Effect of High School Showcase Exposures and Timing of Ulnar Collateral Ligament Tear on Professional Baseball Careers in Elite Pitchers.

Background: Showcase participation has been considered a risk factor for elbow injuries. It remains unclear whether high school (HS) showcase volume negatively affects pitchers' career paths. Because pitchers are achieving 90 mph thresholds at younger ages, it is unknown whether shorter time intervals between achieving 90 mph thresholds and dates of ulnar collateral ligament reconstruction (UCL-R), known as time to tear (TTT), may affect career trajectory.

Ulnar Collateral Ligament Tear in Elite Baseball Pitchers: Are High School Showcase Exposures Associated With Injury?

Background: Ulnar collateral ligament reconstruction (UCLR) surgeries have increased significantly in amateur and professional baseball pitchers. Although showcase participation has been considered an injury risk factor, limited data are available to corroborate this association.

Hypothesis: Elite pitchers achieving fastball velocities ≥90, ≥92, and ≥95 mph at younger ages would be more likely to undergo UCLR earlier in their careers compared with pitchers not achieving these velocity thresholds at younger ages.

Design Features and Rationale of the BEAR-MOON (Bridge-Enhanced ACL Restoration Multicenter Orthopaedic Outcomes Network) Randomized Clinical Trial.

Background: BEAR (bridge-enhanced anterior cruciate ligament [ACL] restoration), a paradigm-shifting technology to heal midsubstance ACL tears, has been demonstrated to be effective in a single-center 2:1 randomized controlled trial (RCT) versus hamstring ACL reconstruction. Widespread dissemination of BEAR into clinical practice should also be informed by a multicenter RCT to demonstrate exportability and compare efficacy with bone--patellar tendon-bone (BPTB) ACL reconstruction, another clinically standard treatment.

Purpose: To present the design and initial preparation of a multicenter RCT of BEAR versus BPTB ACL reconstruction (the BEAR: Multicenter Orthopaedic Outcomes Network [BEAR-MOON] trial).

Reliability of an Observational Biomechanical Analysis Tool in Adolescent Baseball Pitchers.

Background: Improper pitching mechanics are a risk factor for arm injuries. While 3-dimensional (3D) motion analysis remains the gold standard for evaluation, most pitchers and clinicians do not have access to this costly technology. Recent advances in 2-dimensional (2D) video technology provide acceptable resolution for clinical analysis.

Medical Advisability of Youth Pitching Recommendations on the Internet.

Background: As the incidence of youth pitching injuries and surgical procedures attributed to overuse has drastically increased, there are quality concerns about popular internet resources regarding arm care for youth pitchers.

Purpose/hypothesis: To assess the medical advisability of online arm care recommendations for youth pitchers. It was hypothesized that websites contain misleading arm-care information that is discordant with medical advice.

Home Run Derby Participation in Major League Baseball Players: Is There Associated Injury Risk and Impact on Second-Half Performance?

Background: The Major League Baseball (MLB) All-Star Game (ASG) Home Run Derby (HRD) remains a highly anticipated event, during which contestants can take hundreds of maximum-effort swings en route to hitting a multitude of home runs. Critics have openly questioned the risk-benefit of HRD participation as it pertains to injury, alterations in swing mechanics, and timing.

Purpose: To determine whether participation in the MLB ASG HRD was associated with both increased injury risk and decline in second-half performance in MLB players.

Outpatient Management of Sport-Related Concussion, Return to Learn, Return to Play.

Outpatient sports-related concussion (SRC) management continues to evolve as evidence emerges supporting a multidisciplinary approach to the clinical assessment of SRC. Early active rehabilitation has replaced strict cognitive and physical rest. With this paradigm shift in management, pragmatic approaches are highly sought by busy clinicians that provide direction to individualized treatment, which can potentially expedite symptom resolution.

Prevention of Sport-Related Concussion.

Concussion remains a common injury among sports participants. Implementing risk-reduction strategies for sport-related concussion (SRC) should be a priority of medical professionals involved in the care of athletes. Over the past few decades, a multifaceted approach to reducing SRC risk has been developed.

A Battery of Easily Accessible, Simple Tools for the Assessment of Concussion in Children.

Objective: To determine whether a non-proprietary, novel testing battery can identify recently concussed children within 8 weeks of injury.

Study Design: In total, 568 clinic outpatients aged 10-18 years were sorted into 3 groups: 316 had never been concussed, 162 had ever been concussed before 8 weeks earlier, and 90 had been recently concussed within 8 weeks. At initial and any subsequent visits, a neurologic examination and 4 procedures were performed: Stick Drop, Wall Ball, Sharpened Modified Romberg (SMR), and Animal Naming.

Fair Play as an Injury Prevention Intervention: Do Yellow Card Accumulation Policies Reduce High School Soccer Injuries?

