The Role of Humeral Torsion on Glenohumeral Rotation in Injured Baseball Players.

Background: Differences in rotational range of motion (ROM) compared to humeral retrotorsion (HRT)-corrected rotational ROM exist in healthy baseball athletes, but it is unclear whether these differences exist in a pathological population.

Purpose/hypothesis: The purpose of this study was to determine if there are disparities between objectively measured differences in ROM and HRT-corrected deficits in injured baseball players. It was hypothesized that disparities would exist between (1) the side-to-side difference in glenohumeral external rotation (GER) and the HRT-corrected glenohumeral external rotation deficit (GERD) and (2) the side-to-side difference in glenohumeral internal rotation (GIR) and the HRT-corrected glenohumeral internal rotation deficit (GIRD).

A narrative review of little league shoulder: proximal humeral physis widening is only one piece of the puzzle, it is time to consider posterior glenoid dysplasia.

Baseball athletes across all levels of play are at an increased risk for upper extremity injury due to the supraphysiologic demands on the shoulder and elbow during overhead throwing. Little league baseball players present with a unique subset of injuries that can affect the growth plate, commonly at the shoulder or the elbow. Ascertaining a diagnosis and plan of care for little league shoulder (LLS) historically focuses on the proximal humeral physis in skeletally immature throwing athletes presenting with shoulder pain.

Return to Sport and Clinical Outcomes Following Osteochondral Autograft Transplantation in Baseball Players and Gymnasts With Unstable Osteochondritis Dissecans: A Critically Appraised Topic.

Clinical Scenario: Osteochondritis dissecans (OCD) of the capitellum is a condition occurring at the elbow and often seen in both baseball players and gymnasts due to the repetitive loading of the radiocapitellar joint. Treatment options for OCD vary and are dependent on lesion presentation, elbow motion, and growth plate maturity. OCD lesions categorized as unstable can be treated with an osteochondral autograft transplantation surgery (OATS).

Dynamic Posterior Instability Test: A New Test for Posterior Glenohumeral Instability.

Background: Recurrent posterior shoulder instability has become an increasingly recognized cause of shoulder disability, especially among athletes. The presentation can be vague and therefore its clinical diagnosis is often overlooked. Few diagnostic tests exist and these tests are difficult to perform in an anxious and apprehensive patient.

Hypertrophy of the sublime tubercle in elbow ulnar collateral ligament injuries: a case series of baseball pitchers undergoing ulnar collateral ligament reconstruction with short-term follow-up.

Background: The ulnar collateral ligament (UCL) of the elbow is subject to repetitive stress in overhead throwing athletes. This can lead to morphologic changes at the bony attachments of the UCL and hypertrophy of the sublime tubercle. The purpose of this case series is to describe the surgical details and clinical outcomes of a series of competitive baseball pitchers with hypertrophic sublime tubercles who underwent UCL reconstruction (UCLR).

Differences in Shoulder Internal Rotation Strength Between Baseball Players With Ulnar Collateral Ligament Reconstruction and Healthy Controls.

Background: Studies have indicated decreased shoulder internal rotation (IR) and external rotation (ER) strength in the throwing limb of baseball players after ulnar collateral ligament injury. There is limited evidence on the recovery of shoulder rotation strength after primary ulnar collateral ligament reconstruction (UCLR).

Hypothesis: At the time of return to throwing, baseball players who underwent UCLR would demonstrate decreased IR and ER shoulder strength in the throwing arm as compared with healthy baseball players.

Differences in Passive Shoulder Range of Motion Between Baseball Players With Neurogenic Thoracic Outlet Syndrome and Matched Healthy Controls.

Background: Neurogenic thoracic outlet syndrome (nTOS) is becoming more recognized as a diagnosis in the throwing athlete. Currently, there is limited information on the clinical presentation and development of nTOS in baseball players.

Purpose: To compare passive shoulder range of motion (ROM) and anatomic humeral retrotorsion (HRT) of baseball players diagnosed with nTOS with a group of healthy, matched controls.

Effect of Younger Starting Pitching Age on Humeral Retrotorsion in Baseball Pitchers With an Ulnar Collateral Ligament Injury.

Background: Increased humeral retrotorsion (HRT) has been found to be a risk factor for ulnar collateral ligament (UCL) tears in baseball players. Recent work has demonstrated the age of 11 years as a potential watershed age for HRT development.

