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Prevalence of spit tobacco use across studies of professional baseball players.

A review of published data, together with previously unpublished information, shows that the use of spit tobacco among professional baseball players continues to be alarmingly high. In spite of efforts to make players aware of the harmful effects, approximately 35 percent to 40 percent of professional baseball players still use spit tobacco, and about half of those have associated lesions. However, current efforts of the National Spit Tobacco Education Program, Major League Baseball, the Professional Baseball Athletic Trainers Society and the Major League Baseball Players Association are expected to result in a significant reduction in spit tobacco use in this population in the next decade.

Adult↗

Shoulder range of motion characteristics in collegiate baseball players.

BACKGROUND: To determine range of motion and capsular characteristics of dominant and nondominant shoulders in baseball players. Our hypothesis was that there is a significant difference between dominant and nondominant range of motion in collegiate baseball players with unoperated and without shoulder pain. METHODS DESIGN: prospective, range of motion measurements during regular season. SETTING: two collegiate baseball teams in Houston. PARTICIPANTS: 15 pitchers and 23 position players. MAIN OUTCOME MEASURES: shoulder range of motion was evaluated by goniometric technique in all baseball players. Horizontal adduction (cross body reach test) and active internal rotation (reach behind back) in standing position and external rotation and internal rotation in supine lying position were measured for each player. RESULTS: Average external rotation with the arm in 90 degrees of abduction was significantly greater and average internal rotation was less in the dominant shoulder than in the nondominant shoulders, both in pitchers and position players. There was no statistical difference in shoulder horizontal adduction. Both dominant and nondominant shoulders of pitchers had greater average range of motion in horizontal adduction and external rotation at 90 degrees of abduction and less average internal rotation than those of position players. Although there was a significant difference in active internal rotation as cm between dominant and nondominant shoulders both in both groups, no difference was found between pitchers and position players. CONCLUSIONS: Differences in the range of motion in the throwing shoulder of baseball players exist involved in overhead throwing motions and should be considered in rehabilitation of the upper extremity after injury and in the prevention of injury for pitchers and position players.

Adolescent↗

Association between visual reaction time and batting, fielding, and earned run averages among players of the Southern Baseball League.

BACKGROUND: This study was performed to investigate the relationship between vision reaction time (VRT) and batting, fielding, and pitching skill in baseball. METHODS: A vision screening of 213 professional baseball players in the Southern Baseball League was performed, and the visual reaction times of these players were determined. Official Southern Baseball League statistics were consulted to obtain the players' batting average, fielding average, and earned run average. RESULTS: The mean visual reaction time for all players was 239 msec. There was no significant association between mean VRT and age or race. The mean VRT for dominant eyes was not significantly different from the mean VRT for nondominant eyes. For the 92 players who batted at least 100 times, an association was found between mean VRT and batting average (p = 0.017). For the 168 fielders in the league playing at least 20 games, no statistically significant association was found between mean VRT and fielding average. Similarly, no association was found between mean VRT and earned run average for the B8 pitchers who had participated in more than 20 games. CONCLUSIONS: An association was found between visual reaction time and batting skill in baseball. No association was found between visual reaction time and fielding or pitching skill.

Baseball↗

Indirect ultrasound measurement of humeral torsion in adolescent baseball players and non-athletic adults: reliability and significance.

Accurate clinical interpretation of shoulder rotation range requires knowledge of the contribution of humeral torsion. This study compares the reliability of indirectly measuring humeral torsion using ultrasound visualisation with direct palpation and compares the degree of humeral torsion in a non-throwing adult population with a population of elite adolescent baseballers. The reliability of a novel method of indirectly measuring humeral torsion using palpation and ultrasound was established prior to using the ultrasound method to determine the amount of humeral torsion in both humeri of a group of 16 non-throwing subjects and 36 elite adolescent baseball players. Excellent inter-tester reliability was found for the ultrasound method of measuring humeral torsion in each arm (ICC 2,1: 0.98 and 0.94) but poor reliability for the direct palpation method (ICC 2,1: 0.51 and 0.49). Using the ultrasound method, side-to-side differences in humeral torsion ranged from 0 to 13 degrees for the non-throwing group and 0 to 29 degrees for the baseball players. This side-to-side difference was significant in the baseball players (p<0.001) but not significant in the non-throwing group (p=0.43). Whilst side-to-side differences in humeral torsion were noted between all subjects irrespective of arm dominance, only throwers demonstrated consistently greater humeral retrotorsion in their throwing arm. A reliable clinical tool for estimating humeral torsion, such as that employed in this study, will allow for a more valid prescription of interventions for the treatment of shoulder dysfunction.

