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PubMedDate not supplied

Hook of the hamate fractures in athletes.

Five patients have been treated for six hook of the hamate fractures over the past 8 years by the authors. Of these, four patients were professional baseball players and one patient was an accountant. All fractures occurred while playing baseball; four while swinging a bat, and two secondary to a fall on an outstretched hand. Roentgenographic diagnosis was made by carpal tunnel view alone in two, oblique and carpal tunnel view in one, bone scan and subsequent carpal tunnel view in two, and computerized tomography in one fracture. Five of the fractures were through the base of the hook, while one was toward the tip. All patients ultimately underwent hook resection, four early and two late. The patient who sustained the tip of the hook fracture underwent resection of the fracture only to refracture the same hook at its base 6 months later. All patients returned to their previous level of activity in 6 to 8 weeks after surgery without loss of function. Hence, it is the authors' opinion that the entire hook should be resected to the base of the hamate as the primary form of treatment in hook of the hamate fractures.

Adult↗
PubMedDate not supplied

Subscapular elastofibroma in a young pitcher. A case report.

Subscapular elastofibromas and scapulothoracic bursitis can cause symptomatic masses in baseball pitchers. Both processes appear to represent reactive soft tissue responses to repetitive stress at the inferior border of the scapula. It is assumed that most masses in the subscapular area represent scapulothoracic bursitis rather than an elastofibroma. However, it is possible that some of the masses treated conservatively as scapulothoracic bursitis may be elastofibromas. A study is currently under way to evaluate the incidence of subscapular masses in college and professional pitchers in the United States. A follow-up report is anticipated when the study has been completed. The author requests information concerning any confirmed cases of elastofibroma in baseball pitchers.

Adolescent↗
PubMedDate not supplied

Development of a distance-based interval throwing program for Little League-aged athletes.

We developed a distance-based interval throwing program for Little League-aged athletes (9 to 12 years) to be used in training and rehabilitation. The timing and repetition parameters were developed from data collected during 400 innings of organized baseball during a single season, and short toss distance from Little League rules for field dimensions. There were 1022 boys from organized baseball teams in the four studies. Maximal distance and speed measurements were recorded for 853 boys. We developed a mathematical model from these data to predict maximal throwing distance from maximal throwing speed. This model was then tested on a second sample of 114 players. We compared the predicted distance with the actual maximal throwing distance; the correlation coefficient was 0.92. Forty players aged 9 to 12 participated in a study to assess degradation of speed and distance. The average variability of the speed was small (< 5 mph), but the variability in distance was large (22.4 feet). Fifteen boys then threw the entire throwing program as designed. These results show that healthy young athletes can be expected to be able to throw the predicted value of this practical progressive interval throwing program for Little League-aged athletes. The appropriate program can be assigned from age and known preinjury pitch speed.

Adolescent↗
PubMedDate not supplied

Shoulder muscle firing patterns during the windmill softball pitch.

The purpose of this study was to describe the activity of eight shoulder muscles during the windmill fast-pitch softball throw. Ten collegiate female pitchers were analyzed with intramuscular electromyography, high-speed cinematography, and motion analysis. The supraspinatus muscle fired maximally during arm elevation from the 6 to 3 o'clock position phase, centralizing the humeral head within the glenoid. The posterior deltoid and teres minor muscles acted maximally from the 3 to 12 o'clock position phase to continue arm elevation and externally rotate the humerus. The pectoralis major muscle accelerated the arm from the 12 o'clock position to ball release phase. The serratus anterior muscle characteristically acted to position the scapula for optimal glenohumeral congruency, and the subscapularis muscle functioned as an internal rotator and to protect the anterior capsule. Although the windmill softball pitch is overtly different from the baseball pitch, several surprising similarities were revealed. The serratus anterior and pectoralis major muscles work in synchrony and seem to have similar functions in both pitches. Although the infraspinatus and teres minor muscles are both posterior cuff muscles, they are characteristically uncoupled during the 6 to 3 o'clock position phase, with the infraspinatus muscle acting more independently below 90 degrees. Subscapularis muscle activity seems important in dynamic anterior glenohumeral stabilization and as an internal rotator in both the baseball and softball throws.

Adolescent↗
PubMedDate not supplied

Throwing fracture of the humeral shaft. An analysis of 90 patients.

