Sports Medicine Commons^™

Clinical Outcomes After Ulnar Collateral Ligament Reconstruction With Palmaris Longus Versus Gracilis Autograft In Baseball Players: A Cohort Analysis, Michael C. Ciccotti, Brooks Martino, Frank Cautela, Nathaniel Tchangou, Daniel Kwak, Eric Didomenico, Harrison S. Fellheimer, Christopher C. Dodson, Steven B. Cohen, Michael G. Ciccotti

Rothman Institute Papers

BACKGROUND: Ulnar collateral ligament (UCL) reconstruction (UCLR) is a common procedure for overhead athletes, particularly baseball players sustaining partial or full UCL tears. Palmaris longus (PL) and gracilis (GR) autografts are the most frequently used graft sources, yet limited data compare clinical outcomes in baseball athletes.

PURPOSE: To compare patient-reported outcomes after UCLR with PL versus GR autografts in baseball players.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent isolated UCLR with either PL or GR autograft and a minimum of 2 years of follow-up were identified. All reconstructions were performed using the Modified Jobe or …

Return To Sport And Performance Outcomes After Hand Fractures In Professional Baseball Players, Ryan W. Paul, Sean M. Wilson, Gaston Davis, Amit Syal, Steven B. Cohen

Rothman Institute Papers

BACKGROUND: About 7% of injuries in the Major League Baseball (MLB) involve the hand. Fractures of the hand are not uncommon in professional baseball players while fielding or from being hit by a pitch while batting; however, the outcomes of professional baseball players treated both operatively and nonoperatively are unclear.

PURPOSE/HYPOTHESIS: The purpose of this study was to report the return-to-sport (RTS) rate, RTS time, and performance outcomes in professional baseball position players who sustained a hand fracture. The secondary purpose was to compare outcomes between positions and between operatively versus nonoperatively treated players. It was hypothesized that there would …

The Major League Baseball Pitch Clock: One Year Position Player Injury Analysis, Troy Puga, Nicholas Scigliano, Mckenna Box, John T. Riehl

North Texas Research Forum 2025

Background In 2023, Major League Baseball (MLB) implemented the pitch clock. The effects of the pitch clock on player injury rates is largely unknown, and some, including the major league baseball players association, have suggested that pitchers may be at an increased risk of injury with its implementation. Position players have received little attention in these discussions, even though they may be at the same theorized risk of injuries. The aim of this study is to determine if implementation of the 2023 MLB pitch clock influenced the incidence of injuries in position players. It is hypothesized that implementation of the …

Evaluation And Treatment Of Baseball Pitchers: There’S More To Assess Than The Arm, Matthew L. Gauthier, Casey A. Unverzagt, George J. Davies

Physical Therapy Faculty Publications

Injuries are commonplace in the overhead athlete, with many occurring to the shoulder and elbow. The increasing prevalence of injuries to the shoulder and elbow has been discussed at length in recent years, with increased research focus being placed on arm care for rehabilitation and prevention strategies. Even though the pitching motion is well-established as a whole-body kinetic chain movement, most attention in rehabilitation and prevention efforts is often placed on the upper extremity. The purpose of this clinical commentary is to highlight the impact the lower extremity and trunk have on the upper extremity during the throwing motion, better …

Man On The Mound: Pictures Of A Pitcher In Pain, Jean Medina, Matthew Campanella, Elliot Mendelsohn, Carl Mitchell, Murtaza Akhter

HCA Healthcare Journal of Medicine

Atraumatic ball thrower's humerus fracture is an uncommon, and poorly understood injury pattern. The majority of these cases are seen in untrained and younger individuals. A missed diagnosis could severely impact a patient's quality of life, as management is operative in most cases. Here, we present the case of a young patient, suffering an atraumatic "ball thrower's" fracture. We present images of this exceedingly rare injury pattern and showcase original artwork with a proposed mechanism of injury.

The Role Of Humeral Torsion On Glenohumeral Rotation In Injured Baseball Players, Kalie Entler, J Kaylin Kruseman, Sean M Kennedy, John E Conway, Griffin J Reyes, J Craig Garrison, Lane B Bailey, Natalie L Myers

Faculty, Staff and Student Publications

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 …

Throwing Shoulder Adaptations Are Not Related To Shoulder Injury Or Pain: A Preliminary Report., Emily Strama, Karen A Keenan, Timothy Sell, Mallory Faherty, Deirdre Rafferty, Karl Salesi, Jennifer Csonka, Michelle Varnell

OhioHealth Research Institute Articles

BACKGROUND: Overhead throwing in baseball and softball athletes induces shoulder adaptations theorized to increase risk of shoulder musculoskeletal injury (MSI) and/or pain due to range of motion (ROM) deficits.

