Abdominal muscle strains in professional baseball: 1991-2010

Tennis injuries: epidemiology, pathophysiology, and treatment

Tennis places high loads on the joints of players, with supraphysiologic forces being generated at the shoulder and elbow hundreds of times per match. Acute injuries tend to affect the lower extremity; chronic injuries usually involve the upper extremity. Commonly encountered upper extremity conditions include rotator cuff injury, internal impingement, superior labral tears, and epicondylitis of the elbow. Serving is the most strenuous stroke in tennis, with the highest peak muscle activity in the shoulder and forearm occurring during this stroke. The kinetic chain links upper extremity, lower extremity, and core muscle segments by transmitting coordinated activation and motion; in this regard, any pathologic process that disturbs the groin, hip, and abdominal musculature can further result in an increased risk of injury to the shoulder and upper extremity. Evolution in equipment and in play surfaces has also affected the type and frequency of injuries. Prevention programs that address the muscular imbalances throughout the kinetic chain may help reduce the incidence of both acute and chronic injuries experienced by tennis athletes.

Lumbopelvic control and days missed because of injury in professional baseball pitchers

BACKGROUND

Recently, lumbopelvic control has been linked to pitching performance, kinematics, and loading; however, poor lumbopelvic control has not been prospectively investigated as a risk factor for injuries in baseball pitchers.

HYPOTHESIS

Pitchers with poor lumbopelvic control during spring training are more likely to miss ≥30 days because of an injury through an entire baseball season than pitchers with good lumbopelvic control.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

A total of 347 professional baseball pitchers were enrolled into the study during the last 2 weeks of spring training and stayed with the same team for the entire season. Lumbopelvic control was quantified by peak anterior-posterior deviation of the pelvis relative to the starting position during a single-leg raise test (APScore). Days missed because of an injury through the entire season were recorded by each team's medical staff.

RESULTS

A higher APScore was significantly associated with a higher likelihood of missing ≥30 days (P = .023, χ(2) test). When divided into tertiles based on their APScore, participants in the highest tertile were 3.0 times and 2.2 times more likely to miss at least 30 days throughout the course of a baseball season relative to those in the lowest or middle tertiles, respectively. A higher APScore was also significantly associated with missing more days because of an injury within participants who missed at least 1 day (P = .018, ANOVA), with participants in the highest tertile missing significantly more days (mean, 98.6 days) than those in the middle tertile (mean, 45.8 days; P = .017) or lowest tertile (mean, 43.8 days; P = .017).

CONCLUSION

This study found that poor lumbopelvic control in professional pitchers was associated with an increased risk of missing significant time because of an injury.

Uncommon external abdominal oblique muscle strain in a professional soccer player: a case report

BACKGROUND

This is the first report of external abdominal oblique muscle injury occurring in a professional soccer player.

CASE PRESENTATION

A 28-year-old Caucasian professional soccer player presented after experiencing a popping sensation associated with strong parietal pain localized between the left 11th and 12th ribs. Ultrasound examination revealed a collection of fluid under the 11th rib, suggesting injury of the left external oblique muscle. Platelet-rich plasma treatment was administered and the soccer player returned to competition on the 21st day after treatment.

CONCLUSION

This rare injury results from a sudden intrinsic eccentric contraction of the internal oblique muscle while in a stretched position. Ultrasound can help to confirm the diagnosis and to monitor clinical follow-up. Platelet-rich plasma treatment could aid recovery in high-level athletes.

Understanding noninguinal abdominal hernias in the athlete

Abdominal hernias are common with over 20 million hernia repairs performed worldwide. Inguinal hernias are the most common type of hernia. Inguinal and sports hernia have been discussed at length in recent literature, and therefore, they will not be addressed in this article. The noninguinal hernias are much less common but do occur, and knowledge of these hernias is important when assessing the athlete with abdominal pain. Approximately 25% of abdominal wall hernias are noninguinal, and new data show the order of frequency as umbilical, epigastric, incisional, femoral, and all others (i.e., Spigelian, obturator, traumatic). Return-to-play guidelines need to be tailored to the athlete and the needs of their sport. Using guidelines similar to abdominal strain injuries can be a starting point for the treatment plan. Laparoscopic repair is becoming more popular because of safety and efficacy, and it may lead to a more rapid return to play.

Whole-body and segmental muscle volume are associated with ball velocity in high school baseball pitchers

The aim of the study was to examine the relationship between pitching ball velocity and segmental (trunk, upper arm, forearm, upper leg, and lower leg) and whole-body muscle volume (MV) in high school baseball pitchers. Forty-seven male high school pitchers (40 right-handers and seven left-handers; age, 16.2 ± 0.7 years; stature, 173.6 ± 4.9 cm; mass, 65.0 ± 6.8 kg, years of baseball experience, 7.5 ± 1.8 years; maximum pitching ball velocity, 119.0 ± 9.0 km/hour) participated in the study. Segmental and whole-body MV were measured using segmental bioelectrical impedance analysis. Maximum ball velocity was measured with a sports radar gun. The MV of the dominant arm was significantly larger than the MV of the non-dominant arm (P < 0.001). There was no difference in MV between the dominant and non-dominant legs. Whole-body MV was significantly correlated with ball velocity (r = 0.412, P < 0.01). Trunk MV was not correlated with ball velocity, but the MV for both lower legs, and the dominant upper leg, upper arm, and forearm were significantly correlated with ball velocity (P < 0.05). The results were not affected by age or years of baseball experience. Whole-body and segmental MV are associated with ball velocity in high school baseball pitchers. However, the contribution of the muscle mass on pitching ball velocity is limited, thus other fundamental factors (ie, pitching skill) are also important.