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The ulnar collateral ligament loading paradox between in-vitro and in-vivo studies on baseball pitching (narrative review)
Ulnar collateral ligament (UCL) weakening or tears occur in 16% of professional baseball pitchers. To prevent players from sustaining a UCL injury, it is important to understand the relationship between the UCL properties and elbow stabilizers with the load on the UCL during pitching. In-vitro studi...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130712/ https://www.ncbi.nlm.nih.gov/pubmed/33998377 http://dx.doi.org/10.1080/23335432.2021.1916405 |
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author | Van Trigt, Bart Vliegen, Liset (W) Leenen, Ton (Ajr) Veeger, DirkJan (Hej) |
author_facet | Van Trigt, Bart Vliegen, Liset (W) Leenen, Ton (Ajr) Veeger, DirkJan (Hej) |
author_sort | Van Trigt, Bart |
collection | PubMed |
description | Ulnar collateral ligament (UCL) weakening or tears occur in 16% of professional baseball pitchers. To prevent players from sustaining a UCL injury, it is important to understand the relationship between the UCL properties and elbow stabilizers with the load on the UCL during pitching. In-vitro studies showed that the ultimate external valgus torque of 34 Nm would rupture the UCL, which is in apparent conflict with the reported peak valgus torques in pitching (40–120 Nm). Assuming both observations are correct, the question rises why ‘only’ 16 out of 100 professional pitchers sustain a UCL rupture. Underestimation of the effect of other structures in in-vivo studies is most likely the explanation of this mismatch because the calculated in-vivo torque also includes possible contributions of functional and structural stabilizers. In-vitro studies show that the flexor-pronator mass has the potential to counteract valgus torque directly, whereas the elbow flexor-extensor muscles combined with the humeroradial joint might have an indirect effect on valgus torque by increasing the joint compression force. Accurate experimental electromyography data and a more detailed (musculoskeletal)mechanical model of the elbow are needed to investigate if and to what extent the structural and functional stabilizers can shield the UCL during pitching. |
format | Online Article Text |
id | pubmed-8130712 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-81307122021-06-15 The ulnar collateral ligament loading paradox between in-vitro and in-vivo studies on baseball pitching (narrative review) Van Trigt, Bart Vliegen, Liset (W) Leenen, Ton (Ajr) Veeger, DirkJan (Hej) Int Biomech Review Ulnar collateral ligament (UCL) weakening or tears occur in 16% of professional baseball pitchers. To prevent players from sustaining a UCL injury, it is important to understand the relationship between the UCL properties and elbow stabilizers with the load on the UCL during pitching. In-vitro studies showed that the ultimate external valgus torque of 34 Nm would rupture the UCL, which is in apparent conflict with the reported peak valgus torques in pitching (40–120 Nm). Assuming both observations are correct, the question rises why ‘only’ 16 out of 100 professional pitchers sustain a UCL rupture. Underestimation of the effect of other structures in in-vivo studies is most likely the explanation of this mismatch because the calculated in-vivo torque also includes possible contributions of functional and structural stabilizers. In-vitro studies show that the flexor-pronator mass has the potential to counteract valgus torque directly, whereas the elbow flexor-extensor muscles combined with the humeroradial joint might have an indirect effect on valgus torque by increasing the joint compression force. Accurate experimental electromyography data and a more detailed (musculoskeletal)mechanical model of the elbow are needed to investigate if and to what extent the structural and functional stabilizers can shield the UCL during pitching. Taylor & Francis 2021-04-28 /pmc/articles/PMC8130712/ /pubmed/33998377 http://dx.doi.org/10.1080/23335432.2021.1916405 Text en © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Van Trigt, Bart Vliegen, Liset (W) Leenen, Ton (Ajr) Veeger, DirkJan (Hej) The ulnar collateral ligament loading paradox between in-vitro and in-vivo studies on baseball pitching (narrative review) |
title | The ulnar collateral ligament loading paradox between in-vitro and in-vivo studies on baseball pitching (narrative review) |
title_full | The ulnar collateral ligament loading paradox between in-vitro and in-vivo studies on baseball pitching (narrative review) |
title_fullStr | The ulnar collateral ligament loading paradox between in-vitro and in-vivo studies on baseball pitching (narrative review) |
title_full_unstemmed | The ulnar collateral ligament loading paradox between in-vitro and in-vivo studies on baseball pitching (narrative review) |
title_short | The ulnar collateral ligament loading paradox between in-vitro and in-vivo studies on baseball pitching (narrative review) |
title_sort | ulnar collateral ligament loading paradox between in-vitro and in-vivo studies on baseball pitching (narrative review) |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130712/ https://www.ncbi.nlm.nih.gov/pubmed/33998377 http://dx.doi.org/10.1080/23335432.2021.1916405 |
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