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PubMed2006

A 10-yr study of smokeless tobacco use in a professional baseball organization.

PURPOSE: Professional baseball players frequently use smokeless tobacco and are at risk of oral leukoplakia. There are limited long-term data on current trends in tobacco use and resultant oral health in this high-risk group. The purpose of this study was to monitor the prevalence of smokeless tobacco use in a professional baseball organization over a 10-yr period, looking for changes in the patterns of use and resultant changes in the incidence of oral leukoplakia. METHODS: During 10 successive spring training camps (1991-2000), players and management personnel were surveyed on their use of smokeless tobacco. A detailed mouth examination of each participant was performed by an examiner blinded to the questionnaire results. The main outcome measures were trends in self-reported tobacco use and the presence of oral leukoplakia on examination. RESULTS: We performed 2266 mouth examinations on participants with a completed questionnaire, with the yearly sample size ranging from 190 to 259. The prevalence of smokeless tobacco use declined, falling from 41.1% in year 1 to 25.6% in year 10 (P=0.029). Tobacco use was strongly associated with the prevalence of oral leukoplakia. As the overall prevalence of smokeless tobacco use fell, the prevalence of oral leukoplakia in the entire population declined; falling from 22.6% of all participants in year 1 to only 9.4% in year 10 (P<0.001). CONCLUSIONS: The prevalence of smokeless tobacco use showed a steady decline in this professional baseball organization over the 10 yr of the study, with a concomitant decline in the prevalence of oral leukoplakia in this population. We postulate that changes in league rules regarding tobacco use and regular education and support for tobacco cessation might explain the declining use.

Baseball↗
PubMed1998

[A study of the effects of physical load on umpires during the national high school baseball games--the effects of physical load on umpires at the Koshien stadium in a summer-heat environment].

This study attempted to measure the physical load on national high school baseball umpires during games played at Koshien stadium under extremely hot and humid conditions in the summer. Thirty-one umpires participated in this study. Thirteen of them were evaluated twice while eighteen were evaluated only once. The factors used to determine physical load were the following: body weight, oral temperature, blood pressure, heart rate, and serum biochemical elements. These were measured before and after the games. Heart rate was measured at one-minute intervals. The results were as follows. 1) All the games were played under conditions of extremely high temperatures--32.1 degrees celsius dry-bulb, 27.0 degrees celsius wet-bulb, 36.8 degrees celsius black-globe, 29.5 degrees--WBGT which are likely to cause heat-related illnesses. 2) The physical load of baseball umpires during the game showed a 1.69 percent decrease in average body weight due to perspiration, a 0.43 degrees C increase in oral temperature and an increase in heart rate. An examination of the serum biochemical elements showed that muscle deviation enzymes changed due to muscular activity and blood condensed due to perspiration. The physical load levels of baseball umpires were influenced by extreme heat and physical activity during the game. 3) There were no observable differences in either the amount of physical activity or the extreme heat environment among the umpires of different field positions. But the chief umpire's physical load showed a greater decrease in body weight, more blood condensation due to perspiration as a result of the heavier equipment he wore, more muscular activity and higher energy consumption than his counterparts on the bases. 4) The umpire's heart rates were higher during games than before games. The moment they were on the playing field. Their heart rates rose to an average of 134. It remained above 115 for about two hours, apparently caused by physical activity and heart load.

Adult↗
PubMed2004

The relationship between balance and pitching error in college baseball pitchers.

The objective of the study was to examine the relationship between balance and pitching error in college baseball pitchers. Sixteen college baseball pitchers, 9 National Association of Intercollegiate Athletics (NAIA) and 7 National Collegiate Athletic Association (NCAA) Division III, participated in the study. Balance ability, expressed as average sway velocity (deg.s(-1)), during dominant leg unilateral stance with eyes open and eyes closed was quantified for each subject utilizing the Balance Master System 7.04 (long force plate). Additionally, each subject underwent sensory organization testing on the SMART EquiTest System providing information regarding the effective use of the somatosensory, visual, and vestibular inputs. Pitching error was assessed with a high-speed video camera recorder during spring practice. A JUGS radar gun measured pitch velocity. The mean pitching error was 37.50 cm with a mean pitch velocity of 78 miles.h(-1) (35 m.s(-1)). No significant correlation was demonstrated between unilateral stance eyes open and pitching error (r = -0.24; p = 0.36) or unilateral stance eyes closed and pitching error (r = -0.29; p = 0.27). A significant negative correlation was demonstrated between sensory organization test 5 and pitching error (r = -0.50; p = 0.05) and between sensory organization test 5/1 and pitching error (r = -0.50; p = 0.05). Additionally, unilateral stance eyes closed demonstrated a positive correlation with pitch velocity (r = 0.52; p = 0.04). The results reveal that low levels of vestibular input utilization may lead to high levels of pitching error in college baseball pitchers.