Ninety patients with humeral shaft fractures sustained during throwing were analyzed to determine what caused their injuries. All patients were recreational baseball players: 89 were men and 1 was a woman. The average age was 25 years (range, 12 to 43). The throwing style, type of pitch, fielding position, and type of ball used varied; however, the patients sustained their fractures while performing a hard throw in 87 (97%) of the occurrences. The actual courses of the balls thrown ranged from sideways to straight forward. All fractures were external rotation spiral fractures; 25 patients (28%) had a medial butterfly fragment, and 14 patients (16%) had radial nerve palsy. Fractures were most likely to have occurred in the distal half of the humerus, although they occurred frequently in the proximal half in patients in their early teens. We conclude that 1) the fracture can occur at any time during the acceleration phase before ball release, 2) this type of fracture can occur in any recreational baseball player attempting to perform a hard throw, and 3) the cause of this fracture is the throwing action itself.

Adolescent↗
PubMed2000

Measurement of fatigue in knee flexor and extensor muscles.

In order to examine fatigue of the knee flexor and extensor muscles and to investigate the characteristics of muscular fatigue in different sports, a Cybex machine was used to measure muscle fatigue and recovery during isokinetic knee flexion and extension. Eighteen baseball players, 12 soccer players and 13 marathon runners were studied. Each subject was tested in the sitting position and made to perform 50 consecutive right knee bends and stretches at maximum strength. This was done 3 times with an interval of 10 min between each series. The peak torque to body weight ratio and the fatigue rate were determined in each case. In all subjects, the peak torque to body weight ratio was higher for extensors than flexors. Over the 3 trials, the fatigue rate of extensors showed little change, while that of flexors had a tendency to increase. In each subject, knee extensors showed a high fatigue rate but a quick recovery, while knee flexors showed a low fatigue rate but a slow recovery. As the marathon runners had the smallest fatigue rates for both flexors and extensors, we concluded that marathon runners had more stamina than baseball players and soccer players.

Adolescent↗
PubMed2000

Commotio cordis: an underappreciated cause of sudden death in athletes.

Over the last few years, the recognised cardiovascular risks of sporting activities have been extended to include cardiac arrest resulting from low-energy precordial chest impact produced by projectiles (e.g. baseball) or bodily contact, in the young, healthy and active athlete [also known as commotio cordis (CC)]. However, case reports of CC in European medical literature can be traced back for at least 130 years. CC accounts for a small, but important, subset of sudden death during sporting activities. It is a devastating electrophysiological event in the young athlete, and one which has generated considerable concern, both in the medical profession as well as in the public. The mechanism of sudden death appears to be caused by ventricular fibrillation, which occurs when the chest impact is delivered within a narrow, electrically vulnerable portion of the cardiac cycle, that is, during repolarisation, just before the peak of the T wave. Resuscitation of these victims is possible with prompt cardiopulmonary resuscitation and defibrillation. Preventive measures, such as the use of age-appropriate safety baseballs and suitably designed chest wall protection, may reduce the risk of sudden death and, thus, make the athletic field a safer place for young athletes.

Adolescent↗
PubMed2006

The science of softball: implications for performance and injury prevention.

Whilst the sport of softball has achieved worldwide popularity over the last 100 years, a consideration of the scientific principles underpinning softball is in its infancy. It is clear that the various motor skills associated with softball, such as pitching, batting and fielding, place considerable perceptual and physical demands upon players. Each of these skill categories are examined in more detail by reviewing the biomechanical principles associated with skilled performance. For pitching, a certain amount of information can be gleaned from baseball research; however, the underarm technique required by softball places the highest loads on the arm and shoulder during the accelerative, downward phase of the swing. Kinematic analyses of the bat swing suggest that elite batters have approximately 200 ms to decide whether to swing, and approximately the same duration to complete the swing (resulting in reported bat speeds of up to 40 m/sec). The research conducted on fielding has been limited to a consideration of throwing styles adopted in games. A variety of throwing techniques are adopted in the course of a typical game but elite players commonly adopt a sidearm technique when returning to base as quickly as possible. Data obtained from the National Athletic Training Association indicate a similar level of injury incidence in softball as in baseball. Approximately 17% of injuries are experienced by the pitcher and approximately 25% of all injuries are located in the forearm/wrist/hand joint segments. Sports science and sports medicine research have the potential to contribute significantly to performance enhancement and injury prevention in the future.

Athletic Injuries↗
PubMed1999

Correlations for weight, height and two measures of batting performance.

The hypothesis that heavier baseball players are better batters was examined in two correlational studies of major league baseball players' performance. Neither height nor weight was significantly correlated with batting average. Both variables correlated significantly and positively with the number of home runs hit by American League players in the 1997 season. After partial correlations were computed, only the correlation between weight and number of home runs hit remained significant.

Baseball↗
PubMed2002

After-effects of using a weighted bat on subsequent swing velocity and batters' perceptions of swing velocity and heaviness.

