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Medial Ulnar Collateral Ligament Injury Prevention Strategies

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Elbow Ulnar Collateral Ligament Injury

Abstract

Recently, there has been an alarming increase in the rate of elbow injuries in throwers of all ages. In fact, injury to the medial ulnar collateral ligament (UCL) has increased in both amateur and professional players, with one study demonstrating a 50% increase in UCL reconstructions in high school athletes between 1988 and 2003. Injury to the ulnar collateral ligament results in a significant loss of participation time. While these injuries are not completely avoidable, there are modifiable risks factors and preventative strategies to decrease their incidence. This chapter reviews the risk factors for and preventative strategies to avoid injury to the medial ulnar collateral ligament at the youth, adolescent, and professional level.

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References

  1. Nuckols B. Put me in, coach: youth baseball participation on the rise. USA Today. 2019;August(23):2019.

    Google Scholar 

  2. Petty DH, Andrews JR, Fleisig GS, Cain EL. Ulnar collateral ligament reconstruction in high school baseball players: clinical results and injury risk factors. Am J Sports Med. 2004;32(5):1158–64.

    Article  Google Scholar 

  3. Fleisig GS, Andrews JR. Prevention of elbow injuries in youth baseball pitchers. Sports Health. 2012;4(5):419–24.

    Article  Google Scholar 

  4. Yang J, Mann BJ, Guettler JH, Dugas JR, Irrgang JJ, Fleisig GS, et al. Risk-prone pitching activities and injuries in youth baseball: findings from a national sample. Am J Sports Med. 2014;42(6):1456–63.

    Article  Google Scholar 

  5. Makhni EC, Morrow ZS, Luchetti TJ, Mishra-Kalyani PS, Gualtieri AP, Lee RW, et al. Arm pain in youth baseball players: a survey of healthy players. Am J Sports Med. 2015;43(1):41–6.

    Article  Google Scholar 

  6. Popkin CA, Bayomy AF, Ahmad CS. Early sport specialization. J Am Acad Orthop Surg. 2019;27(22):e995–e1000.

    Article  Google Scholar 

  7. Fleisig GS, Andrews JR, Cutter GR, Weber A, Loftice J, McMichael C, et al. Risk of serious injury for young baseball pitchers: a 10-year prospective study. Am J Sports Med. 2011;39(2):253–7.

    Article  Google Scholar 

  8. Olsen SJ 2nd, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am J Sports Med. 2006;34(6):905–12.

    Article  Google Scholar 

  9. Matthys SP, Vaeyens R, Coelho ESMJ, Lenoir M, Philippaerts R. The contribution of growth and maturation in the functional capacity and skill performance of male adolescent handball players. Int J Sports Med. 2012;33(7):543–9.

    Article  CAS  Google Scholar 

  10. Melugin HP, Leafblad ND, Camp CL, Conte S. Injury prevention in baseball: from youth to the pros. Curr Rev Musculoskelet Med. 2018;11(1):26–34.

    Article  Google Scholar 

  11. Chalmers PN, Sgroi T, Riff AJ, Lesniak M, Sayegh ET, Verma NN, et al. Correlates with history of injury in youth and adolescent pitchers. Arthroscopy. 2015;31(7):1349–57.

    Article  Google Scholar 

  12. Dun S, Loftice J, Fleisig GS, Kingsley D, Andrews JR. A biomechanical comparison of youth baseball pitches: is the curveball potentially harmful? Am J Sports Med. 2008;36(4):686–92.

    Article  Google Scholar 

  13. Nissen CW, Westwell M, Ounpuu S, Patel M, Solomito M, Tate J. A biomechanical comparison of the fastball and curveball in adolescent baseball pitchers. Am J Sports Med. 2009;37(8):1492–8.

    Article  Google Scholar 

  14. Oliver GD, Plummer H, Henning L, Saper M, Glimer G, Brambeck A, et al. Effects of a simulated game on upper extremity pitching mechanics and muscle activations among various pitch types in youth baseball pitchers. J Pediatr Orthop. 2019;39(8):387–93.

    Google Scholar 

  15. https://www.mlb.com/pitch-smart. Major League Baseball; 2020.

  16. Bohne C, George SZ, Zeppieri GJ. Knowledge of injury prevention and prevalence of risk factors for throwing injuries in a sample of youth baseball players. Int J Sports Phys Ther. 2015;10(4):464–75.

    PubMed  PubMed Central  Google Scholar 

  17. Ahmad CS, Grantham WJ, Greiwe RM. Public perceptions of Tommy John surgery. Phys Sportsmed. 2012;40(2):64–72.

    Article  Google Scholar 

  18. Davis JT, Limpisvasti O, Fluhme D, Mohr KJ, Yocum LA, Elattrache NS, et al. The effect of pitching biomechanics on the upper extremity in youth and adolescent baseball pitchers. Am J Sports Med. 2009;37(8):1484–91.

