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Physical therapy AND baseball

Aaron R Hellem, Elena J Jelsing, Wendy J Hurd
A 16-year-old high school baseball pitcher with a 3-week history of acute-onset pain in his medial elbow during throwing presented to physical therapy. Following examination, physical therapy was initiated and the patient was referred for imaging, with suspicion of ulnar collateral ligament (UCL) injury. Radiographs were noncontributory. Ultrasound imaging, however, was performed by a physiatrist and was suggestive of a partial-thickness tear of the UCL and ulnar nerve enlargement. The physiatrist ordered magnetic resonance imaging, which confirmed a medial apophyseal stress reaction, a mild UCL sprain, and reactive ulnar nerve edema...
May 2018: Journal of Orthopaedic and Sports Physical Therapy
Todd P Pierce, Jennifer Kurowicki, Kimona Issa, Anthony Festa, Vincent K McInerney, Anthony J Scillia
Medial-sided elbow pain is becoming more common among pediatric overhead sport athletes. One potential cause of this is a partial or complete tear of the ulnar collateral ligament (UCL). Because the growth plate remains open in many of these athletes, the most common injury experienced is an avulsion at the medial epicondyle. However, although rare, there is a potential to tear the UCL, with the most common tears occurring at the anterior bundle. However, tears to the posterior bundle are quite rare in pediatric patients...
December 22, 2017: Surgical Technology International
Mark C Zipser, Jonathan C Sum, Alison G Wilcox
A 15-year-old baseball pitcher presented to physical therapy with a 1-week history of acute right shoulder pain experienced during the acceleration phase of throwing. The week after physical therapy evaluation, the patient returned with radiographs and magnetic resonance imaging results that revealed lateral physeal widening with adjacent edema. Additionally, a nondisplaced labral tear was noted. In this case, imaging was necessary for an accurate diagnosis of lateral physeal widening, commonly referred to as "Little League shoulder...
January 2018: Journal of Orthopaedic and Sports Physical Therapy
J Banks Deal, Ed Smith, Wendell Heard, Michael J O'Brien, Felix H Savoie
Background: Jobe revolutionized the treatment of medial ulnar collateral ligament (MUCL) tears with his reconstruction technique. However, not all MUCL injuries require operative management; Rettig showed that 42% of MUCL injuries respond to conservative management. This was improved by Podesta, who showed that augmentation of nonoperative management with platelet-rich plasma (PRP) and magnetic resonance imaging (MRI) for detecting partial MUCL tears resulted in significantly higher success rates...
November 2017: Orthopaedic Journal of Sports Medicine
William Shutze, Brad Richardson, Ryan Shutze, Kimberly Tran, Allen Dao, Gerald O Ogola, Allan Young, Greg Pearl
BACKGROUND: Neurogenic thoracic outlet syndrome (NTOS) results from compression of the brachial plexus by the clavicle, first rib, and scalene muscles and may develop secondary to repetitive motion of the upper extremity. Athletes routinely perform repetitive motions, and sports requiring significant arm and shoulder use may put the participant at increased risk for NTOS. Competitive athletes who develop NTOS may require first rib resection and scalenectomy (FRRS) for symptomatic relief...
December 2017: Journal of Vascular Surgery
Austin Cole, John L Hiatt, Christopher Arnold, Terry Sites, Ramon Ylanon
BACKGROUND: Chronic exertional compartment syndrome (CECS) is a recognized condition in the lower limb, with many reports in the literature. However, very few instances include CECS of the upper limb. This article presents the case of a collegiate softball pitcher presenting with CECS in her right forearm. To our knowledge, this is the first case report of a softball player with CECS, with only one similar incident in a major league baseball player. PURPOSE: The rarity of this condition normally places it low on the differential diagnosis...
December 2017: Sports Medicine—Open
Janine E Curcio, Matthew J Grana, Stacey England, Paige M Banyas, Benjamin D Palmer, Arielle E Placke, William A Rieck, Amber M Eade
CONTEXT: Repeated overhead throwing in baseball players alters range of motion (ROM), contributing to shoulder injury. The Spencer technique has been used, anecdotally, to reduce the effects of throwing-induced limitations in ROM. OBJECTIVE: To quantify the effects of a single administration of the Spencer technique on the ROM and performance of collegiate baseball pitchers. METHODS: Pitchers from the Seton Hill University men's baseball team were randomly assigned to 2 treatment groups: Spencer technique or sham therapy...