In baseball and softball, warm-up swings with a weighted bat have been believed to increase swing velocity when an ordinary bat is used in the subsequent competitive situation. The purpose of this study was to investigate the after-effects of using a weighted bat on subsequent swing velocity and batters' perceptions of swing velocity and heaviness. Eight men in varsity softball and baseball hit a ball suspended from the ceiling 45 times (3 sets of 15 trials). For each set, the initial 5 trials were done using an ordinary 920-g wooden bat (Control condition), and the following 5 trials by a bat with an 800-g bat ring (Weighted condition), and the final 5 trials again by the ordinary bat (post-Weighted condition). Analysis of variance showed a significant decrease of 3.3% in the measured linear velocity of the bat prior to impact with the ball for the first swing of the post-Weighted condition compared with the Control condition. From the second swing the velocity returned to the level of the Control condition. Subjective judgment of the heaviness and velocity of swings for the Weighted and post-Weighted conditions by each participant showed that the ordinary bat felt lighter and swing speed felt faster for the post-Weighted condition. The advantage of the warm-up with a weighted bat was thus psychological and not biomechanical.

Adult↗
PubMed1999

Reliability and validity of a new method of measuring posterior shoulder tightness.

STUDY DESIGN: Repeated measures of shoulder flexibility on nonimpaired subjects and intercollegiate baseball pitchers. OBJECTIVES: To present a new objective method of measuring posterior shoulder tightness, define the intratester and intertester reliability of the measurement, and assess its construct validity. BACKGROUND: Posterior shoulder tightness has been linked to anterior humeral head translation and decreased internal rotation. The reliability of an objective assessment of posterior shoulder tightness has yet to be established in the literature. METHODS AND MEASURES: Five repeat measurements were made using a standardized protocol on 21 nonimpaired subjects to determine intratester reliability. To determine intertester reliability, 2 testers (blinded to their measurement) each performed 1 measurement on 49 shoulders. Twenty-two intercollegiate baseball pitchers were measured once by 1 tester to evaluate the construct validity of the measurement. RESULTS: Measurements of posterior shoulder tightness performed by the same physical therapist had high reliability (ICC dominant = 0.92, nondominant = 0.95). Intertester measures revealed good reliability (ICC = 0.80). Pitchers had reduced dominant arm internal rotation and increased external rotation ROM compared to their other arm whereas nonimpaired subjects had less reduction in external rotation compared to the nondominant arm (pitchers: dominant, 109.7 degrees +/-2.4 degrees, nondominant, 98.9 degrees +/-1.6 degrees; nonimpaired subjects: dominant, 95.9 degrees +/-1.5 degrees, nondominant, 95.2 degrees +/-1.6 degrees) and internal rotation (pitchers: dominant, 50.0+/-2.0 degrees, nondominant, 69.5+/-2.5 degrees; nonimpaired subjects: dominant, 46.4+/-1.3 degrees, nondominant, 50.2+/-1.4 degrees). Pitchers had significantly greater posterior shoulder tightness compared to nonimpaired subjects (pitchers; dominant, 44.9+/-0.8 cm, nondominant, 37.5+/-0.7 cm, nonimpaired subjects; dominant, 32.9+/-0.8 cm, nondominant, 31.4+/-0.8 cm) and manifested a significant correlation between posterior shoulder tightness and internal rotation (r = -0.61) that was not evident in nonimpaired subjects. CONCLUSIONS: Measurement of posterior shoulder tightness using this technique is objective and reliable when done by the same physical therapist. Validity of this measurement is supported from the observation of athletes thought to have tight posterior structures. Further study is needed to determine the relationship of this measurement to patients diagnosed with shoulder impingement syndrome.

Adolescent↗
PubMed1999

Baseball/lacrosse injuries.

With the expansion of baseball into all age groups, the game is becoming as much a recreational sport as a youth sport. Throwing arm injuries eventually limit the participation of most players. Analysis is made of these injuries with the goal of complete rehabilitation for the baseball player. Lacrosse has also seen an increase in popularity as a recreational sport. Analysis of lacrosse injuries and rehabilitation of the most common injuries is reviewed.

Athletic Injuries↗
PubMed1992

Isolated injury of the infraspinatus branch of the suprascapular nerve.

A 30-year-old recreational baseball player developed dominant-sided infraspinatus atrophy and shoulder pain after throwing a baseball. Partial denervation of the infraspinatus muscle with delayed motor latency was documented. Isolated lesions of the branch to the infraspinatus may be more common than previously suspected, particularly in throwing athletes with shoulder pain.

Adult↗
PubMed1990

Axillary artery compression and thrombosis in throwing athletes.

