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At least 973 records · Page 54Linked to original sources
PubMed2004

Radiographic changes in the lumbar spine in former elite athletes.

STUDY DESIGN: The authors conducted a retrospective cohort study. OBJECTIVE: The objective of this study was to clarify the occurrence of radiographic changes (vertebral osteophytes, heights of lumbar discs, concavity index) of the lumbar spine in former elite athletes of different track and field disciplines. SUMMARY OF BACKGROUND DATA: The influence of physical activity on occurrence of radiographic changes in the lumbar spine is not well known and seems to be contradictory. The loadings in the different track and field disciplines seem to play an important role in the development of radiographic changes. METHODS: One hundred fifty-nine former male elite track and field athletes were selected for a radiologic study. The heights of lumbar discs, the concavity index, the presence of anterior vertebral osteophytes, a radiographic evaluation according to Kellgren and Lawrence, and the FFbH-R score for the assessment of functional limitations in activities of daily living (ADLs) were determined. The influence of age, body mass index, current physical activity, and training history was also examined. RESULTS: In high jumpers and throwers, the absolute heights of lumbar discs increased from level T12/L1 to a maximum at L4/L5 and decreased again from level L4/L5-L5/S1. In endurance athletes and other jumpers, the absolute heights increased linearly from level T12/L1 to a maximum at L5/S1. The concavity index did not yield any significant differences between athlete categories. Shot putters, discus throwers, and high jumpers showed a significantly higher prevalence of osteophytes after adjustment for possible confounders. According to Kellgren and Lawrence, the highest prevalence of radiographic changes in the lumbar spine is seen in javelin throwers. Significant differences in the assessment of functional limitations in ADLs are not found between the disciplines. CONCLUSION: In throwing disciplines, the lumbar spine is more highly loaded than in jumpers and runners. Despite the observation of evident degenerative changes in some former athletes, there were only minor changes seen in ADLs. Even if body constitution is taken as a preselection factor, athletes in throwing disciplines as well as high jumpers have a higher risk of developing vertebral osteophytes of the lumbar spine.

Adult↗
PubMed2003

Evidence of motor planning in infant reaching behavior.

When adults reach for an object, kinematic measures of their approach movement are affected by what they intend to do after grasping it. We examined whether such future intended actions would be reflected in the approach-to-grasp phase of infant reaching. Twenty-one 10-month-old infants were encouraged to either throw a ball into a tub or fit it down a tube. Kinematic measures of the approach phase of the reach toward the ball were obtained using a motion analysis system. Infants, like adults, reached for the ball faster if they were going to subsequently throw it as opposed to using it in the precision action. The perceptual aspects of the ball were the same and cannot account for these kinematic differences. Infants appear to be planning both segments of their actions in advance. Our findings provide evidence for a level of sophistication in infant motor planning not reported before.

Biomechanical Phenomena↗
PubMed2005

Relationship of biomechanical factors to baseball pitching velocity: within pitcher variation.

To reach the level of elite, most baseball pitchers need to consistently produce high ball velocity but avoid high joint loads at the shoulder and elbow that may lead to injury. This study examined the relationship between fastball velocity and variations in throwing mechanics within 19 baseball pitchers who were analyzed via 3-D high-speed motion analysis. Inclusion in the study required each one to demonstrate a variation in velocity of at least 1.8 m/s (range 1.8-3.5 m/s) during 6 to 10 fastball pitch trials. Three mixed model analyses were performed to assess the independent effects of 7 kinetic, 11 temporal, and 12 kinematic parameters on pitched ball velocity. Results indicated that elbow flexion torque, shoulder proximal force, and elbow proximal force were the only three kinetic parameters significantly associated with increased ball velocity. Two temporal parameters (increased time to max shoulder horizontal adduction and decreased time to max shoulder internal rotation) and three kinematic parameters (decreased shoulder horizontal adduction at foot contact, decreased shoulder abduction during acceleration, and increased trunk tilt forward at release) were significantly related to increased ball velocity. These results point to variations in an individual's throwing mechanics that relate to pitched ball velocity, and also suggest that pitchers should focus on consistent mechanics to produce consistently high fastball velocities. In addition, pitchers should strengthen shoulder and elbow musculature that resist distraction as well as improve trunk strength and flexibility to maximize pitching velocity and help prevent injury.

