of impact is often not of unusual force, although this has been difficult to quantify. METHODS: Juvenile swine (8 to 25 kg) were anesthetized, placed prone in a sling to receive chest-wall strikes during the vulnerable time window during repolarization for initiation of VF with a baseball propelled at 20 to 70 mph. RESULTS: Impacts at 20 mph did not induce VF; incidence of VF increased incrementally from 7% with 25 mph impacts, to 68% with chest impact at 40 mph, and then diminished at >/=50 mph (p < 0.0001). Peak left ventricular pressure generated by the chest blow was related to the incidence of VF in a similar Gaussian relationship (p < 0.0001). CONCLUSIONS: The energy of impact is an important variable in the generation of VF with chest-wall impacts. Impacts at 40 mph were more likely to produce VF than impacts with greater or lesser velocities, suggesting that the predilection for commotio cordis is related in a complex manner to the precise velocity of chest-wall impact.

Animals↗
PubMedDate not supplied

Dynamic stability of the elbow: electromyographic analysis of the flexor pronator group and the extensor group in pitchers with valgus instability.

The medical collateral ligament is a common site of injury in baseball pitchers, causing substantial morbidity and loss of pitching time. Twenty-six skilled baseball pitchers with medial collateral ligament insufficiency were studied before surgery with high-speed cinematography and fine-wire electromyography of eight muscles around the elbow. Data from the pitchers with injured elbows were compared with data obtained from uninjured pitchers. The flexor carpi radialis muscle in the pitchers with medial collateral ligament deficiencies revealed significantly decreased firing during the acceleration and deceleration phase of the fastball when compared with that of the pitchers with normal elbows, and the flexor carpi radialis muscle was significantly depressed during the early cocking and deceleration phases. The extensor muscles revealed slightly increased activity in the injured elbows; however, this was not statistically significant. Although the muscles of the flexor pronator group (especially the flexor carpi ulnaris muscle and the flexor digitorum superficialis muscles) are anatomically positioned to provide dynamic stability of the elbow, they did not demonstrate increased electrical activity in pitchers with medial collateral ligament deficiencies. This finding suggests that the muscles on the medial side of the elbow do not supplant the role of the medial collateral ligament during the fastball pitch.

Baseball↗
PubMed2004

Suppressing irrelevant information: knowledge activation or inhibition?

In 3 experiments, the authors examined the role of knowledge activation in the suppression of contextually irrelevant meanings for ambiguous homographs. In Experiments 1 and 2, participants with greater baseball knowledge, regardless of reading skill, more quickly suppressed the irrelevant meaning of ambiguous words in baseball-related, but not general-topic, sentences. Experiment 3 demonstrated that participants with greater general knowledge, regardless of reading skill, more quickly suppressed the irrelevant meaning of the ambiguous words in general-topic sentences. As predicted by D. S. McNamara's (1997) knowledge-based account of suppression, ambiguity effects are influenced by greater activation of knowledge related to the intended meaning of the homograph. These results challenge inhibition (e.g. M. A. Gernsbacher, K. R. Varner. & M. Faust, 1990) as the sole mechanism responsible for the suppression of irrelevant information.

Attention↗
PubMed2005

Long-term trends in home advantage in professional team sports in North America and England (1876-2003).

Home advantage is quantitatively defined and calculated for each season since the start of the main professional sports in North America and England. Over 400,000 games are analysed. The leagues represented are the National League (1876-2002) and American League (1901-2002) for baseball, the National Hockey League (1917-2003) for ice hockey, the National Football League (1933-2002) for American football, the National Basketball Association (1946-2003) for basketball, and the four levels of professional football, formerly called the Football League, in England (1888-2003). Problems caused by unbalanced playing schedules are considered. The results are presented graphically to show long-term trends and sudden changes. The highest levels of home advantage for all sports were in their early years of existence. Home advantage in ice hockey, basketball and football in England has declined over the last two decades. In baseball there has been very little change over the last 100 years, with home advantage consistently lower than in other sports. There was a large drop in home advantage in football in England following the 7-year suspension of the league during the Second World War. The trends and changes provide some evidence that travel and familiarity contribute to home advantage, but little in support of crowd effects.

Baseball↗
PubMed2006

When "where" is more important than "when": birthplace and birthdate effects on the achievement of sporting expertise.

