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Szabolcs Lajos Molnár, Péter Hidas, György Kocsis, Gábor Rögler, Péter Balogh, Miklós Farkasházi and Péter Lang

Background:

Upper extremity injuries are common in wrestling, most of which do not require surgery.

Methods:

We retrospectively documented the case histories of six elite wrestlers who sustained elbow injuries that required surgical treatment, three of which involved reinjury and another surgical procedure.

Results:

All but one of the six initial injuries were associated with a defensive maneuver. Reinjury was more common for freestyle wrestling than for Greco-Roman style. The average time between the initial elbow injury and surgical intervention was 22 months. One-half of the wrestlers with elbow injuries that required surgery were reinjured and underwent revision surgery.

Conclusions:

All of the elite wrestlers waited for a long period of time before receiving surgery for the initial injury, and the reinjury rate was high.

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Thomas W. Kaminski, Michael E. Powers and Bernadette Buckley

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Column-editor : Neil Curtis

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Noah X. Tocci, David R. Howell, Dai Sugimoto, Corey Dawkins, Amy Whited and Donald Bae

, Hassell N , Andrews JR . Prevention of elbow injuries in youth baseball pitchers . Curr Sports Med Rep . 2009 ; 8 ( 5 ): 250 – 254 . PubMed doi:10.1249/JSR.0b013e3181b7ee5f 10.1249/JSR.0b013e3181b7ee5f 19741352 2. Lyman S , Fleisig GS , Waterbor JW

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Michael M. Reinold, Glenn S. Fleisig, James R. Andrews, Kevin E. Wilk and Gene G. Jameson

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Craig M. Buettner and Deidre Leaver-Dunn

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Yin-Chou Lin, Angela Thompson, Jung-Tang Kung, Liang-Wei Chieh, Shih-Wei Chou and Jung-Charng Lin

Context:

Elbow injuries are widely reported among baseball players. The elbow is susceptible to injury when elbow-flexor and -extensor forces are imbalanced during pitching or throwing. Assessment of muscle-strength ratios may prove useful for diagnosing elbow injury.

Objective:

The purpose of this study was to assess the relationship between the elbow-flexor and -extensor functional isokinetic ratios and elbow injury in baseball players.

Design:

Retrospective study.

Setting:

Biomechanics laboratory.

Participants:

College baseball players with (n = 9) and without (n = 12) self-reported elbow pain or loss of strength were recruited.

Intervention and Main Outcome Measures:

Trials were conducted using a dynamometer to assess dominant-arm flexor and extensor concentric and eccentric strength at angular velocities of 60° and 240°/s. Functional isokinetic ratios were calculated and compared between groups.

Results:

Regression analysis revealed that a ratio of biceps concentric to triceps concentric strength greater than 0.76 (the median value) significantly predicted elbow injury (P = .01, odds ratio of injury = 24). No other ratios or variables (including position played) were predictive of injury status.

Conclusions:

These findings suggest that the ratio of biceps concentric to triceps concentric functional strength strongly predicts elbow-injury status in baseball players. Assessment of this ratio may prove useful in a practical setting for training purposes and both injury diagnosis and rehabilitation.

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James R. Andrews, James M. Dennison and Kevin E. Wilk

Most physicians, trainers, and therapists are accustomed to thinking of open and closed kinetic chain terminology in terms of exercise and its application in rehabilitation protocols. This terminology can also be used to describe the mechanism by which injuries occur. Categorizing upper extremity injuries in this way not only provides vital insight into the mechanism of the injuries and helps identify possible injured structures but also allows the clinician to better develop treatment protocols. In this article, this categorization is applied to common shoulder and elbow injuries to provide insight into the nature of these injuries.

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Tomoyuki Matsuo, Glenn S. Fleisig, Naiquan Zheng and James R. Andrews

Elbow varus torque is a primary factor in the risk of elbow injury during pitching. To examine the effects of shoulder abduction and lateral trunk tilt angles on elbow varus torque, we conducted simulation and regression analyses on 33 college baseball pitchers. Motion data were used for computer simulations in which two angles— shoulder abduction and lateral trunk tilt—were systematically altered. Forty-two simulated motions were generated for each pitcher, and the peak elbow varus torque for each simulated motion was calculated. A two-way analysis of variance was performed to analyze the effects of shoulder abduction and trunk tilt on elbow varus torque. Regression analyses of a simple regression model, second-order regression model, and multiple regression model were also performed. Although regression analyses did not show any significant relationship, computer simulation indicated that the peak elbow varus torque was affected by both angles, and the interaction of those angles was also significant. As trunk tilt to the contralateral side increased, the shoulder abduction angle producing the minimum peak elbow varus torque decreased. It is suggested that shoulder abduction and lateral trunk tilt may be only two of several determinants of peak elbow varus torque.

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Harold King, Stephen Campbell, Makenzie Herzog, David Popoli, Andrew Reisner and John Polikandriotis

Background:

More than 1 million US high school students play football. Our objective was to compare the high school football injury profiles by school enrollment size during the 2013–2014 season.

Methods:

Injury data were prospectively gathered on 1806 student athletes while participating in football practice or games by certified athletic trainers as standard of care for 20 high schools in the Atlanta Metropolitan area divided into small (<1600 students enrolled) or large (≥1600 students enrolled) over the 2013–2014 football season.

Results:

Smaller schools had a higher overall injury rate (79.9 injuries per 10,000 athletic exposures vs. 46.4 injuries per 10,000 athletic exposures; P < .001). In addition, smaller schools have a higher frequency of shoulder and elbow injuries (14.3% vs. 10.3%; P = .009 and 3.5% vs. 1.5%; P = .006, respectively) while larger schools have more hip/upper leg injuries (13.3% vs. 9.9%; P = .021). Lastly, smaller schools had a higher concussion distribution for offensive lineman (30.6% vs. 13.4%; P = .006) and a lower rate for defensive backs/safeties (9.2% vs. 25.4%; P = .008).

Conclusions:

This study is the first to compare and show unique injury profiles for different high school sizes. An understanding of school specific injury patterns can help drive targeted preventative measures.