Adolescent↗
PubMed2006

Effect of wrist and forearm training on linear bat-end, center of percussion, and hand velocities and on time to ball contact of high school baseball players.

This study examined the effects of 12 weeks of wrist and forearm training on linear bat-end velocity (BV), center of percussion velocity (CV), hand velocity (HV), and time to ball contact of high school baseball players. Forty-three baseball players were randomly assigned by a stratified sampling technique to 1 of 2 training groups. Group 1 (n = 23) and group 2 (n = 20) performed the same full-body resistance exercises while training 3 days a week for 12 weeks according to a stepwise periodized model. Group 2 also performed wrist and forearm exercises 3 days a week for 12 weeks. Wrist and forearm strength were measured pre- and posttraining. Linear BV, CV, HV, and time to ball contact were recorded pre- and posttraining by a motion-capture system. A 3 repetition maximum (RM) parallel squat and bench press were measured at baseline and after 4, 8, and 12 weeks of training. Both groups showed statistically significant increases (p < or = 0.01) in linear BV, CV, and HV (m.s(-1) +/- SD) after 12 weeks of training; however, there were no differences between the 2 groups. Both groups statistically increased wrist and forearm strength (p < or = 0.05). Group 2 had statistically greater increases (p < or = 0.05) in 10 of 12 wrist and forearm strength measures than did group 1. Both groups made statistically significant increases in predicted 1RM parallel squat and bench press after 4, 8, and 12 weeks of training; however, there were no differences between groups. These data indicate that a 12-week stepwise periodized training program can significantly increase wrist and forearm strength, linear BV, CV, and HV among high school baseball players. However, increased wrist and forearm strength did not contribute to further increases in linear BV, CV, or HV.

Adolescent↗
PubMed2004

Relation of handedness with season of birth of professional baseball players revisited.

We reexamined the relationship between month and season of birth and handedness in male professional baseball players listed in Lahman's Baseball Archive Vol. 4.5 database. The sample of 8,016 individuals (left-handed = 1,658; right-handed = 6,358) played major league baseball between 1900-2001. A slightly higher, but statistically significant, percentage of left-handed players were born in June compared to other months, and in the winter-spring months, but we were unable to corroborate Rogerson's spring and early summer categorization of handedness as related to birth season. The data did not support the hypothesis that the prevalence of left-handedness is related to season of birth.

Baseball↗
PubMed2000

Assessment of shoulder strength in professional baseball pitchers.

STUDY DESIGN: A bilateral comparison of strength and range of motion testing in professional baseball pitchers. OBJECTIVE: We studied 39 professional male baseball pitchers to determine if the shoulder used for throwing was weaker or had less passive range of motion, compared to the nondominant arm. BACKGROUND: Shoulder muscle weakness has been proposed as a possible risk factor for developing injury. Therefore, objective quantification of the strength of glenohumeral and scapular rotator muscle groups should be studied in a population of professional baseball pitchers. METHODS AND MEASURES: Passive internal and external range of motion was bilaterally measured at 90 degrees of abduction. Muscle strength of the following muscles was measured bilaterally with a hand-held dynamometer: external and internal glenohumeral rotators, supraspinatus, middle trapezius, lower trapezius, and serratus anterior. RESULTS: Passive external rotation of the glenohumeral joint at 90 degrees of abduction on the pitching side was significantly greater than on the nonpitching side. Passive internal rotation range of motion on the nonpitching side was significantly greater than on the pitching side. The pitching arm's internal rotators, when tested in abduction, were significantly stronger than the nonpitching arm. The nonpitching arm's external rotators in the plane of the scapula, and in abduction, were significantly greater than those of the pitching arm. The pitching arm's middle and lower trapezius muscles were significantly stronger than those of the nonpitching arm. CONCLUSION: The range of motion and strength characteristics measured in this study can assist clinicians in evaluating athletes who use overhead throwing motions.