A 28-year-old major league baseball pitcher sustained an axillary artery thrombosis which was successfully treated with intraarterial urokinase. Subsequent angiography and duplex scanning with the arm elevated in the pitching position demonstrated inducible compression of the axillary artery by the humeral head as well as compression at the thoracic outlet. To determine the incidence of axillary and subclavian artery compression and to investigate the mechanism of injury, brachial artery blood pressures and duplex scans of the subclavian and axillary arteries were performed in both the neutral position and the throwing position in the 92 extremities of 19 major league baseball pitchers, 16 non-pitching major league players, and 11 nonathlete controls. A drop in blood pressure of greater than 20 mm Hg was noted in the position in 56% of extremities tested, with a loss of a detectable blood pressure in 13%. Compression of the axillary artery by the humeral head was documented in 83% of extremities, but in only 7.6% was a greater than 50% stenosis inducible. No statistical difference was found in the incidence of arterial compression between the three groups tested or between their dominant and nondominant extremities. Dissection of the axillary artery in two cadavers documented that abduction and external rotation of the arm causes compression of the axillary artery by the humeral head, which acts as a fulcrum. We conclude that the repetitive mechanical trauma of the throwing motion can cause intermittent compression and contusion of the axillary artery by the humeral head and predisposes the athlete who throws to thrombosis of the axillary artery.

Adult↗
PubMed1984

The relationship of contrast sensitivity functions to sports vision.

Contrast sensitivity, a more recent test of visual function, has never been studied in its relationship to sports vision. The hypothesis that contrast sensitivity functions among college varsity level baseball players significantly differs from that of a random sample of optometry students was tested using Arden grating plates. A statistically significant difference was found at the 98 percent confidence level, demonstrating that in this study, a sample of college varsity level baseball players have higher level contrast sensitivity functions than those of a randomly selected sample of Southern California College of Optometry students.

Adolescent↗
PubMed1993

Smokeless tobacco cessation: report of a preliminary trial using nicotine chewing gum.

BACKGROUND: Smokeless tobacco use is a major public health hazard whose incidence is increasing, particularly among male adolescents. Little research has been done on cessation programs designed to assist smokeless tobacco users in ending their habit. There have been no studies on the use of nicotine polacrilex chewing gum as an adjunct to cessation. METHODS: Fourteen of 88 male smokeless tobacco users in a professional baseball organization enrolled in a cessation program and were followed for up to 12 months. The program consisted of two support group sessions at the spring training camp followed by adjunctive use of nicotine polacrilex chewing gum during the baseball season as monitored by the athletic trainers. RESULTS: At 2 to 4 months, only 3 of 14 participants were completely abstinent from smokeless tobacco. Follow-up data at 6 to 12 months revealed that only one participant was abstinent. The 14 ballplayers experienced various side effects of nicotine chewing gum: bad taste (6), nausea (4), headache (4), jaw discomfort (3), and dizziness (1). Despite these side effects, 11 of the 14 participants replied that they would recommend the gum to others trying to quit. Most participants (10) felt that quitting the smokeless tobacco habit was "very difficult." CONCLUSIONS: We conclude that nicotine chewing gum as an adjunct to smokeless tobacco cessation had limited effectiveness. Further study on smokeless tobacco cessation methods is needed.

Adult↗
PubMed1997

Treatment of grade III acromioclavicular separations in professional throwing athletes: results of a survey.

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.

Acromioclavicular Joint↗
PubMedDate not supplied

Parental attitudes toward mouthguards.

An 11-item, one-page questionnaire was mailed to 1800 parents chosen at random in the Henrico County, VA public school system. Parents were asked questions such as "who should be responsible for mouthguard wear?" "what sports should require mouthguards?" and "has [their] child ever sustained an oral or facial injury?" The parental responses indicate that mouthguard enforcement is the responsibility of both parents and coaches. Of the total injuries reported, 19% were sustained in basketball, 17% in baseball, and 11% in soccer. Despite these high injury rates, however, there was a lack of perceived need for mouthguard use in these sports. When asked which sports should require a mouthguard rule, the sports that generated the most responses were, in decreasing order, football, boxing, ice hockey, wrestling, field hockey, and karate. Parents were more likely to require mouthguards for their sons than daughters, and more likely to require them for their children who participated in a mandatory mouthguard sport, a contact sport, or who had been previously injured. The authors conclude that because parents view themselves as equally responsible as coaches for maintaining mouthguard use, both groups should be targeted and approached as a possible source for the recommendation of mandatory mouthguard rules in basketball, baseball, and soccer.

Adolescent↗