Adolescent↗

Assessment of stereopsis in college baseball pitchers and batters.

BACKGROUND/PURPOSE: In baseball pitching is a much less visually demanding task than hitting is. We sought to find a stronger relationship between visual function (as measured by stereopsis) and hitting a baseball than between stereopsis and pitching skill. METHODS: Multiple parameters including near and distance stereopsis (as a measure of visual function) were measured in 23 returning college baseball players (with a prior year's record). Their level of stereopsis (measured at distance with use of the B-VAT II BVS Binocular Vision Testing System) was compared with their batting statistics (in the case of the 14 position players) or their pitching statistics (for the 9 pitchers). Batting average and slugging percentage were used as measures of hitting skill, and earned run average, "out percentage" (1.000--Opposing players' batting average) and "strike-out percentage" (frequency of batters struck out) were used as pitching parameters. RESULTS: As a group, visual parameters were excellent in these college athletes. Although the newer test of distance stereopsis correlated with the standard near stereo test (Spearman coefficients), there was no correlation between distance stereopsis and any of the pitching or hitting performance parameters. CONCLUSIONS: The nature of the visual demands required of successful baseball hitters may have yet to be determined or are difficult to identify among a population homogeneous for excellent visual function, true for most groups of competitive athletes. In addition, simpler parameters such as plain visual acuity may be the most important factor(s).

Baseball↗

Survey of medical services at major league baseball stadiums.

OBJECTIVE: To analyze the availability and level of medical services for fans at major league baseball games in the United States. METHODS: A 10-item questionnaire was sent to the operations managers of each of 28 major league baseball stadiums. The survey was distributed in cooperation with a major league baseball club. Telephone follow-up was used to complete missing responses. The survey addressed five areas of fan medical services: 1) health-care provider availability and compensation; 2) advanced cardiac life support (ACLS) capabilities, including equipment; 3) presence of on-site ambulance(s); 4) fan fatalities; and 5) alcohol consumption limitations. RESULTS: Survey response was 100%. Healthcare providers are on-site at all stadiums: nurses (86%), physicians (75%), emergency medical technicians (EMTs, [68%]), and paramedics (50%). Ninety-six percent use a combination of health-care providers. The most common medical teams are nurse+EMT+physician (25%) and nurse+EMT+paramedic+physician (18%). All health-care providers receive some form of compensation. All stadiums have at least one ACLS-certified provider; 96% have ACLS equipment. Ambulances are on-site 75% of the time. Sixty-eight percent of the clubs reported at least one fan fatality through the 1992 and 1993 seasons (mean 1.1, range 0-4). All clubs limit alcohol consumption; 96% use multiple approaches. The various approaches include: 1) specific inning discontinuation (86%); 2) maximum purchase (68%); 3) restricted sale locations (64%); and 4) crowd conduct (57%). Advertisement for responsible alcohol consumption is displayed at 75% of the stadiums; designated-driver programs exist at 46%. CONCLUSIONS: All major league baseball clubs provide medical services for fans. Furthermore, almost all stadiums have ACLS capabilities. Responsible alcohol consumption also is a recognized priority for fan safety.

Alcohol Drinking↗

The development of sport-specific planning, rehearsal, and updating of plans during defensive youth baseball game performance.

The development of planning, rehearsal, and updating of defensive baseball plans was investigated in this study. Thirty-two male shortstops (seven 8-year-olds, eight 10-year-olds, nine 12-year-olds, and eight high school youths) were trained to perform a concurrent talk-aloud procedure before a pitch was thrown to the opposing batter. Participants completed a 40-item baseball knowledge test. Players' ages were highly correlated with their baseball knowledge (omega 2 = .88). Any subsequent age differences reflect differences in players' knowledge. Shortstops ages 12 years or younger frequently did not produce: (a) advanced defensive plans, (b) active rehearsal of plans, or (c) updating of defensive plans. When the young players did produce these strategies, the quality was generally poor; High school shortstops produced all these sport-specific strategies with advanced quality. The younger players' production and quality deficits in sport-specific strategy use may be related to their lack of a highly developed knowledge representation and the types of practice and game experiences they have had playing baseball.

Adolescent↗

Shoulder and elbow kinematics in throwing of young baseball players.