HYPOTHESIS: Shoulder ROM adaptations are associated with a higher risk for developing shoulder MSI and pain.

STUDY DESIGN: Prospective cohort study.

LEVEL OF EVIDENCE: Level 3.

METHODS: A total of 60 National Collegiate Athletic Association Division I athletes cleared for full athletic participation and free from upper extremity MSI in the last 4 weeks (age, 19.0 ± 1.2 years; weight, 82.1 ± 13.7 kg; height, 178.6 ± 11.2 cm; softball, n …

Physical Examination Versus Ultrasonography For Detection Of Ulnar Nerve Subluxation In Professional Baseball Pitchers, Austin Looney, Hannah Day, Manoj Reddy, Ryan Paul, Levon Nazarian, Steven Cohen

Rothman Institute Papers

Background: Despite the importance of accurately detecting ulnar nerve subluxation in vulnerable athletes, few studies have compared the performance of physical examination and ultrasound in this population. Purpose/Hypothesis: The purpose of this study was to compare the diagnostic validity of physical examination versus ultrasound in detecting ulnar nerve subluxation at the cubital tunnel of the elbow in professional baseball pitchers. It was hypothesized that ultrasound would more sensitively detect ulnar nerve subluxation. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Physical and sonographic examinations for ulnar nerve subluxation were performed on 186 elbows of 95 consecutive male professional …

Impact Of Draft Order On Stress Sonography Of The Ulnar Collateral Ligament Of The Elbow In Professional Baseball Pitchers: An 18-Year Study, Adeeb Hanna, John Sonnier, Brian Fliegel, Matthew Sherman, Michael Ciccotti, Robert Jack, Steven Cohen

Rowan-Virtua Research Day

Background: The MLB draft is a common route for players to enter professional baseball in the United States. Individuals taken in earlier rounds are typically higher-performing players. When looking at pitchers specifically, higher performance at the amateur level may be associated with increased frequency of adaptive change in the throwing elbow.

Purpose/Hypothesis: To determine if players taken in earlier rounds of the MLB draft have a greater frequency or extent of pathological change in the elbow, as measured by dynamic stress ultrasound.

Study Design: Retrospective Cohort Study Methods: Dynamic stress ultrasounds (SUS) were performed over an 18-year period on the …

Adaptive Changes Of The Ulnar Collateral Ligament Of Professional Baseball From Different Climates Over Multiple Seasons: An 18-Year Study, Adeeb Hanna, Brian Fliegel, John Sonnier, Matthew Sherman, Michael Ciccotti, Robert Jack, Steven Cohen

Rowan-Virtua Research Day

Background: The ulnar collateral ligament (UCL) is put under high levels of stress through the overhead throwing motion typical of professional baseball pitchers. In response to repetitive stress the UCL undergoes adaptive changes including thickening of the ligament and increased joint laxity under valgus stress. Studies examining the adaptive changes in the elbows of professional pitchers over multiple seasons are limited. Investigations such as this one offer insight into the changes in the UCL of professional pitchers over multiple years of professional play as well as the risk for injuries that may be associated with these changes.

Purpose/Hypothesis: The purpose …

Does Prehabilitation Before Surgery Affect Return To Sport In Baseball Pitchers With Partial Ulnar Collateral Ligament Tears?, Kourtney Snigar, Ryan W. Paul, Joshua M. Spada, Usman Zareef, Anya Hall, Brandon J. Erickson, Michael G. Ciccotti, Stephen J. Thomas

Rothman Institute Papers

BACKGROUND: Purposeful rehabilitation before surgery (prehabilitation) has been researched and implemented in the treatment of anterior cruciate ligament tears. However, it is unclear whether prehabilitation would affect outcomes for baseball pitchers with partial ulnar collateral ligament (UCL) tears.