March 1, 2017: Journal of the American Osteopathic Association
Benjamin F Donohue, Marc G Lubitz, Timothy E Kremchek
Injuries to the latissimus dorsi and teres major muscles, while rare, are debilitating. They are seen in a variety of sports, although disproportionately in the throwing shoulder of baseball pitchers. There have been 25 case reports and 2 case series published on the nonoperative and operative management of these injuries. Latissimus dorsi and teres major muscle anatomy, function, and common injury patterns are well described in these case reports. Also well detailed are the typical patient presentation, physical examination, and imaging findings...
August 2017: American Journal of Sports Medicine
A Pellegrini, P Tonino, D Salazar, K Hendrix, I Parel, A Cutti, P Paladini, F Ceccarelli, G Porcellini
PURPOSE: Scapular dyskinesis is a recognized cause of shoulder pain in the throwing shoulder of baseball pitchers and athletes who participate in overhead sports. Past studies have assessed scapular kinematics using electromagnetic tracking devices and have shown a correlation between posterior shoulder tightness and forward scapular posture. The purpose of our study is to evaluate the scapular kinematics, before and after a 4-week posterior stretching protocol in asymptomatic pitchers...
December 2016: Musculoskeletal Surgery
Rachel Patrick, Josh McGinty, Ann Lucado, Beth Collier
BACKGROUND: Ulnar collateral ligament (UCL) tears and associated Tommy Johns surgical intervention from excessive and poor quality pitching has increased immensely-with more college and professional pitchers undergoing the surgery in 2014 alone than in the 1990s as a whole.(1) Faulty mechanics developed at young ages are often well-engrained by the late adolescent years and the minimal healing ability of the largely avascular UCL often leads to delayed safe return to sport.(2). PURPOSE: The purpose of this case study was to describe an innovative, multimodal approach to conservative management of a chronic UCL injury in a college-aged baseball pitcher...
August 2016: International Journal of Sports Physical Therapy
Benton E Heyworth, Dennis E Kramer, Daniel J Martin, Lyle J Micheli, Mininder S Kocher, Donald S Bae
BACKGROUND: With rising participation in youth sports such as baseball, proximal humeral epiphysiolysis, or Little League shoulder (LLS), is being seen with increasing frequency. However, there remains a paucity of literature regarding the causes, natural history, or treatment outcomes of LLS. PURPOSE: To analyze the demographic, clinical, and diagnostic features of a population of LLS patients, with an emphasis on identifying underlying risk factors for the development and recurrence of LLS after nonoperative treatment...
June 2016: American Journal of Sports Medicine
David Wasylynko
OBJECTIVE: To describe a case of chronic Little Leaguer's Shoulder in reference to pain presentation, physical capabilities, and recovery time. CLINICAL FEATURES: A 17-year-old, junior baseball pitcher presented with shoulder pain when performing high velocity pitching. Conservative treatment for an assumed soft tissue injury failed to resolve the pain, which was regularly aggravated by pitching, and which subsequently prompted further evaluation, and eventual confirmation of Little Leaguer's Shoulder on subsequent computerized tomography (CT) imaging...
December 2015: Journal of the Canadian Chiropractic Association
Kevin E Wilk, Todd R Hooks
The overhead athlete has unique physical traits and adaptive changes as a result of the repetitive nature of throwing. An effective rehabilitation program depends on an accurate evaluation to determine the causative factors for an athlete's pathology. A treatment program is individualized with specific strengthening and flexibility exercises to achieve dynamic stability that is required for overhead function. In this article the characteristics of the throwing shoulder and specific injuries are described. The rehabilitation program is described in a multiphased approach that allows for the restoration of strength, mobility, endurance, and power to return to sporting activity...