In this study we compared the kinematic features of the throwing motion between young baseball players of different age groups. Forty-four Japanese baseball players aged 6.1 to 12.3 years who regularly played baseball, including pitchers and position players, had their throwing actions analyzed three-dimensionally using high speed videography. Of this sample, 26 players aged above 9 years of age were categorized as the senior group, while the remaining 18 were categorized as the junior group. Senior group throwers had greater height and body mass, and produced a greater ball speed than junior group throwers. The throwing arm movement of senior group throwers was similar to that of adult skilled players. However, in the junior group throwers, the shoulder horizontal adduction angle was larger during the arm acceleration phase, and the maximum angular velocities of elbow extension and shoulder internal rotation occurred later than in senior group throwers. These results indicate that players aged above 9 years can acquire a mature throwing arm movement, while players younger than that will use an immature motion. A possible reason why these differences were shown is that the official baseball is relatively heavy for junior group throwers; they would be better advised to use a lighter ball in throwing practice.

Baseball↗

The healthy worker effect in major league baseball revisited.

We investigated the "healthy worker effect" (HWE) in major league baseball. Ages of death of major league baseball players who debuted between 1900 and 1939 were obtained and differences between those ages and age-adjusted life expectancies were examined to determine if longevity increased with career length, controlling for decade in which a player debuted, player position, and handedness. Major league baseball players (N = 4,492) lived an average of 4.8 (+/- 15.0 Standard deviation [SD]) years longer than age-matched controls from the general public. Career length significantly and incrementally increased longevity of players from an average of 4.1 years for players playing one season to 7.4 years for players playing 11 or more years. None of the other factors, nor any of the interactions, was statistically significant. These data provide strong support for the HWE in professional baseball.

Baseball↗

Longevity of major league baseball players.

The purpose of this study was to determine whether major league baseball players live lontger than the general public. Ages of death of major league baseball players who debuted between 1900 and 1950 were obtained, and differences between ages of death and age-adjusted life expectancies were determined by analysis of variance and t-tests, taking into account player position. Correlational analysis also was conducted to determine if career length affected longevity. Baseball players lived an average of four years longer than age-matched controls from the general public. Career length did not affect longevity among players. We concluded that professional athletes, as represented by major league baseball players, have increased life expectancies. This increase cannot be explained by increased fitness associated with working as a professionral athlete, but is likely the result of an initial selection process for becoming a professional athlete.

Aged↗

Isokinetic profile of baseball pitchers' internal/external rotation 180, 300, 450 degrees.s-1.

PURPOSE: The purpose of this study was to develop further normative data for an isokinetic profile for intercollegiate baseball pitchers at 180, 300, and 450 degrees.s-1. Information on isokinetic performance at 450 degrees.s-1 was not found in previously published literature. METHODS: Sixteen intercollegiate baseball pitchers volunteered for isokinetic strength testing of internal and external rotators of the shoulder. The testing was conducted at 180, 300, and 450 degrees.s-1; with the pitchers in a position of function (90 degrees/90 degrees). RESULTS: The subjects were able to reach maximal velocity for each of the speeds tested, including 450 degrees.s-1. These pitchers demonstrated no significant difference between dominant and nondominant arms for peak torque, torque/body weight, work/body weight, or average power (P < 0.05). Torque produced at 0.2 s was significantly greater in the dominant arm compared with the nondominant arm at 450 degrees.s-1 only. Internal rotation values were significantly greater than external rotation values for all areas of comparison. External rotation/internal rotation ratios remained consistent for each speed tested (approximately 0.65). CONCLUSIONS: There is minimal difference in strength values between dominant and nondominant arms of intercollegiate baseball pitchers, with the exception of significantly greater internal rotation peak torque at 0.2 s at 450 degrees.s-1 in the dominant arm. Dominant arm, as well as nondominant arm, ER/IR ratios remain consistent throughout the velocity spectrum. A valid test speed for intercollegiate baseball pitchers appears to be 450 degrees.s-1 when tested before the start of throwing from the pitcher's mound.

Adolescent↗

Evaluation of cricket helmet performance and comparison with baseball and ice hockey helmets.