Adolescent↗
PubMed1998

EMG analysis of the lower extremities during pitching in high-school baseball.

I evaluated the contractions of the muscles of the lower extremities during baseball pitching using video imaging and simultaneous surface EMG. The subjects were 10 members of a high school baseball club and, for contrast, 10 students without any baseball club experience. I divided their pitching movements into two phases determined with respect to the landing of the non-pivot leg. The EMG signal intensities over the 2 seconds prior to landing, and over the 2 seconds after landing, were then integrated to give an EMG value to each phase. I then computed this value as the % MMT. The abductor and adductor of the hip muscles of both lower extremities in the players were strongly contracted, especially the adductor. This finding was consistent with the observation that pitching tends to lead to adductor muscle disorders. Strengthening the adductor and its antagonist abductor can therefore directly influence the capability for pitching, and can reduce the risk for the adductor disorders.

Adolescent↗
PubMed2003

The effects of various therapeutic measures on shoulder strength and muscle soreness after baseball pitching.

AIM: This study was intended as an investigation of the effects of various therapeutic measures on the shoulder strength and muscle soreness after baseball pitching. METHODS EXPERIMENTAL DESIGN: participants threw 98 pitches in a simulated single game. The mode of the therapeutic measures after pitching were classified into 4 groups; the control group (CON), the ice treatment group (IT), the light shoulder exercise group (LSE) and the ice treatment with LSE group (ILSE). Each therapeutic measure was applied to the dominant shoulder immediately after pitching. PARTICIPANTS: 7 healthy, skilled baseball pitchers. MEASURES: both shoulder strength and muscle soreness were measured before pitching, immediately after pitching (Post-P), at the time of the therapeutic measure (Post-TM), and 24 hours after pitching (Post-24 h). RESULTS: All 4 groups showed shoulder strength losses in shoulder abduction, internal/external rotation with no shoulder abduction or with the shoulder abducted to 90 degrees immediately after pitching. ILSE had greater recovery from Post-P values at Post-TM or Post-24 h than the other methods in all 5 shoulder strengths. On the other hand, the soreness in shoulder internal rotation was increased significantly from Post-P and continued by Post-24 h. Both IT and ILSE had beneficial effects on reducing the shoulder muscle soreness at Post-TM or Post-24 h. CONCLUSION: The findings of this study suggested that ILSE was the optimal therapeutic measure against decreased shoulder strength or increased shoulder muscle soreness resulting from the repetitive baseball pitching.

Adult↗
PubMed2003

Evaluation of the peak torque, total work, average power of flexor-estensor and prono-supinator muscles of the elbow in baseball players.

The Authors, after a short analysis on biomechanics of the elbow during throwing in baseball, show the movements of the elbow during the different phases of the throw and the stabilizing action of the ulnar collateral ligament, flexor-pronator muscles of the wrist, anconeus and brachial triceps muscles. Aim of this study is the evaluation of the peak torque, total work and average power of the flexor-extensor and pronator-supinator muscles of the elbows in professional baseball players. Isokinetic test data show that a mayor peak torque in flexo-extension at power and resistance test in the pitchers compared to the strikers. Whereas the strikers show a higher peak torque in pronation at the resistance test. This may happen because during a baseball match the ball is hit many times by the bat and the pronator muscle of the wrist are notably stimulated and reinforced.

Adult↗
PubMed2003

Magnetic resonance imaging of the rotator cuff muscles after baseball pitching.