    Article  CAS  Google Scholar 

  19. Knapik DM, Continenza SM, Hoffman K, Gilmore A. Youth baseball coach awareness of pitch count guidelines and overuse throwing injuries remains deficient. J Pediatr Orthop. 2018;38(10):e623–e8.

    Article  Google Scholar 

  20. DeRenne CBB, Hetzler RK, Ho KW. Effects of under-and-overweighted implement training on pitching velocity. J Strength Cond Res. 1994;8:247–50.

    Google Scholar 

  21. Derenne C, Ho KW, Murphy JC. Effects of general, special, and specific resistance training on throwing velocity in baseball: a brief review. J Strength Cond Res. 2001;15(1):148–56.

    CAS  PubMed  Google Scholar 

  22. Derenne CSD. Effects of baseball weighted implement training: a brief review. Strength Cond J. 2009;31:30–7.

    Article  Google Scholar 

  23. Escamilla RF, Speer KP, Fleisig GS, Barrentine SW, Andrews JR. Effects of throwing overweight and underweight baseballs on throwing velocity and accuracy. Sports Med. 2000;29(4):259–72.

    Article  CAS  Google Scholar 

  24. Fleisig GS, Diffendaffer AZ, Aune KT, Ivey B, Laughlin WA. Biomechanical analysis of weighted-ball exercises for baseball pitchers. Sports Health. 2017;9(3):210–5.

    Article  Google Scholar 

  25. Reinold MM, Macrina LC, Fleisig GS, Aune K, Andrews JR. Effect of a 6-week weighted baseball throwing program on pitch velocity, pitching arm biomechanics, passive range of motion, and injury rates. Sports Health. 2018;10(4):327–33.

    Article  Google Scholar 

  26. www.drivelinebaseball.com. 2020.

  27. Dines JS, Frank JB, Akerman M, Yocum LA. Glenohumeral internal rotation deficits in baseball players with ulnar collateral ligament insufficiency. Am J Sports Med. 2009;37(3):566–70.

    Article  Google Scholar 

  28. Garrison JC, Arnold A, Macko MJ, Conway JE. Baseball players diagnosed with ulnar collateral ligament tears demonstrate decreased balance compared to healthy controls. J Orthop Sports Phys Ther. 2013;43(10):752–8.

    Article  Google Scholar 

  29. Conte S, Camp CL, Dines JS. Injury trends in major league baseball over 18 seasons: 1998–2015. Am J Orthop (Belle Mead NJ). 2016;45(3):116–23.

    Google Scholar 

  30. Erickson BJ, Bach BRJ, Bush-Joseph CA, Verma NN, Romeo AA. Medial ulnar collateral ligament reconstruction of the elbow in major league baseball players: where do we stand? World J Orthop. 2016;7(6):355–60.

    Article  Google Scholar 

  31. Portney DA, Buchler LT, Lazaroff JM, Gryzlo SM, Saltzman MD. Influence of pitching release location on ulnar collateral ligament reconstruction risk among major league baseball pitchers. Orthop J Sports Med. 2019;7(2):2325967119826540.

    Article  Google Scholar 

  32. Keller RA, Marshall NE, Guest JM, Okoroha KR, Jung EK, Moutzouros V. Major League Baseball pitch velocity and pitch type associated with risk of ulnar collateral ligament injury. J Shoulder Elb Surg. 2016;25(4):671–5.

    Article  Google Scholar 

  33. Crotin RL, Bhan S, Karakolis T, Ramsey DK. Fastball velocity trends in short-season minor league baseball. J Strength Cond Res. 2013;27(8):2206–12.

    Article  Google Scholar 

  34. Keller RA, Mehran N, Marshall NE, Okoroha KR, Khalil L, Tibone JE, et al. Major League pitching workload after primary ulnar collateral ligament reconstruction and risk for revision surgery. J Shoulder Elb Surg. 2017;26(2):288–94.

    Article  Google Scholar 

  35. Vance DD, Alexander FJ, Kunkle BW, Littlefield M, Ahmad CS. Professional and amateur pitchers’ perspective on the ulnar collateral ligament injury risk. Orthop J Sports Med. 2019;7(6):2325967119850777.

    Article  Google Scholar 

  36. Chalmers PN, Erickson BJ, Ball B, Romeo AA, Verma NN. Fastball pitch velocity helps predict ulnar collateral ligament reconstruction in major league baseball pitchers. Am J Sports Med. 2016;44(8):2130–5.

    Article  Google Scholar 

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Schulz, B.M., Stein, S.M., Conte, S.A. (2021). Medial Ulnar Collateral Ligament Injury Prevention Strategies. In: Dines, J.S., Camp, C.L., Altchek, D.W. (eds) Elbow Ulnar Collateral Ligament Injury. Springer, Cham. https://doi.org/10.1007/978-3-030-69567-5_5

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  • DOI: https://doi.org/10.1007/978-3-030-69567-5_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-69566-8

  • Online ISBN: 978-3-030-69567-5

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