In this study, we assessed whether contextual factors related to where or when an athlete is born influence their likelihood of playing professional sport. The birthplace and birth month of all American players in the National Hockey League, National Basketball Association, Major League Baseball, and Professional Golfer's Association, and all Canadian players in the National Hockey League were collected from official websites. Monte Carlo simulations were used to verify if the birthplace of these professional athletes deviated in any systematic way from the official census population distribution, and chi-square analyses were conducted to determine whether the players' birth months were evenly distributed throughout the year. Results showed a birthplace bias towards smaller cities, with professional athletes being over-represented in cities of less than 500,000 and under-represented in cities of 500,000 and over. A birth month/relative age effect (in the form of a distinct bias towards elite athletes being relatively older than their peers) was found for hockey and baseball but not for basketball and golf. Comparative analyses suggested that contextual factors associated with place of birth contribute more influentially to the achievement of an elite level of sport performance than does relative age and that these factors are essentially independent in their influences on expertise development.

Achievement↗
PubMedDate not supplied

The Bennett lesion of the shoulder.

In this article we review the imaging features and significance of the Bennett lesion of the shoulder. Standard radiographic, computed arthrotomographic, and MR findings in three baseball pitchers diagnosed with Bennett lesions of the shoulder are discussed. A crescent-shaped region of mineralization at the posteroinferior aspect of the glenoid rim, consistent with a Bennett lesion, arises at the insertion of the posterior joint capsule. The diagnosis of this lesion, typically in baseball pitchers, should raise suspicion for associated labral and rotator cuff abnormalities.

Adult↗
PubMed1993

Fracture of the shaft of the humerus secondary to muscular violence.

Fractures of a normal humeral shaft secondary to muscular violence have been uncommonly reported in the literature since the early 1900s. These injuries have been associated with throwing javelins, hand grenades, and baseballs. We report a case of a similar injury occurring in a healthy young amateur baseball pitcher. Pertinent anatomy, pathomechanics, and electromyographic study results are discussed.

Adolescent↗
PubMed2004

The influence of impact object characteristics on impact force and force absorption by mouthguard material.

Most impact force and impact energy absorption tests for mouthguards have used a steel ball in a drop-ball or the pendulum device. However, in reality most sports-related trauma is caused by objects other than the steel ball, e.g. various sized balls, hockey puck, or bat or stick. Also, the elasticity, the velocity and the mass of the object could change the degree and the extent of injuries. In this study, we attempted to measure the impact force from actual sports equipment in order to clarify the exact mechanism of dental-related sports injuries and the protective effects of mouthguards. The present study was conducted using the pendulum impact device and load cell. Impact objects were removable. Seven mobile impact objects were selected for testing: a steel ball, baseball, softball, field hockey ball, ice hockey puck, cricket ball, and wooden baseball bat. The mouthguard material used in this study was a 3-mm-thick Drufosoft (Dreve-Dentamid GmbH, Unna, Germany), and test samples were made of the one-layer type. The peak transmitted forces without mouthguard ranged from the smallest (ice hockey stick, 46.9 kgf) to the biggest (steel ball, 481.6 kgf). The peak transmitted forces were smaller when the mouthguard was attached than without it for all impact materials but the effect was significantly influenced by the object type. The steel ball showed the biggest (62.1%) absorption ability while the wooden bat showed the second biggest (38.3%). The other balls or the puck showed from 0.6 to 6.0% absorbency. These results show that it is important to test the effectiveness of mouthguards on specific types of sports equipment. In future, we may select different materials and mouthguard designs suitable for specific sports.

Absorption↗
PubMed2004

The influence of the sensor type on the measured impact absorption of mouthguard material.

Mouthguards have been tested for impact energy absorption using drop-ball and/or pendulum devices. While all reports show efficiency of the mouthguard, the impact absorption abilities reported differ considerably. This difference has been attributed to differences of mouthguard material, design, and the impact force used. However, it is also possibly because of the difference in the sensors used in the experiments. The purpose of this study was to test three types of sensors and to assess which type was most appropriate for measurement of the impact absorption ability of mouthguards. A pendulum-type testing equipment and steel ball, wooden bat, baseball, field-hockey ball were used as the impact object. For all sensors or impact objects, the mouthguard decreased the impact forces. However, the absorption ability of the mouthguard varied according to the sensor or impact object. The absorbency values became smaller with the strain gauge, the accelerometer, and the load cell, respectively. With the steel ball as the impact object, 80.3% of impact absorption was measured with the strain gauge and the accelerometer but, only 62.1% with the load cell sensor. With the wooden bat, impact absorption was 76.3% with the strain gauge and 38.8% for the load cell. For the baseball ball, the absorption measurement decreased from 46.3% with the strain gauge to 4.36 with the load cell and for the field-hockey ball, the decrease in measurement values were similar (23.6% with the strain gauge and 2.43% with the load cell). It is clear that the sensor plays an important role in the measurement values reported for absorbency of mouthguard materials and a standard sensor should be used for all experiments.

Absorption↗
PubMed2005

Use of virtual, interactive, musculoskeletal system (VIMS) in modeling and analysis of shoulder throwing activity.