AIM: The purposes of present study were to investigate quantitatively using functional MR imaging the effect of a series of throwing activities on rotator cuff muscles and to compare the effect of pitching with that of all-out shoulder external rotator exercise as the targeted external rotator muscle group (the infraspinatus and the teres minor). METHODS EXPERIMENTAL DESIGN: MRI measurements after 135 baseball pitches or all-out shoulder external rotator exercise (concentric mode) in each subject's nondominant shoulder. PARTICIPANTS: 6 amateur baseball pitchers. MEASURES: serial T2-weighted images of rotator cuff muscles were obtained before pitching (or shoulder exercise) and immediately, 30, 60 min, 24, 48, 96 hrs after pitching (or shoulder exercise). T2 relaxation times (T2) at each measurement time were calculated for the rotator cuff muscles. RESULTS: Both the supraspinatus and the external rotator muscle group showed significant T2 elevations until 96 hrs after pitching. The subscapularis also showed significantly increased T2 until postpitching 48 hrs. On the other hand, a significant T2 elevation continued until 60 min after shoulder exercise, but thereafter returned towards the value at rest over the next 24 hrs. CONCLUSION: Long lasting T2 elevations in rotator cuff muscles would be associated with an increase in each intramuscular water content, and may be attributed to the muscle damage that resulted from eccentric contraction during pitching. This information should serve as a useful complement to shoulder injury prevention for baseball pitchers.

Adult↗
PubMed1992

Smokeless tobacco use and oral pathology in a professional baseball organization.

BACKGROUND: Smokeless tobacco has been implicated as a risk factor for numerous oral conditions. Since baseball players are known to have a high incidence of smokeless tobacco use, they are an excellent group in which to study the effects of smokeless tobacco on the oral cavity. We report our findings in 206 of 220 eligible men during spring training of a professional baseball organization. Major and minor league ballplayers, coaches, and management personnel were included. METHODS: Participants completed a 2-page, 23-item questionnaire on smokeless tobacco use. This was followed by a detailed examination for oral leukoplakia, periodontal disease, and dental caries performed by a physician who was blinded to the results of the questionnaire. Oral leukoplakia was graded I, II, or III according to severity. RESULTS: Eighty-eight of 206 participants (42.7%) reported current use of smokeless tobacco; 62 of these men used smokeless tobacco year round, while 26 used smokeless tobacco only during the baseball season. The 88 smokeless tobacco users often used more than one form of tobacco. Moist snuff was the most common form (73.9% of users) followed by loose leaf tobacco (53.4%) and plug tobacco (9.1%). Oral leukoplakia was found in 25 of 88 current users (28.4%). Only the year-round users, however, had an incidence rate (37.1%) that was significantly different from all others (odds ratio = 9.35, 95% CI = 3.46 to 26.21). Year-round users were also more likely to have a higher grade of oral leukoplakia. Periodontal disease and dental caries were no more prevalent among smokeless tobacco users than nonusers. CONCLUSIONS: We conclude that the use of smokeless tobacco products is a significant risk factor for the development of oral leukoplakia, and that this risk is greatest in those individuals who use smokeless tobacco continuously throughout the year.

Adolescent↗
PubMed2006

Magnetic resonance imaging evaluation of the ulnar collateral ligament in young baseball pitchers less than 18 years of age.

INTRODUCTION: It has been shown that the asymptomatic, dominant elbow of professional baseball pitchers can demonstrate magnetic resonance (MR) imaging signal abnormalities of the ulnar collateral ligament (UCL) consistent with a strain. The purpose of this study was to determine if younger, asymptomatic, adolescent baseball pitchers exhibit similar signal abnormalities in the UCL. METHODS: Magnetic resonance images of both elbows of 14 asymptomatic, young male baseball pitchers (ranging in age from 12 to 20 years) were performed on an outpatient basis using a 1.5-T Sigma MRI unit with a dedicated extremity coil to obtain T1 and T2 coronal and axial images which were subsequently evaluated by a musculoskeletal radiologist. Chronic tears of the UCL were suspected if the signal was attenuated or absent. Magnetic resonance images of the UCL were also evaluated for high-intensity signal or thinning. Morphologic changes such as complete tears, avulsions or thickening were identified. The images were classified into 4 grades from 0 to 3 depending on the degree of signal abnormality. RESULTS: No discrete tears were found in any of the subjects. For the dominant pitching arm, 4 of 14 subjects had increased thickness of the ulnar collateral ligament, 3 of 14 demonstrated Grade 1 changes, and 11 of 14 demonstrated no abnormal signal within the ligament. No focal tears were present in any of the subjects. Contralateral elbows in 13 of 14 patients demonstrated Grade 0 signals with 1 patient demonstrating morphological thickening of the ligament without increased signal. DISCUSSION: Signal abnormalities in the throwing elbow of asymptomatic, adolescent pitchers were uncommon. These pitchers may not have experienced sufficient pitching time to develop changes in the UCL.