Objectives: Evaluate yellow card policies' (YCPs) effectiveness in reducing competition contact injuries (CCIs).

Design: Retrospective cohort.

Setting: High schools.

Shoulder and Elbow Injuries in the Adolescent Throwing Athlete.

Shoulder and elbow injuries in the adolescent population can be generally divided into skeletally immature and skeletally mature. Skeletally immature injuries refer to damage to the open growth plate (physis) in the young athlete, which have distinct differences in long-term risks if not managed correctly due to the potential for growth disturbance. Skeletally mature injuries occur in athletes with closed growth plates and are less likely to limit growth potential.

COVID-19 and Review of Current Recommendations for Return to Athletic Play.

In December 2019 a respiratory illness known as Coronavirus 2 (SARS-CoV-2, COVID-19) broke out in a region in China and rapidly spread to become a pandemic affecting all sporting events worldwide. The Summer Olympics scheduled to be held in Tokyo were postponed until 2021, and all professional leagues in the United States postponed or canceled events. As the United States has begun to open up, there remains uncertainty of when sporting events can safely be held.

Effect of Penalty Minute Rule Change on Injuries and Game Disqualification Penalties in High School Ice Hockey.

Background: Recent efforts have focused on eliminating dangerous hits in ice hockey. Fair play rule changes have successfully reduced injury risk but have not been widely implemented.

Purpose: To determine the effect of a penalty infraction minutes (PIM) rule change in high school boys' ice hockey on injuries and game disqualification penalties.

Incidence of Combat Sport-Related Mild Traumatic Brain Injuries Presenting to the Emergency Department From 2012 to 2016.

Objectives: We sought to investigate the incidence and characteristics of traumatic brain injuries [mild traumatic brain injury (MTBI)] presenting to the emergency department as a result of boxing, wrestling, and martial arts (MA).

Design: Retrospective cross-sectional study of MTBI in combat sport athletes who were evaluated in emergency departments in the United States.

Setting: Patient data were taken from the National Electronic Injury Surveillance System.

Concussion Symptom Profiles Among Child, Adolescent, and Young Adult Athletes.

Objectives: (1) To examine how age influences initial symptom presentation following concussion; and (2) to determine whether specific symptom profiles are associated with duration of postconcussion symptoms, and whether they vary by age group.

Design: A total of 689 patients (20% children 7-12 years of age, 69% adolescents 13-18 years of age, and 11% young adults 19-30 years of age) were seen and diagnosed with a concussion within 21 days after injury. Patients completed the Post-Concussion Symptom Scale (PCSS) and were followed until they no longer required care.

Neurocognitive Deficits of Concussed Adolescent Athletes at Self-reported Symptom Resolution in the Zurich Guidelines Era.

Background: Previous studies have evaluated high school and collegiate athletes in the pre-Zurich guidelines era; whether adolescent athletes demonstrate similar neurocognitive decrements in the current concussion management era remains unclear.

Purpose: To assess for the presence of neurocognitive deficits in adolescents with a sport-related concussion at the time of self-reported symptom resolution.

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

Bone Stress Injuries in the Military: Diagnosis, Management, and Prevention.

Bone stress injuries occur when forces applied to a bone for an extended period exceed the ability of the bone to adequately remodel. These injuries, which range from stress reactions to nondisplaced and even displaced fractures, most often affect people who experience high levels of repetitive stress and loading in the lower extremity or changes in physical activity level. For example, stress fractures are common in endurance athletes, in athletes engaged in preseason and early-season conditioning, and in military recruits.

Epidemiology of Snow Skiing- Versus Snowboarding-Related Concussions Presenting to the Emergency Department in the United States from 2010 to 2014.

Objectives: To examine the trend of concussions in skiers and snowboarders from 2010 to 2014; and to quantify and compare the incidence of concussions injuries in skiers and snowboarders who presented to emergency departments in the United States in 2014.

Design: Cross-sectional study of concussions in skiers and snowboarders who were evaluated in emergency departments in the United States.

Main Outcomes Measure: Incidence of concussions.

Preparticipation Physical Exams: The Rhode Island Perspective, A Call for Standardization.

As of 2015, 98% of U.S. states require preparticipation exams (PPE) before participating in scholastic sports.

Two-Dimensional Video Analysis of Youth and Adolescent Pitching Biomechanics: A Tool For the Common Athlete.

Three-dimensional (3D) motion analysis is the gold standard for analyzing the biomechanics of the baseball pitching motion. Historically, 3D analysis has been available primarily to elite athletes, requiring advanced cameras, and sophisticated facilities with expensive software. The advent of newer technology, and increased affordability of video recording devices, and smartphone/tablet-based applications has led to increased access to this technology for youth/amateur athletes and sports medicine professionals.