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History of elbow symptoms associated with thicker UCL anterior band in pitchers
Pitchers had a negative association between UCL band thickness and self-satisfaction score.
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High school baseball pitchers who had a history of elbow symptoms had a thicker ulnar collateral ligament anterior band on the throwing side compared with pitchers with no history of elbow symptoms, according to study results.
“The differences between the [ulnar collateral ligament] UCL anterior band thickness on the throwing side was greater in participants with a history of elbow symptoms than in participants with no history of elbow symptoms,” Tsuyoshi Tajika, MD, PhD, assistant professor of the Department of Orthopaedic Surgery at the Gunma University Graduate School of Medicine, told Orthopedics Today.
UCL thickness
Tajika and his colleagues conducted a gravity stress ultrasonography elbow examination with 30° of flexion with and without valgus stress on 122 high school baseball pitchers. Researchers compared UCL thickness and ulnohumeral joint space width with and without valgus stress between high school pitchers with and without a history of elbow symptoms. All pitchers completed a self-administered questionnaire related to the self-satisfaction score for pitching performance and throwing-related elbow joint pain sustained during a 3-year period.
Results showed a significantly smaller range of motion of elbow extension and flexion and greater thickness of the anterior band of the UCL on the dominant side of all participants compared to the non-dominant side. Researchers also noted a significantly greater width of the ulnohumeral joint space with and without gravity valgus stress and a greater difference between the ulnohumeral joint width with and without valgus stress on the dominant side.
According to results, a greater difference in UCL thickness on the throwing side was found among pitchers with a history of elbow symptoms compared to those without a history of elbow symptoms. Pitchers with a history of elbow symptoms also had a significantly greater mean width of the stressed ulnohumeral joint space on the throwing side. While all pitchers had a positive association between years of playing baseball and the self-satisfaction score for throwing, researchers found a significant negative association between thicknesses of UCL anterior band on the pitching side and the self-satisfaction score for pitching.
“I hope that [this study] is useful to assess the UCL thickness measured by [ultrasonography] US that might reflect the prior pitching conditions for the prevention of elbow injury, in young baseball players especially,” Tajika said.
Future evaluations
According to Tajika, the study had several limitations that should be addressed in future research, including how differences in pitching motions among pitchers may cause morphologic change to the UCL. He noted future research should also evaluate reference and cut-off points related to elbow injury and pain.
“I want to investigate the longitudinal morphologic change of UCL in each young baseball player in order to evaluate the reference and cut-off points related to elbow injury and elbow pain,” Tajika said. – by Casey Tingle
- Reference:
- Tajika T, et al. J Shoulder Elbow Surg. 2016;doi:10.1016/j.jse.2016.04.013.
- For more information:
- Tsuyoshi Tajika, MD, PhD, can be reached at Gunma University Graduate School of Medicine, 3-39-22, Showamachi, Maebashi, Gunma 371-8511, Japan; email: tajika@gunma-u.ac.jp.
Disclosure: Tajika reports no relevant financial disclosures.