Adolescent↗
PubMed1996

Baseball injuries: a Little League survey.

OBJECTIVES: To determine the patterns of injury in youth baseball and apply the data to estimate the value of proposed safety equipment. DESIGN: Prospective population-based injury survey. PARTICIPANTS: 2861 Little League baseball players (ages 7 to 18) for 140 932 player-hours. MEASUREMENTS: An injury was included in the data only if it was serious enough to require medical/dental care, caused missing a game, or disallowed playing a certain position. The injuries were subdivided into acute or overuse. The acute injuries were classified as either catastrophic, severe, or minor. Injuries were categorized according to mechanism, area injured, and whether the player was on offense or defense. RESULTS: There were 81 total injuries, of which 66 (81%) were acute and 15 (19%) were overuse. Of the acute injuries, 11 were severe and 55 were minor. The overall injury rate was .057 injuries per 100 player-hours. The severe injury rate was .008 injuries per 100 player-hours, of which 46% were ball-related injuries and 27% were collisions. The most frequent mechanism of injury was being hit by the ball, which represented 62% of the acute injuries. Of the 41 ball-related injuries, 28 (68%) occurred to players on defense. Of the 18 ball-related facial injuries, 16 occurred to players on defense. CONCLUSIONS: 1) Little League baseball is a safe activity with a low injury rate and a particularly low rate of severe injury; 2) impact by the ball causes more than half the acute injuries, thus safety interventions should be directed towards decreasing these injuries, especially on defense; and 3) facemasks on batters can safely eliminate facial injuries to offensive players, but would only moderately reduce the incidence of ball-related facial injuries as most of these injuries are sustained by defensive players.

Acute Disease↗
PubMed1998

Major review: ocular sighting dominance: a review and a study of athletic proficiency and eye-hand dominance in a collegiate baseball team.

PURPOSE REVIEW: Laterality preference in sensory and motor functions of symmetrically disposed organisms have been studied for centuries. The relation between handedness and the eyes and vision (ocular sighting dominance) has been a focal point despite their physiologic dissimilarity. STUDY: To examine a college varsity baseball team for handedness and ocular sighting dominance to determine if their patterns of eye-hand dominance differed from the normal population and/or contributed to their individual relative success compared to their peers. Specifically: whether crossed eye- hand dominance favors the batter and uncrossed eye-hand dominance favors the pitcher. SUBJECTS AND METHODS: Twenty five UF varsity players were examined. All were male. Their visual acuity, stereoscopic vision, ocular motility and ocular sighting dominance were determined, the last by a pointing test which allowed the diagnosis of a central form of ocular dominance, but was not per se affected by handedness. Handedness was determined by preferred arm for throwing or hitting. No subject was ambidextrous. A control population was established consisting of the first 100 consecutive adults seen by the first author in the UF Eye Center with 20/20 vision O.U. and a normal eye exam. RESULTS: The control group displayed eye-hand dominance patterns similar to those previously reported in the literature for the general population. In the experimental group of baseball players, the incidence of conventionally predominant (in normals) ipsilateral or uncrossed eye-hand dominance was much lower (39%) than the normal control population (65%). The incidence of contralateral or crossed eye- hand dominance was 35%, twice that of the normal control population (18%) (p<0.01). The incidence of central ocular dominance with right or left handedness was 26% or 50% higher than a normal control population (17%) (p<0.25). With regard to individual performance, those players with central ocular dominance, whether right or left handed, were the most successful players in both pitching and batting. Pitchers who were uncrossed eye-hand dominant were distinctly more successful than crossed. Batters who were crossed eye-hand dominant were slightly more successful than uncrossed. CONCLUSIONS: The pattern of eye-hand dominance appears related to athletic proficiency for baseball. Warning: Note well: This information may be useful in career guidance but does not justify or medically indicate attempts to alter ocular sighting dominance or eye-hand dominance patterns as these are determined probably genetically or at such an early age that they cannot be successfully altered later. Attempts to so alter them are historically fraught with irremediable psychological or physical injury to the subject, including permanent incapacitating double vision.