Acceleration↗
PubMed1999

Natural goal-directed movements and the triphasic EMG.

Triphasic electromyographic (EMG) patterns have been described as characteristic of rapid, discrete, uniplanar, goal-directed movements. This experiment examined the effects of Response Type (experimenter- vs. subject-determined), Hand (preferred vs. nonpreferred), and Practice (early vs. late) on performance accuracy, and specific temporal EMG and kinematic measures during a dart throw. EMG was recorded from triceps (main agonist), brachioradialis, and biceps (main antagonist). The number of trials in which a triphasic EMG occurred varied systematically across conditions. The experimenter-determined, early practice condition resulted in greatest frequency (92%) of trials displaying a triphasic EMG and least accurate performance. In contrast, the lowest frequency (79%) of triphasic EMG and most accurate performance occurred in the subject-determined, late practice condition. The association among 14 temporal EMG, and kinematic measures for each trial of the dart throw was analyzed with multivariate factorial ANOVA. Four clusters of variables emerged: initial phase, braking phase, terminal phase, and movement speed and duration. Variables contributing to the initial-phase cluster were most strongly associated within the experimenter-determined, early practice condition, and the strength of association was directly related to diminished performance accuracy. Paradoxically, best performance accuracy (subject-determined, late practice) was identified with a weaker association among variables representing the initial phase.

Adult↗
PubMed2005

Thrower's fracture of the humerus with radial nerve palsy: an unfamiliar softball injury.

A fracture of the normal humerus in a healthy young adult most commonly results from significant direct trauma. Throwing sports have become increasingly popular outside of North America and bring with them a novel injury mechanism for clinicians. A 21 year old woman sustained a "thrower's fracture" of the distal humerus and radial nerve palsy while throwing a softball. She was treated by internal fixation. Her fracture united, and radial nerve neurapraxia resolved after 8 weeks. Clinicians should be aware of this entity so that prodromal symptoms can be recognised early and thrower's fractures are not investigated unnecessarily.

Adult↗
PubMed2006

Evolution of the treatment options of ulnar collateral ligament injuries of the elbow.

Ulnar collateral ligament (UCL) insufficiency is potentially a career threatening, or even a career ending, injury, particularly in overhead throwing athletes. The evolution of treating modalities provides afflicted athletes with the opportunity to avoid premature retirement. There have been several clinical and basic science research efforts which have investigated the pathophysiology of UCL disruption, the biomechanics specific to overhead throwing, and the various types of treatment modalities. UCL reconstruction is currently the most commonly performed surgical treatment option. An in depth analysis of the present treatment options, both non-operative and operative, as well as their respective results and biomechanical evaluation, is lacking in the literature to date. This article provides a comprehensive current review and comparative analysis of these modalities. Over the last 30 years there has been an evolution of the original UCL reconstruction. Yet, despite the variability in modifications, such as the docking technique, interference screw fixation, and use of suture anchors, the unifying concepts of UCL reconstruction are that decreased dissection of the flexor-pronator mass and decreased handling of the ulnar nerve leads to improved outcomes.

Adolescent↗
PubMed1995

Proprioceptive coordination of discrete movement sequences: mechanism and generality.

