Introduction: Medial elbow ulnar collateral ligament (UCL) injuries are common in baseball with increased surgical incidence in pitchers. There is no consensus on which modifiable injury risk metrics or performance screening tools to use to identify at risk collegiate baseball pitchers. Current literature on UCL injury risk has focused on local passive glenohumeral rotational motion with limited forays into more global movement patterns. The aim of this study was to assess possible relationships involving UCL injuries and modifiable local and global motor control performance risk factors. Material and Methods: An observational single cohort case series involving 15 collegiate baseball pitchers aimed to elucidate disparitites in glenohumeral active and passive range of motion alongside an assessment of general movement competency and dynamic motor control performance to identify injury risk for the UCL. Preseaon baseline metrics, including the Functional Movement Screen, Upper and Lower Quarter Y Balance Test, and glenohumaral internal and external rotation active, passive, and total arc range of motion were examined. Results: The two pitchers with UCL injury demonstrated less ability to actively move into their available passive rotational range with decreased lower extremity dynamic postural control, but no difference with general movement competency. The pitcher requiring UCL surgical intervention demonstrated even greater excessive passive range compared to the other injured pitcher and a decreased ability to control base of support during the dynamic single-leg balance performance test. Discussion: Participants with UCL injuries exibited noticable deficiencies in baseline active and passive mobility, suggestive of a potential motor control deficit and a compromised ability to fully access available range of motion. Furthermore, diminished performance on the Lower Quarter Y Balance Test identified potential motor control limitations involving a decreased ability to dynamically maintain a base of support. Conclusions: This is the first study designed to identify motor control issues in the both the local shoulder region and global body movement to identify modifiable risk factors for UCL injuries in baseball pitchers. This study may begin to address the gap in the literature by combining modifiable local shoulder range of motion and global balance metrics to identify pitchers at risk for UCL injuries. It underscores the significance of comparing active and passive range of motion in tandem with dynamic postural control assessments to better evaluate the risk of injuries in baseball pitchers. This case series lays the groundwork for future randomized clinical trials to evaluate the utiliity of combining this information.
Harper, B. A., Bailey, L. J., Jones, M. N., & Bradley, J. (2023). Integrating glenohumeral range of motion with dynamic postural control for early detection of elbow injury risk in collegiate baseball pitchers: A preliminary prospective case series. Journal of Physical Education and Sport, 23(10), 2794-2803. 10.7752/jpes.2023.10319
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