Adult↗
PubMed2005

Cluster-Randomized Controlled Trial of An Athletic Trainer-Directed Spit (Smokeless) Tobacco Intervention for Collegiate Baseball Athletes: Results After 1 Year.

Context: Athletes in the United States are at high risk for using spit (smokeless) tobacco (ST) and incurring its associated adverse health effects.Objective: To examine whether an athletic trainer-directed ST intervention could decrease initiation and promote cessation of ST use among male collegiate baseball athletes.Design: Stratified, cluster-randomized controlled trial.Setting: Fifty-two California colleges.Patients or Other Participant(s): A total of 883 subjects in 27 intervention colleges and 702 subjects in 25 control colleges participated, as did 48 certified athletic trainers.Intervention(s): For college athletic trainers and associated dental professionals, a 3-hour video conference, and for collegiate athletes, an oral cancer screening with feedback and brief counseling during the preseason health screenings, athletic trainer support for cessation, and a peer-led educational baseball team meeting.Main Outcome Measure(s): The subjects' ST use over 1 year was assessed by self-report. At the end of the study, the certified athletic trainers were mailed a survey assessing their tobacco use and perceptions and behavior related to tobacco control in the athletic environment. We used multivariable logistic regression models for clustered responses (generalized estimating equations) to test the difference between groups in ST-use initiation and cessation and to identify significant overall predictors of noninitiation and cessation of ST use.Results: Of the 1585 athletes recruited, 1248 (78.7%) were followed up at 12 months. In addition, 48 of the 52 athletic trainers (92%) responded to the 1-year follow-up survey. The ST-use initiation (incidence) was 5.1% in intervention colleges and 8.4% in control colleges (generalized estimating equation odds ratio = 0.58, 95% confidence interval = 0.35-0.99). Predictors of ST noninitiation were low lifetime tobacco and monthly alcohol use (odds ratio = 1.98, 95% confidence interval = 1.40- 2.82) and athletic trainers' report that the baseball coach supported ST-use prevention activities (odds ratio = 1.43, 95% confidence interval = 1.11-1.83). Although at 1 year, cessation of ST use was relatively high in both groups (36%), we noted no significant difference between the groups (odd ratio = 0.94, 95% confidence interval = 0.70-1.27).Conclusions: The intervention was significantly effective in preventing incident ST use but did not significantly increase cessation beyond that seen in the control group. The latter finding is inconsistent with previous studies and may be explained by spillover of the intervention to control colleges, other anti-tobacco activity in control colleges, and/or the small sample of dependent ST users enrolled in the study.

Journal Article↗
PubMed1999

Traumatic hyphema in an intercollegiate baseball player: a case report.

OBJECTIVE: To present the case of a collegiate baseball player struck in the right eye. BACKGROUND: While attempting a bunt, a 20-year-old collegiate baseball player was hit in the right eye when the ball was deflected off the bat. The athlete bled from the nose, and the right eye swelled shut from eyelid edema. Initial nasal hemorrhage was controlled, and the athlete was referred to the emergency room for further care due to pain in the inferior orbit. DIFFERENTIAL DIAGNOSIS: Eyelid contusion, traumatic iritis, or traumatic microhyphema to the right eye secondary to blunt trauma. TREATMENT: Immediate treatment consisted of controlling the nasal bleeding with sterile gauze pads. Because of palpable tenderness over the inferior orbit, the athlete was immediately transported to the emergency room. UNIQUENESS: Hyphema is one of the most common sport-related eye injuries: the incidence is 12.2 cases per 100,000 population, with approximately 37% resulting from sports injury. Racquet sports, baseball, and softball account for more than half of all hyphema injuries in athletics. Individuals with traumatic hyphema rarely require surgery; however, proper initial care, treatment, and referral are imperative to a good prognosis. CONCLUSIONS: Athletic trainers need to be able to recognize the signs and symptoms of hyphema and seek medical evaluation immediately in order to avoid secondary complications. With proper recognition, initial care and referral, and appropriate, well-fitted protective eyewear as needed, hyphema can have minimal complications, and the athlete may be able to compete again within 1 to 2 weeks.