Our purpose in this study was to apply the virtual, interactive, musculoskeletal system (VIMS) software for modeling and biomechanical analysis of the glenohumeral joint during a baseball pitching activity. The skeletal model was from VIMS library and muscle fiber attachment sites were derived from the visible human dataset. The muscular moment arms and function changes are mainly due to the large humeral motion involved during baseball pitching. The graphic animation of the anatomic system using VIMS software is an effective tool to model and visualize the complex anatomical structure of the shoulder for biomechanical analysis.

Baseball↗
PubMedDate not supplied

Operative treatment of ulnar collateral ligament injuries of the elbow in athletes.

Over a 6-year period, the senior author (JRA) performed 91 ulnar collateral ligament reconstructions (N = 78) or repairs (N = 13). All patients were male and between the ages of 15 and 39 years (average, 21.6). Thirty-seven patients (41%) were professional baseball players, 41 (45%) were collegiate baseball players, and 7 (7.7%) were high school or recreational players. Subcutaneous ulnar nerve transposition with stabilization of the nerve with fascial slings of the flexor pronator mass was performed in all patients, and additional procedures were performed in 27 patients (29.7%), including 22 excisions of posteromedial olecranon osteophytes. Average follow-up was 35.4 months. Ten patients had preoperative ulnar nerve symptoms, nine of whom had complete resolution of symptoms after surgery. Complications occurred in eight patients. The average time from surgery to initiation of the interval throwing program was 3.4 months, and the average time to return to competitive throwing was 9.8 months. Sixty-seven patients (74%) were available for follow-up; of these, 53 (79%) had returned to their previous levels of competition or to a higher level. Reconstruction of the ulnar collateral ligament, with transposition and stabilization of the ulnar nerve and appropriate rehabilitation, was found to be effective in correcting medial instability of the elbow and allowed most athletes to return to previous levels of play in less than 1 year.

Adolescent↗
PubMedDate not supplied

Quantification of anterior translation of the humeral head in the throwing shoulder. Manual assessment versus stress radiography.

Clinical evaluation of humeral head translation relies mainly on manual tests to measure laxity in the human shoulder. The purposes of this study were to determine whether side-to-side differences exist in anterior humeral head translation in professional baseball pitchers, to compare manual laxity testing with stress radiography for quantifying humeral head translation, and to test intrarater reliability of the manual humeral head translation and stress radiography tests. Twenty professional baseball pitchers underwent bilateral manual anterior humeral head translation and stress radiographic tests. Stress radiography was performed by imparting a 15-daN anterior load to the shoulder in 90 degrees of abduction with both neutral and 60 degrees of external rotation and recording the glenohumeral joint translation at rest and under stress in each position. Eight subjects were retested to assess the reliability of these methods. Results showed no significant difference between the dominant and nondominant extremity in the amount of anterior humeral head translation measured manually and with stress radiography, nor significant correlation between anterior humeral head translation measured manually and by stress radiography. Test-retest reliability was moderate-to-poor for the manual humeral head translation test and moderate for stress radiography.

Adolescent↗
PubMedDate not supplied

Greater tuberosity notch: an important indicator of articular-side partial rotator cuff tears in the shoulders of throwing athletes.

We examined the location of rotator cuff tears, associated labral injuries, and notches on the greater tuberosity of the humeral head in shoulders of throwing athletes. Arthroscopic findings (rotator cuff tear, labral condition, and greater tuberosity notch) as well as other factors (duration of playing baseball, range of motion, and joint laxity) of 61 baseball players were retrospectively studied. The presence of a greater tuberosity notch was also evaluated for by plain radiographs. Forty patients had articular-side partial rotator cuff tears, most of which occurred in the interval between the supraspinatus and infraspinatus tendons. The existence of a rotator cuff tear was not related to the range of motion, joint laxity, the detachment of the superior glenoid labrum, or posterosuperior labral injury. Greater tuberosity notches were recognized in 38 shoulders by arthroscopy and most were detected on plain radiographs. The presence of a notch was significantly related to the existence of a rotator cuff tear, while the size of the notch was significantly related to the depth and width of the tear. The greater tuberosity notch seems to be one of the most important diagnostic indicators for a rotator cuff tear in throwing athletes.

Adolescent↗
PubMedDate not supplied

Rehabilitation of the pitching shoulder.

Shoulder pain is a common complaint among baseball pitchers. Frequently, the nature of shoulder pathology can be traced to lack of flexibility and muscular imbalance. This paper describes: the normal biomechanics of a properly functioning shoulder during a baseball pitch, pathomechanics of shoulder problems, flexibility requirements of the throwing shoulder, and the muscular balance necessary for an effective throwing shoulder. Appropriate examination procedures are described along with remedial exercises which ensure normal glenohumeral motion and integrated muscle action.

Athletic Injuries↗