PURPOSE/HYPOTHESIS: The purpose of this study was to determine whether baseball pitchers with partial UCL tears who completed ≥4 weeks of prehabilitation (prehab group) have different return to play (RTP) outcomes than pitchers with 0 to 3 weeks of preoperative physical therapy (no prehab group). We hypothesized that pitchers in the prehab group would have similar RTP rates compared with pitchers in …

Does Prehabilitation Prior To Ulnar Collateral Ligament Surgery Affect Return To Sport Rate Or Time In Baseball Players With Partial Ucl Tears?, Joshua Spada, Kourtney Snigar, Ryan W. Paul, Usman Zareef, Anya Hall, Brandon J. Erickson, Michael G. Ciccotti, Stephen J. Thomas

Rowan-Virtua Research Day

Those who suffer a partial thickness ulnar collateral ligament (UCL) tear often undergo a period of nonoperative management including physical therapy rehabilitation. This treatment is aimed at optimizing range of motion (ROM) and strengthening the supporting structures around the elbow to help offload the UCL.

Unfortunately, some of these patients fail nonoperative management and require surgical intervention. This creates a unique set of patients who essentially underwent “prehabilitation” prior to their UCL surgery. Prehabilitation is considered a period of structured physical therapy rehabilitation aimed at strengthening structures surrounding an injured tendon or ligament, to allow for dissipation of stress away …

Long-Term Sports Participation And Satisfaction After Ucl Reconstruction In Amateur Baseball Players., Robert A Jack, Somnath Rao, Taylor D'Amore, Donald Willier Iii, Robert Gallivan, Steven B. Cohen, Christopher C Dodson, Michael G. Ciccotti

Rothman Institute Papers

Background: While the incidence of ulnar collateral ligament reconstruction (UCLR) has increased across all levels of play, few studies have investigated the long-term outcomes in nonprofessional athletes.

Purpose: To determine the rate of progression to higher levels of play, long-term patient-reported outcomes (PROs), and long-term patient satisfaction in nonprofessional baseball players after UCLR.

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

Methods: We evaluated UCLR patients who were nonprofessional baseball athletes aged(KJOC), the Timmerman-Andrews (T-A) Elbow score, the Mayo Elbow Performance Score (MEPS), and a custom return-to-play questionnaire.

Results: A total of 91 baseball players met the inclusion criteria, and …

Sports Under Quarantine: A Case Study Of Major League Baseball In 2020, Kari L.J. Goold, Reynafe N. Aniga, Peter B. Gray

Anthropology Faculty Research

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This case study entailed a Twitter content analysis to address the pandemic-delayed start to Major League Baseball (MLB) in the shortened 2020 season. This case study helps address the overarching objective to investigate how the sports world, especially fans, responded to MLB played during the 2020 COVID-19 pandemic. The methods investigated the common themes and determined who used predetermined Twitter hashtags. We recorded how many times external links, photos, emojis, and the 30 MLB teams were mentioned in the 779 tweets obtained during 39 days of data retrieval. Results showed that …

Comparison Of Pitching From Flat Ground Vs. 10-Inch Mound Regarding Elbow Varus Torque And Arm Speed, Stephen A. Cage, X. Neil Dong, Brandon J. Warner, Diana M. Gallegos

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: The purpose of this study was to examine the effect of throwing surface and distance on varus elbow torque and arm speed. Methods: 11 male collegiate baseball pitchers (age = 20.73 ± 1.56 years, height = 175.26 ± 9.03 cm, mass = 70.31 ± 9.03 kg) participated in this study. Varus elbow torque and distance were measured using a 3D motion sensor housed in a spandex sleeve at the medial joint line of the elbow. Participants were instructed to complete their normal warmup routine as if they were about to pitch in a bullpen session or a game. Participants …

Examining Upper Extremity Injuries In Male Baseball Players Between The Ages Of 14 To 22 Years Old, James T. Yancy

Graduate Student Theses, Dissertations, & Professional Papers

Yancy, James T. (J.T.), MAT., May 2018 AthleticTraining

Examining Upper Extremity Injuries In Male Baseball Players Between The Ages Of 14 To 22 Years Old

Chairperson: Melanie McGrath

The number of upper extremity injuries is increasing in advanced baseball (14 to 22 years old) at an alarming rate. The length of seasons, multiple leagues and the velocity of throwing in overhead sports are the most common causes of elbow and shoulder injuries. In addition, biomechanical variables also influence the risk of injury. Any alteration in range of motion (ROM) directly impacts the biomechanics of overhead activities, such as pitching or …