April 2015: Clinics in Sports Medicine
Scott T Watson, Douglas J Wyland
BACKGROUND: Treatment of type III acromioclavicular (AC) separations is controversial, especially in the dominant shoulder of a high-level throwing athlete. This case report describes the return to play after nonoperative management of a collegiate baseball pitcher with a severe type III AC separation in his throwing shoulder. HYPOTHESIS/PURPOSE: Case report of return to play with nonoperative management of a type III AC separation in the throwing shoulder of a collegiate pitcher...
February 2015: Physician and Sportsmedicine
Kazuhisa Matsui, Takashi Tachibana, Mary Magarey
STUDY DESIGN: Case report. BACKGROUND: A case of an athlete with accessory nerve injury has not been previously reported although there have been a number of case reports and case series of non-athletes with accessory nerve injury. This case study reports motor control intervention for an amateur baseball pitcher with isolated paralysis of the right trapezius who lost pitching control after changing his pitching technique. The subject was able to restore ball control during overhead throwing after physiotherapy...
December 2014: International Journal of Sports Physical Therapy
Jeffrey Dugas, Justin Chronister, E Lyle Cain, James R Andrews
Ulnar collateral ligament (UCL) injuries are most commonly reported in baseball players (particularly in pitchers) but have also been observed in other overhead athletes including javelin, softball, tennis, volleyball, water polo, and gymnastics. Partial injuries have been successfully treated with appropriate nonoperative measures but complete tears and chronic injuries have shown less benefit from conservative measures. In these cases, surgical reconstruction has become the treatment modality for overhead athlete who wishes to continue to play...
September 2014: Sports Medicine and Arthroscopy Review
Venita Chandra, Christine Little, Jason T Lee
OBJECTIVE: Repetitive upper extremity use in high-performance athletes is associated with the development of neurogenic and vascular thoracic outlet syndrome (TOS). Surgical therapy in appropriately selected patients can provide relief of symptoms and protection from future disability. We sought to determine the incidence and timing of competitive athletes to return to their prior high-performance level after TOS treatment and surgery. METHODS: We reviewed all competitive high school, collegiate, and professional athletes treated for venous or neurogenic TOS (nTOS) from 2000 to 2012...
October 2014: Journal of Vascular Surgery
Jun-Youl Cha, Jae-Hak Kim, Ju Hong, Young-Tae Choi, Min-Ho Kim, Ji-Hyun Cho, Il-Gyu Ko, Yong-Seok Jee
The aim of this study was to investigate the effects of a 12-week rehabilitation program on body composition, shoulder pain, and isokinetic internal/external torques of pitchers with impingement syndrome. A total of 30 pitchers were divided into 2 groups: experimental group (EG, n = 16) and control group (CG, n= 14). The rehabilitation program consisted of physical therapy, warm-up, work-out, and cool-down. As results, body weight and fat mass of EG were decreased whereas muscle mass of EG was significantly increased after the experiment...
February 2014: Journal of Exercise Rehabilitation
Wasyl W Fedoriw, Prem Ramkumar, Patrick C McCulloch, David M Lintner
BACKGROUND: The published return-to-play (RTP) rates for athletes who have undergone surgical repair of superior labrum anterior-posterior (SLAP) tears vary widely and are generally accepted to be lower in the subset of competitive throwers. The efficacy of nonsurgical treatment for this group is unknown. HYPOTHESIS: Nonsurgical treatment of SLAP tears in professional baseball players leads to RTP before consideration of surgical treatment. Incorporating performance statistics and level of competition will result in lower calculated RTP rates than have been previously reported...
May 2014: American Journal of Sports Medicine
Luke Stephens, James J Kinderknecht, Dennis Y Wen
: Nontraumatic musculocutaneous nerve palsy is a rare injury that can occur in throwers. We present a case of musculocutaneous nerve injury in a high school pitcher, which has rarely been previously reported. The unique electromyography findings add to the overall spectrum seen with musculocutaneous nerve injuries in throwers. Sensory abnormalities may not be present at initial evaluation, but rather weakness or pain of the biceps is the most common presenting concern. Electrodiagnostic evaluation is paramount for confirmation of diagnosis, yet the timing of this study is critical for its accuracy...
November 2014: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
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