BACKGROUND: Protective helmets in sport are important for reducing the risk of head and facial injury. In cricket and other sports with projectiles, national test standards control the minimum helmet performance. However, there are few field data showing if helmets are effective in reducing head injury. OBJECTIVES: (a) To examine the performance of cricket helmets in laboratory tests; (b) to examine performance with regard to test standards, game hazards, and helmet construction; (c) to compare and contrast these findings with baseball and ice hockey helmets. METHODS: Impact tests were conducted on a selection of helmet models: five cricket, two baseball, and two ice hockey. Ball to helmet impacts at speeds of 19, 27, 36, and 45 m/s were produced using an air cannon and a Hybrid III dummy headform and neck unit. Free fall drop tests with a rigid headform on to a selection of anvils (flat rigid, flat deformable, and hemispherical rigid) were conducted. Resultant headform acceleration was measured and compared between tests. RESULTS: At the lower speed impacts, all helmets produced a good reduction in headform acceleration, and thus injury risk. At the higher speed impacts, the effectiveness was less. For example, the mean maximum headform accelerations for all cricket helmets at each speed were: 67, 160, 316, and 438 g for 19, 27, 36, and 45 m/s ball speeds respectively. Drop tests on to a hemispherical anvil produced the highest accelerations. The variation in performance increased as the magnitude of the impact energy increased, in both types of testing. CONCLUSIONS: The test method used for baseball helmets in which the projectile is fired at the helmet may be superior to helmet drop tests. Cricket helmet performance is satisfactory for low speed impacts, but not for impacts at higher, more realistic, speeds. Baseball and ice hockey helmets offer slightly better relative and absolute performance at the 27 m/s ball and puck impacts.

Acceleration↗

Arthroscopic surgery for isolated capitellar osteochondritis dissecans in adolescent baseball players: minimum three-year follow-up.

BACKGROUND: Osteochondritis dissecans of the capitellum of the humerus usually occurs in adolescence and is caused by the valgus forces associated with excessive throwing. HYPOTHESIS: Arthroscopic surgery is an appropriate procedure for this condition. STUDY DESIGN: Retrospective cohort study. METHODS: Arthroscopic surgery was performed on 10 baseball players (average age, 13.8 years) with osteochondritis dissecans whose symptoms had been apparent for an average of 9 months before the operation. Follow-up at an average of 3.9 years included use of a standard rating scale, radiographs, and a questionnaire regarding return to sport. RESULTS: There were two grade I, one grade II, two grade IV, and five grade V lesions. Symptoms and objective findings correlated poorly with the grade of the lesion. The postoperative score averaged 195, reflecting excellent results. Radiographically, the primary lesion was still apparent in one patient, secondary degenerative changes were evident in one patient, and, in one patient, the lesion was still evident and degenerative changes had occurred. Only four athletes returned to organized baseball. CONCLUSIONS: Arthroscopic surgery for symptomatic osteochondritis dissecans of the capitellum in adolescent baseball players can provide excellent rating scores with intermediate follow-up but does not assure return to baseball.

Adolescent↗

Arthroscopic removal of symptomatic Bennett lesions in the shoulders of baseball players: arthroscopic Bennett-plasty.

BACKGROUND: Bennett lesions are often observed in throwing athletes, and, although usually asymptomatic, they can sometimes become painful and disturb an athlete's throwing ability. Because it is clinically difficult to determine whether a Bennett lesion is symptomatic or whether pain is from another lesion, the outcome of surgical treatment is variable. HYPOTHESIS: Arthroscopic resection of Bennett lesions diagnosed according to our criteria and arthroscopic treatment of associated lesions performed simultaneously were effective for treatment of baseball players with symptomatic Bennett lesions. STUDY DESIGN: Prospective cohort study. METHODS: The following criteria for diagnosis of a symptomatic Bennett lesion were used to identify 16 baseball players who later underwent arthroscopic removal of the symptomatic Bennett lesion (arthroscopic Bennett-plasty): 1) detection of a bony spur at the posterior glenoid rim on radiographs; 2) posterior shoulder pain during throwing, especially in the follow-through phase; 3) tenderness at the posteroinferior aspect of the glenohumeral joint; and 4) relief of pain by injection of local anesthesia. RESULTS: After a minimum follow-up of 1 year, there was no tenderness at the posteroinferior aspect of the glenohumeral joint in any of the patients. Throwing pain disappeared in 10 shoulders and was mitigated in 6 shoulders. Eleven patients returned to baseball at their previous level of competition. CONCLUSIONS: Accurate diagnosis and minimally invasive arthroscopic surgery are important for appropriate treatment of baseball players with symptomatic Bennett lesions.

Adolescent↗

Catastrophic injuries in high school and college baseball players.

BACKGROUND: There are few epidemiologic studies of catastrophic baseball injuries. PURPOSE: To develop a profile of catastrophic injuries in baseball players and to describe relevant risk factors. STUDY DESIGN: Retrospective cohort study. METHODS: The authors reviewed 41 incidents of baseball injuries reported to the National Center for Catastrophic Sports Injury Research from 1982 until 2002. RESULTS: There were an estimated 1.95 direct catastrophic injuries per year, or 0.43 injuries per 100,000 participants. The most common mechanisms of injury were a collision of fielders (9) or of a base runner and a fielder (8), a pitcher hit by a batted ball (14), and an athlete hit by a thrown ball (4). Catastrophic injuries included 23 severe head injuries, 8 cervical injuries, 3 cases of commotio cordis, and 2 cases each of a collapsed trachea and facial fractures. Three athletes sustained a severe head injury and facial fractures. Ten of the 41 injuries were fatalities. CONCLUSIONS: Suggestions for reducing catastrophic injuries in baseball include teaching proper techniques to avoid fielding and baserunning collisions, protecting the pitcher via a combination of screens and/or helmets with faceguards, continued surveillance and modifications of the bat and ball, eliminating headfirst slides, and continued analysis of chest protectors and automatic external defibrillators for commotio cordis.