Hypothesis: In a group of baseball pitchers with UCL injuries, athletes who started pitching before the age of 10 years will demonstrate significantly more dominant limb humeral retrotorsion (DHRT) when compared with a group of baseball pitchers who reported starting pitching at 10 years or older.

Traumatic Elbow Instability: How to Fix It and When to Phone a Friend.

Traumatic elbow instability is a difficult condition to manage. Many surgeons consider the elbow a perplexing black box and evaluating damaged structures in the setting of pain and swelling a diagnostic challenge. Injury most commonly occurs from a fall onto an outstretched hand but also results from elbow dislocation, direct trauma, and sporting activities.

RESIDENTS CASE REPORT: MUSCULOCUTANEOUS NERVE INJURY IN A COLLEGIATE BASEBALL PITCHER.

Background: Literature regarding musculocutaneous nerve injuries among the athletic population is scarce, with only several reported clinical cases among baseball and softball pitchers.

Purpose: To present a unique case of a musculocutaneous nerve injury to aid in clinician awareness and propose innovative rehabilitation practices that may facilitate improved patient outcomes during recovery.

Case Description: A 23-year-old Division 1 NCAA collegiate baseball pitcher presented with vague anterior arm pain following a pre-season game.

Gravitational Test beyond the First Post-Newtonian Order with the Shadow of the M87 Black Hole.

The 2017 Event Horizon Telescope (EHT) observations of the central source in M87 have led to the first measurement of the size of a black-hole shadow. This observation offers a new and clean gravitational test of the black-hole metric in the strong-field regime. We show analytically that spacetimes that deviate from the Kerr metric but satisfy weak-field tests can lead to large deviations in the predicted black-hole shadows that are inconsistent with even the current EHT measurements.

BASEBALL PLAYERS DIAGNOSED WITH ULNAR COLLATERAL LIGAMENT TEARS DEMONSTRATE GREATER SIDE TO SIDE DIFFERENCES IN PASSIVE GLENOHUMERAL ABDUCTION RANGE OF MOTION COMPARED TO HEALTHY CONTROLS.

Background: Numerous studies have shown that baseball players develop range of motion adaptations in their throwing arm. While some of these shoulder range of motion adaptations can lead to greater throwing velocity, excessive changes in shoulder range of motion can increase the risk of injury to the ulnar collateral ligament (UCL).

Purpose/hypotheses: The purpose of this study was to compare the passive GH-ABD ROM measures of baseball players with a diagnosed UCL tear (UCL group) to a group of age, activity, and position matched healthy controls (CONT group).

Correlation Among Y-Balance Test-Lower Quarter Composite Scores, Hip Musculoskeletal Characteristics, and Pitching Kinematics in NCAA Division I Baseball Pitchers.

Numerous studies have reported kinematic data on baseball pitchers using three-dimensional (3D) motion analysis, but no studies to date have correlated this data with clinical outcome measures. To examine the relationship among Y-Balance Test-Lower Quarter (YBT-LQ) composite scores, musculoskeletal characteristics of the hip, and pitching kinematics in National Collegiate Athletic Association (NCAA) Division I baseball pitchers. Cross-sectional.

The Relationship Between Humeral Retrotorsion and Shoulder Range of Motion in Baseball Players With an Ulnar Collateral Ligament Tear.

Background: Humeral retrotorsion has been investigated in relation to shoulder range of motion (ROM) in healthy baseball players. Currently, there is limited information on the osseous anatomy and development of ulnar collateral ligament (UCL) tears.

Purpose: To determine the relationship between humeral retrotorsion and shoulder ROM in baseball players with a UCL tear.

Baseball Players With an Ulnar Collateral Ligament Tear Display Increased Nondominant Arm Humeral Torsion Compared With Healthy Baseball Players.

Background: Previous work has suggested that an increase in the amount of developmentally acquired, dominant arm humeral retrotorsion (D HRT) in the thrower's shoulder may be a potentially protective mechanism. Although the relationship between HRT and shoulder injuries has been reported, the relationship between HRT and ulnar collateral ligament (UCL) tears in baseball players is not known.

Purpose: To determine whether D HRT and nondominant arm HRT (ND HRT) measurements in baseball players with a UCL tear differ statistically from a matched healthy cohort.

The Clinical Impact of Bicipital Tunnel Decompression During Long Head of the Biceps Tendon Surgery: A Systematic Review and Meta-analysis.