Journal Article↗
PubMedDate not supplied

Glenohumeral joint laxity and stiffness in the functional throwing position of high school baseball pitchers.

CONTEXT: Repetitive overhead throwing has been theorized to result in chronic adaptations to the capsuloligamentous restraints of the glenohumeral joint. OBJECTIVE: To compare glenohumeral joint laxity and stiffness between the throwing and nonthrowing shoulders of high school baseball pitchers. DESIGN: Repeated measures. SETTING: High school athletic training facilities. PATIENTS OR OTHER PARTICIPANTS: Twenty-two asymptomatic high school baseball pitchers (age = 16.50 +/- 0.74 years, height = 178.51 +/- 7.66 cm, mass = 75.43 +/- 13.24 kg) from a sample of convenience. MAIN OUTCOMES MEASURE(S): We used computerized stress arthrometry to measure glenohumeral joint laxity and stiffness. Anterior glenohumeral joint laxity and stiffness measures were obtained with the shoulder in 90 degrees of abduction and both neutral rotation and 90 degrees of external rotation. Posterior laxity and stiffness measures were obtained with the shoulder in 90 degrees of abduction and neutral rotation. RESULTS: No clinically significant differences were found for glenohumeral laxity or stiffness between sides. However, a statistically significant main effect for position was present for both laxity and stiffness. Anterior glenohumeral joint laxity in the 90 degrees external rotation position was significantly decreased and stiffness was increased in this position compared with the anterior at neutral and posterior at neutral positions. CONCLUSIONS: Glenohumeral joint laxity decreases and stiffness increases in the functional throwing position of 90 degrees of abduction and 90 degrees of external rotation. No clinically significant side-to-side differences or directional differences were found in high school baseball pitchers.

Journal Article↗
PubMed2003

Role of radiofrequency denervation in lumbar zygapophyseal joint synovitis in baseball pitchers: a clinical experience.

Lumbar zygapophyseal joints have long been considered a source of low back pain with or without leg pain. The objective of this prospective study was to investigate the therapeutic effectiveness of lumbar zygapophyseal joint radiofrequency denervation (RFD) followed by physical therapy, for the treatment of refractory lumbar zygapophyseal joint mediated low back pain secondary to lumbar zygapophyseal joint synovitis, in baseball pitchers. Participants included twelve male baseball pitchers with a diagnosis of lumbar zygapophyseal joint synovitis mediated low back pain and a subsequent difficulty in pitching. These athletes underwent a trial of treatment, including oral anti-inflammatory medication, physical therapy, osteopathic manipulations, and fluoroscopically guided intra-articular zygapophyseal joint injection utilizing steroid and local anesthetic agent. Failure to progress led to these athletes receiving percutaneous, fluoroscopically-guided, radiofrequency denervation of the bilateral L 4-L5 and L5-S1 zygapophyseal joints. A good response to a diagnostic medial branch block was a prerequisite for RFD treatment. In all cases, the medial branch above and below the involved level was treated. Post procedure, all athletes participated in a phased physical therapy program followed by a progressive return to pitching. Success was defined as the ability to return to pre-procedure level of baseball pitching combined with greater than 50% low back pain reduction. Pre- and post-RFD, Visual Analog (Numeric) Scale (VAS) and Roland-Morris (R-M) tests were administered. Ten out of 12 (83%) athletes were able to return to pitching at a level attained prior to RFD. All 12 patients, experienced statistically significant low back pain relief, with a mean pre-RFD VAS of 8.4; mean post-RFD VAS of 1.7; mean pre-RFD R-M score of 12.3; and mean post-RFD R-M score of 22.3. In conclusion, athletes, experiencing lumbar zygapophyseal joint mediated low back pain secondary to zygapophyseal joint synovitis and have failed more conservative management may benefit from radiofrequency zygapophyseal joint denervation followed by a formal rehabilitation program.

Journal Article↗