A "discrete" movement sequence is defined as a movement with a single goal that involves a series of overlapping joint rotations. Reaching-and-grasping and throwing are examples of discrete movement sequences. The central nervous system (CNS) can use reafferent proprioceptive information from one joint rotation in a sequence to coordinate subsequent rotations at other joints. The experiments reported in this paper demonstrate how the human CNS uses proprioceptive information to coordinate discrete movement sequences. We examined the mechanism (at an information processing level) underlying proprioceptive coordination and the generality (i.e., the boundary conditions) of these mechanisms as they apply to everyday movement sequences. Adult human subjects performed a discrete movement sequence that resembles backhand throwing: elbow extension followed by hand opening. The task was to open the hand as the elbow passed through a prescribed "target" angle. We eliminated visual information and made the arrival time at the target angle unpredictable so that the available kinematic information was provided exclusively by proprioception. The subjects were capable of performing this motor task with a high degree of precision, thereby demonstrating that the nervous system can use proprioceptive input to coordinate discrete movement sequences. Our data indicate that precise coordination is achieved by extracting kinematic information related to both the velocity of elbow rotation as well as the elbow position during movement (i.e., "dynamic position"). Dynamic position information appears to be encoded as both absolute joint angle and angular distance, although more precisely as angular distance. Although our experiments were conducted under rather restrictive laboratory conditions, this mechanism of motor coordination might also apply to everyday movement. Our results suggest that this mechanism could be employed for passive as well as active movement sequences, with and without opposing loads; it could exert its influence in discrete movement sequences as brief as 210 ms or as long as 1.5 s; and it does not involve any significant degree of learning (this proprioceptive mechanism appears to be readily available for use on the first attempt of a novel motor task).

Adult↗
PubMed1987

Some realities of present-day cardiologic journal publishing in the USA.

The types and quantities of cardiological publications in the USA have changed drastically in recent years. The small, independent medical publisher in the USA is vanishing. Medical publishers in the USA today primarily are parts of larger, nonmedical publishing corporations, and the nonmedical publications are affecting the medical publications. The 'throw-away' journals are increasing and their existence is diminishing the reading time available and advertising support provided to the peer-review subscription journals. The publication of symposia proceedings supported entirely by grants from single pharmaceutical or medical device companies in otherwise peer-review journals is increasing. It is better, in my view, for physicians not to exert efforts to discontinue this practice, which is here to stay, but to exert their influence to reduce excess bias and overstatement. The peer-review subscription journals, most of which are published by for-profit corporations, are the sources of our new medical information and the 'storehouse' of our knowledge. They need our strong support. They need to be published on acid-free paper which will not deteriorate, for they are the permanent record of our information. We need more editorial pages in the peer-review subscription journals so that more review and experimental-type articles can be published, and less pages in the 'throw-away' journals which diminish support available to the peer-review subscription journals.

Cardiology↗
PubMed2001

Injury reduction and bounce characteristics of safety baseballs and acceptability by youth leagues.

The only reasonable way to reduce the potential for ball-related youth baseball injuries sustained by the defensive players (the majority of ball-related injuries) is to make the ball less injurious. The American Academy of Pediatrics' 1994 statement on youth baseball injuries in this regard reads, "Consideration should be given to utilizing low-impact NOCSAE-approved baseballs and softballs for children 5 to 14 years of age, if these balls demonstrate satisfactory playing characteristics and reduce injury risk. A variety of studies should be undertaken to determine the efficacy of low-impact balls in reducing serious impact injuries." The purpose of this study, in accordance with this AAP policy, is to investigate the following: A) injury reduction potential of softer baseballs, B) their bounce characteristics, and C) their acceptability by youth leagues. Six simple injury models were studied, baseball bounce characteristics were analyzed, and attitudes of safety baseballs among statewide Little League district presidents were surveyed. Injury models demonstrated less injury potential with safety baseballs compared to that with standard hard baseballs. Safety baseballs bounced higher after vertical drops and slow throws, but during fast throws (with the greatest injury potential), the bounce heights were similar for all ball types. Of 27 survey cards sent out, 13 were returned. While 9 respondents indicated that they were already using safety baseballs for the younger players, none of the 13 respondents indicated that they were planning to expand the use of safety baseballs in their leagues. In conclusion, safety baseballs are less injurious in these models. The bounce characteristics of safety baseballs are satisfactory. Youth baseball league officials are not very willing to expand the use of safety baseballs. We recommend using safety baseballs as a standard for all youth baseball leagues because these balls are safer.

