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Youth Pitcher Fatigue: Medial Elbow Laxity, Ultrasonographic Assessment of Flexor-Pronator Mass Energy Depletion, and Association With Pitch Count.
- Source :
- Orthopaedic Journal of Sports Medicine; Jun2024, Vol. 12 Issue 6, p1-10, 10p
- Publication Year :
- 2024
-
Abstract
- Background: Ulnar collateral ligament (UCL) injuries in youth pitchers continue to be concerning despite the institution of pitch count limits. Flexor-pronator mass fatigue can lead to diminished dynamic stability, resulting in greater stress on the UCL. Purpose/Hypothesis: To evaluate fatigue of the flexor-pronator mass by assessing changes in medial elbow laxity; noninvasively characterizing alterations in muscle glycogen; and identifying changes in subjective fatigue, strength, range of motion (ROM), pitching velocity, and accuracy with increasing pitches thrown by youth pitchers to their recommended 75-pitch count limit. It was hypothesized that, with increased pitches, medial elbow laxity would increase and that the glycogen content of the flexor-pronator mass would decrease. Study Design: Descriptive laboratory study. Methods: Healthy male pitchers aged 10 years (n = 22) threw 3 sets of 25 pitches with 12 minutes between sets (3 timepoints). Bilateral ulnohumeral joint gapping was measured by applying a standardized valgus force and utilizing ultrasound imaging. Relative changes in muscle glycogen in the bilateral flexor carpi radialis (FCR), and the flexor digitorum superficialis/flexor carpi ulnaris (FDS/FCU) muscles were measured with ultrasound software and recorded as fuel percentiles. Additional measures obtained included subjective fatigue, strength, ROM, velocity, and accuracy. Results: There were no differences in medial elbow joint-line gapping between the throwing and nonthrowing arms or between timepoints. The throwing arm demonstrated a significant decline in fuel percentile of the FCR from baseline to after 75 pitches (P =.05). There were no differences across timepoints for FDS/FCU fuel percentile values. Fatigue measurements for both arms were significantly higher at all timepoints compared with baseline (P ≤.03). Grip strength of the dominant arm after 75 pitches was decreased significantly compared with after 25 pitches (P =.02). Conclusion: Although an increase in medial elbow joint gapping was not demonstrated within the recommended 75 pitch count limit in 10-year-olds, a relative decrease in glycogen stores of the flexor-pronator mass did occur, as well as a decrease in grip strength, with increasing subjective fatigue. Clinical Relevance: This study provides a foundation for further objective testing of physiologic changes that occur with pitching to better guide pitch count limits and improve the safety of young athletes. [ABSTRACT FROM AUTHOR]
- Subjects :
- COLLATERAL ligament injuries
MUSCLE fatigue
STATISTICAL power analysis
DATA analysis
T-test (Statistics)
BASEBALL injuries
DESCRIPTIVE statistics
ENERGY metabolism
RESEARCH methodology
STATISTICS
PHYSIOLOGICAL stress
GLYCOGEN
DATA analysis software
JOINT instability
RANGE of motion of joints
GRIP strength
ADOLESCENCE
Subjects
Details
- Language :
- English
- ISSN :
- 23259671
- Volume :
- 12
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Orthopaedic Journal of Sports Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 178594715
- Full Text :
- https://doi.org/10.1177/23259671241256294