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Baseball Players and Hurt Elbows: The Long Term Complications

by Nora Gilman, MS, LAT, ATC

If you recall being injured as a child or adolescent, you have three times the risk of having Tommy John Surgery as a professional player.

This was the result of a study published by Vance et al which examined professional and amateur pitchers and their likelihood of sustaining a UCL injury based on their childhood.

The study surveyed 169 major league and minor league baseball players during their baseball spring training period. They were asked if they were injured as a child or adolescent.

55% of pitchers with a UCL injury had a history of elbow issues as a young baseball player, compared with 18% of the uninjured group.

There have been substantial efforts devoted to reducing the amount of elbow injuries in baseball, such as pitch count, pitch velocity, pitching while fatigued, and proper mechanics. This study suggests a new remarkable risk factor, childhood/adolescent medial elbow injuries that present mild and manageable with rest. We now know this presentation should not be ignored. Two things to consider in this scenario:

  • Youth baseball players' growth plates are open in the elbow. Mild trauma to this area may not have healed back to normal despite pain free throwing.

  • There is underlying scar tissue in response to the injury and the ligament is still weak. If the ligament never heals to full strength after an injury, it is predisposed to further injuries.

Further recommendations include not pitching through fatigue. When the elbow becomes injured, the rest period can severely decondition the athlete. While the athlete can experiences pain free throwing, pay more attention to fatigue. Allowing the elbow to recover properly can ensure the weakened ligament can thicken and heal.

Conclusions of this study describe, “pitchers with a previous childhood elbow injury had a significantly higher incidence of UCL injuries during their adult career, suggesting possible predisposition to UCL injury and warranting of further research.”

Source: Vance, D. Frank, A. Kunkle, B. 2019. Professional and amateur pitchers’ perspective on the ulnar collateral ligament injury risk. OJSM.

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