Athletic Injuries↗
PubMedDate not supplied

A clinical and roentgenographic study of Little League elbow.

BACKGROUND: Comparisons of medial elbow injury rate and the incidence of clinical and radiographic findings among Little League baseball players have not been documented. HYPOTHESIS: Injury rate and clinical and radiographic findings in Little Leaguers of different positions may be similar. STUDY DESIGN: Survey and retrospective review. METHODS: Altogether, 343 Little Leaguers (120 pitchers, 40 catchers, and 183 fielders) participated in the study. The survey (including age, playing position, playing experience, and symptoms), clinical examination, and roentgenogram of both elbows were obtained for analysis using Pearson's chi-square test. RESULTS: Clinically, 58% of the pitchers presented with soreness compared to 63% in catchers and 47% in fielders. Radiographic examination revealed hypertrophy of the medial humeral epicondyle in all pitchers and catchers and 90% of the fielders. Separation of the medial epicondyle was found in 63% of pitchers, 70% of catchers, and 50% of fielders, while fragmentation was found in 19% of pitchers, 40% of catchers, and 15% of fielders. In subjects with separation or fragmentation, 49% and 56% complained of elbow soreness, respectively. CONCLUSION: Similar rates of medial elbow changes in Little Leaguers may imply that the roentgenological changes of the medial epicondyle could be an adaptive yet physiological reaction to the excessive valgus stress of throwing. The higher incidence of medial epicondylar separation and fragmentation in catchers that has not been reported before may be secondary to the increased stress placed on the elbow when throwing from the squatting position.

Athletic Injuries↗
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

Assessment of shoulder proprioception in the female softball athlete.

BACKGROUND: There have been reports of overhand throwing athletes having decreased joint position sense in their dominant shoulder as compared with the nondominant shoulder. Very little research, however, exists concerning joint position sense in the female athlete. HYPOTHESIS: Female softball athletes have decreased joint position sense in their dominant shoulder as compared with their nondominant shoulder. STUDY DESIGN: Factorial design with investigation of multiple independent variables. METHODS: Joint position sense was assessed in 50 female softball players and 50 nonthrowing female athletes by using an inclinometer during four glenohumeral joint motions. Both the dominant and nondominant shoulders were assessed and error scores were calculated to describe joint position sense. Data were collected during the course of a fall semester and analyzed by using a mixed model analysis of variance with repeated measures on the dependent variable (error scores). RESULTS: A significant group by movement interaction was observed, with the softball athletes demonstrating significantly greater external rotation error scores than the nonthrowing athletes. CONCLUSION: We failed to reject the null hypothesis. Increased error scores (less joint position sense) were observed in both arms of subjects in the softball group. CLINICAL RELEVANCE: This study suggests that there is decreased shoulder proprioception in asymptomatic female athletes involved in overyhand throwing sports, which may predispose them to injury.

Adult↗
PubMedDate not supplied

The incidence of injuries in elite junior figure skaters.

BACKGROUND: There has been rapid growth in the technical and physiologic demands made on skaters who perform more and more difficult jumps, spins, lifts, throws, and free skating movements. PURPOSE: To investigate the frequency of injuries and overuse syndromes in elite junior skaters. STUDY DESIGN: Questionnaire. METHODS: During four consecutive Junior World Figure Skating Championships and the Croatia Cup, we interviewed 236 female and 233 male skaters by questionnaire to determine the frequency of injuries and overuse syndromes. RESULTS: Fifty-nine of the female skaters (25%) and 65 of the male skaters (27.9%) reported sustaining acute injuries; 101 female (42.8%) and 106 male (45.5%) skaters reported overuse syndromes. Low back pain was reported by 19 female and 23 male skaters. The most frequent acute injury was ankle sprain. In singles female skaters, the most frequent overuse injury was stress fracture (19.8%), followed by jumper's knee (14.9%). In singles male skaters, jumper's knee (16.1%) was the most frequent injury, followed by Osgood-Schlatter disease (14.2%). More than 50% of injuries in young singles figure skaters involved overuse syndromes. Pairs skaters and ice dance skaters had a higher risk of acute injury than overuse syndrome because of falls from lifts and throw jumps. CONCLUSIONS: Programs to improve postural alignment, flexibility, and strength, especially during the asynchronous period of bone and soft tissue development, should be instituted to prevent and reduce overuse syndromes.