Adolescent↗

A numerical model for risk of ball-impact injury to baseball pitchers.

INTRODUCTION: Metal baseball bats produce higher ball exit velocity (BEV) than wood bats, increasing the risk of impact injuries to infield players. In this paper, maximum BEV from a wood and a metal bat were determined using the finite element method. METHODS: Three-dimensional (3-D) bat kinematics at the instant of impact were determined from high-speed videography (N = 17 high-performance batters). A linear viscoelastic constitutive model was developed for stiffer and softer types of baseballs. The risk of impact injury was determined using available movement time data for adult pitchers; the data indicate that 0.400 s is required to evade a batted ball. RESULTS: The highest BEV (61.5 m.s(-1)) was obtained from the metal bat and the stiffer ball model, equating to 0.282 s of available movement time. For five impacts along the long axis of each bat, the "best case scenario" resulted from the wood bat and the softer ball (46.0 m.s(-1), 0.377 s). CONCLUSIONS: The performance difference between the bats was attributed to the preimpact linear velocity of the bat impact point and to differences in orientation on the horizontal plane. Reducing the swing moment of the baseball bat, and the shear and relaxation modulii of the baseball, increased the available movement time.

Algorithms↗

Ultrasonographic assessment of the ulnar collateral ligament and medial elbow laxity in college baseball players.

BACKGROUND: The prevalence of medial elbow instability is high in athletes who throw, such as baseball players. The aim of this study was to assess the medial aspect of the elbow with ultrasonography to detect changes in baseball players. METHODS: Ultrasonography of the medial aspect of the elbow was performed, while gravity stress was applied with the elbow in 90 degrees of flexion, on thirty college baseball players (twelve pitchers and eighteen fielders) to assess medial joint laxity and deformity of the ulnar collateral ligament. The dominant (throwing) extremity was compared with the contralateral extremity. Clinical data were correlated with ultrasonographic findings. RESULTS: The medial joint space was significantly wider on the throwing side than it was on the contralateral side (2.7 mm and 1.6 mm, respectively; p < 0.01), and the proximal part of the ulna was shifted significantly laterally on the throwing side (p < 0.01). Angular deformity of the ulnar collateral ligament was found in five subjects, and it was significantly associated with lateral shift of the proximal part of the ulna (p < 0.01). Medial elbow pain was associated with widening of the medial joint space (p < 0.05) and with the presence of angulation of the ulnar collateral ligament (p < 0.01). CONCLUSIONS: Medial elbow laxity and elbow valgus on the throwing side of baseball players were increased compared with those in nonplayers. Angular deformity of the ulnar collateral ligament suggests that the ligament bends over the distal-medial edge of the trochlea. Ultrasonography can provide useful information about the condition of the ulnar collateral ligament and about medial elbow laxity in athletes who throw.

Adolescent↗

Using sonography for the early detection of elbow injuries among young baseball players.

OBJECTIVE: The aim of this study was to determine the usefulness of sonography for detecting elbow injuries among young baseball players. SUBJECTS AND METHODS: One hundred fifty-three volunteers ranging in age from 9 to 12 years and belonging to youth baseball teams participated. Sonography of the elbow was performed in the field when baseball exercises were being conducted. We analyzed the relationship between elbow pain and sonographic abnormalities and the relationship between pitchers and sonographic abnormalities. RESULTS: Sonography showed that 33 subjects had medial epicondylar fragmentation and two had early-stage osteochondritis dissecans of the capitellum. In 25 subjects who agreed to further examination and treatment, radiography confirmed the sonographic findings. All of the 23 subjects with medial epicondylar fragmentation, who stopped throwing, obtained union of the bone and returned to baseball. The two subjects with osteochondritis dissecans of the capitellum underwent surgery before the osteochondral fragment became loosened. Sonographic abnormalities correlated with episodes of elbow pain. Pitchers statistically significantly had sonographic abnormalities. CONCLUSION: Sonography in the field can provide an opportunity to detect and treat elbow injuries before they become more advanced.

Age Factors↗