Purpose: (1) To identify existing outcomes studies and (2) to use meta-analysis techniques to summarize pooled clinical outcomes for surgical techniques that decompress the bicipital tunnel and those that do not, to identify important areas for future clinical investigation.

Methods: A systematic review of the PubMed database was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Patients were categorized into 2 groups for analysis.

Knee Extension Range of Motion at 4 Weeks Is Related to Knee Extension Loss at 12 Weeks After Anterior Cruciate Ligament Reconstruction.

Background: The anterior cruciate ligament (ACL) is commonly torn, and surgical reconstruction is often required to allow a patient to return to their prior level of activity. Avoiding range of motion (ROM) loss is a common goal, but little research has been done to identify when ROM loss becomes detrimental to a patient's future function.

Purpose: To determine whether there is a relationship between early knee side-to-side extension difference after ACL reconstruction and knee side-to-side extension difference at 12 weeks.

BASEBALL PLAYERS WITH ULNAR COLLATERAL LIGAMENT TEARS DEMONSTRATE DECREASED ROTATOR CUFF STRENGTH COMPARED TO HEALTHY CONTROLS.

Background: Ulnar Collateral Ligament (UCL) tears are common in baseball players. Alterations in rotator cuff strength are believed to be associated with injury to the shoulder and/or elbow in baseball players.

Hypothesis/purpose: Baseball players diagnosed with a UCL tear will demonstrate decreased internal (IR) and external rotation (ER) force as an indication of isometric muscular strength in the throwing arm compared to IR and ER force of the throwing arm in healthy baseball players.

Baseball players diagnosed with ulnar collateral ligament tears demonstrate decreased balance compared to healthy controls.

Study Design: Cross-sectional.

Objectives: To compare lower extremity balance and shoulder range of motion in baseball players with ulnar collateral ligament (UCL) tears to a healthy cohort. Background Throwing is a complex motion that requires balance and coordination to effectively transfer energy through the kinetic chain.

Shoulder range of motion deficits in baseball players with an ulnar collateral ligament tear.

Background: Shoulder range of motion (ROM) deficits are associated with elbow injury in baseball players.

Purpose: To compare the ROM characteristics of baseball players with a diagnosed ulnar collateral ligament (UCL) tear with those of a group of age-, activity-, and position-matched healthy controls.

Study Design: Cross-sectional study; Level of evidence, 3.

Elbow arthroscopy: valgus extension overload.

Valgus torque combined with deceleration produces high compression and shear forces acting on the posteromedial olecranon and the posteromedial trochlea. This valgus extension overload process may cause posteromedial trochlea chondromalacia, chondral flap formation, osteochondrosis, subchondral erosion, a subchondral insufficiency fracture, and marginal exostosis formation. Olecranon pathologies include proximal stress reaction, a posteromedial tip stress fracture, a transverse proximal process stress fracture, exostosis formation, exostosis fragmentation, and intra-articular loose bodies.

Distal semitendinosus ruptures in elite-level athletes: low success rates of nonoperative treatment.

Background: No case series of isolated complete rupture of the distal semitendinosus tendon have been reported previously.

Purpose: This study was undertaken to increase awareness and report the authors' treatment experience, particularly the less than favorable results of nonoperative initial treatment.

Study Design: Case series; Level of evidence, 4.

Clinical outcomes of the DANE TJ technique to treat ulnar collateral ligament insufficiency of the elbow.

Background: Many improvements in ulnar collateral ligament reconstruction have been made since Jobe et al first described the procedure. A novel elbow ulnar collateral ligament reconstruction technique that combines interference screw fixation on the ulna with docking of the graft on the humeral side (DANE TJ) has been reported.

Hypothesis: Outcomes of ulnar collateral ligament reconstructions performed with the DANE TJ technique are as good as other recently published results of ulnar collateral ligament reconstruction, particularly in cases of insufficient bone stock on the sublime tubercle and revision reconstructions.

PLRI: posterolateral rotatory instability of the elbow.

Recurrent and persistent instability of the elbow has long been a source of confusion and dismay for both patients and physicians. Early recognition after elbow injury and careful attention to soft tissue repair during lateral elbow surgery may diminish the incidence of this condition. Repair and reconstruction of the lateral ulnar collateral ligament (LUCL) now offers practical and often successful solutions for patients with posterolateral rotatory instability (PLRI) of the elbow.