Adolescent↗
PubMed2004

Humeral torque in professional baseball pitchers.

BACKGROUND: Spontaneous fracture of the humeral shaft in throwers is a rare but well-known phenomenon. Although it has been hypothesized that the biomechanics of the throw cause such fractures, it is not clear how or when the fractures occur in the pitching motion. METHODS: The torque acting about the long axis of the humerus was calculated in 25 professional baseball pitchers throwing in game situations. RESULTS: Peak humeral axial torque reached a mean value of 92 +/- 16 Nm near the time of maximum shoulder external rotation at the end of the cocking phase. This torque tended to externally rotate the distal end of the humerus relative to its proximal end. The direction of the torque was consistent with the external rotation spiral fractures of the humerus noted to occur in throwers. The magnitude of the peak humeral torque averaged 48% of the theoretical torsional strength of the humerus, suggesting that repetitive stress plays a role in humeral shaft fractures. CONCLUSIONS: Fractures are most likely to occur near the time of maximum shoulder external rotation when humeral torque peaks. Pitchers whose elbows were more extended at stride foot contact tended to have lower peak humeral torques.

Adult↗
PubMedDate not supplied

Prevalence of the Bennett lesion of the shoulder in major league pitchers.

BACKGROUND: The Bennett lesion is a mineralization of the posterior inferior glenoid noted in overhead throwing athletes. Although previous studies have debated appropriate treatment of the lesion, no studies have indicated the lesion prevalence in throwing athletes. HYPOTHESIS: The Bennett lesion is more common than previously believed and may represent an asymptomatic finding. STUDY DESIGN: Uncontrolled retrospective review. METHODS: Fifty-five asymptomatic major league pitchers underwent routine preseason radiographic screening. Radiographs were reviewed for the presence of a Bennett's lesion. Player demographics, pitching, and baseball records were reviewed to obtain the patient's dominant arm, age, years and innings pitched, and time on the disabled list or surgery. RESULTS: Twelve pitchers (22%) were noted to have a radiographic Bennett lesion. No statistically significant difference was noted in age, years pitched, or innings pitched between pitchers with and without a Bennett lesion. No player who demonstrated a Bennett lesion required surgical treatment for shoulder pain during his time with the club. Two players required time on the disabled list, but neither player had complaints of posterior shoulder pain. CONCLUSIONS: This lesion is a relatively common finding in major league pitchers. Concomitant pathology should be suspected when evaluating throwers with posterior shoulder pain and this lesion.

Adult↗
PubMed2004

Shoulder injuries to quarterbacks in the national football league.

BACKGROUND: Quarterbacks are at risk for shoulder injury secondary to both the throwing motion as well as from contact injury. OBJECTIVE: To delineate the incidence and etiology of shoulder injuries to quarterbacks in the National Football League (NFL). METHODS: Using the NFL Injury Surveillance System (NFLISS), all reported injuries to quarterbacks between 1980 and 2001 were identified. RESULTS: A total of 1534 quarterback injuries were identified with a mean of 18.8 and a median of 6.0 days of playing time lost. The majority of these injuries occurred during a game (83.8%). Passing plays were responsible for 77.4% of all quarterback-related injuries. Shoulder injuries were the second most common injury reported (233 or 15.2%), following closely behind head injuries (15.4%). Direct trauma was responsible for 82.3% of the injuries, with acromioclavicular joint sprains being the most common injury overall (40%). Overuse injuries were responsible for 14% of the injuries, the most common being rotator cuff tendinitis (6.1%) followed by biceps tendinitis (3.5%). CONCLUSION: In this review, the vast majority of shoulder injuries in quarterbacks occurred as a result of direct trauma (82.3%), and less than 15% were overuse injuries resulting from the actual throwing motion.

Adult↗
PubMed2005

Rotational motion changes in the glenohumeral joint of the adolescent/Little League baseball player.

BACKGROUND: Differences in range of motion and rotational motion between the dominant and nondominant shoulders in throwing athletes are well documented, although the age at which these changes begin to occur is not known. HYPOTHESIS: Changes in glenohumeral rotational motion in the shoulder of the Little League/adolescent baseball player occur during the most formative years of physical development. STUDY DESIGN: Cross-sectional study. METHODS: Elevation, internal rotation at 90 degrees of abduction, and external rotation at 90 degrees of abduction were measured in the dominant and nondominant shoulders of 294 baseball players, aged 8 to 16 years. RESULTS: Analysis of variance revealed 2-way interactions between arm dominance by age for elevation (P = .005) and internal rotation (P = .001). Significant differences were noted between dominant and nondominant arms for internal rotation at 90 degrees (P = .001) and external rotation at 90 degrees (P = .001). Elevation, internal rotation at 90 degrees , external rotation at 90 degrees , and total range of motion varied significantly (P = .001) among age groups. Elevation in the dominant arms of 16-year-olds was on average 5.3 degrees less than in 8-year-olds (179.6 degrees vs 174.3 degrees ). In the nondominant arms, mean elevation for 16-year-olds was 5.6 degrees less than in 8-year-olds (179.7 degrees vs 174.1 degrees ). Internal rotation at 90 degrees for the dominant arms averaged 39.0 degrees at age 8 and only 21.3 degrees at age 16. In the non-dominant arms, internal rotation for 8-year-olds averaged 42.2 degrees and only 33.1 degrees for 16-year-olds. CONCLUSIONS: Elevation and total range of motion decreased as age increased. These changes may be consequences of both bone and soft tissue adaptation. The most dramatic decline in total range of motion was seen between the 13-year-olds and 14-year-olds, in the year before peak incidence of Little Leaguer's shoulder. This decrease in rotational motion may cause increased stress at the physis during throwing.

Adolescent↗
PubMed2006

Thermal capsulorrhaphy for the treatment of shoulder instability.

Thermal capsulorrhaphy has been used to treat many different types of shoulder instability, including multidirectional instability, unidirectional instability, and microinstability in overhead-throwing athletes. A device that delivers laser energy or radiofrequency energy to the capsule tissue causes the collagen to denature and the capsule to shrink. The optimal temperature to achieve the most shrinkage without causing necrosis of the tissue is between 65 degrees and 75 degrees centigrade. This treatment causes a significant decrease in mechanical stiffness for the first 2 weeks, and then, after the tissue undergoes active cellular repair from the surrounding uninjured tissue, the mechanical properties return to near normal by 12 weeks. If the thermal energy is applied in a grid pattern, then the tissue heals with more stiffness by 6 weeks. Clinical studies on thermal capsulorrhaphy for the treatment of multidirectional instability have shown a high rate of recurrent instability (12%-64%). The clinical studies on unidirectional instability showed much better recurrence rates (4%-25%), but because most of the patients also underwent concomitant Bankart repairs and superior labral anterior posterior lesion repairs, the efficacy of the thermal treatment cannot be ascertained. A randomized controlled trial would be needed to assess whether instability with Bankart lesions requires augmentation with thermal capsulorrhaphy. For the patients with microinstability who are overhead-throwing athletes, thermal capsulorrhaphy has shown varying results from a 97% rate of return to sports to a 62% rate of return to sports. Complications of this technique include temporary nerve injuries that usually involve the sensory branch of the axillary nerve and thermal necrosis of the capsule, which is rare.

Animals↗