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. 2011 Jun;39(6):1233-7.
doi: 10.1177/0363546510396319. Epub 2011 Feb 18.

Relationship between the medial elbow adduction moment during pitching and ulnar collateral ligament appearance during magnetic resonance imaging evaluation

Wendy J Hurd  1 , Kenton R Kaufman, Naveen S Murthy
Affiliations

Relationship between the medial elbow adduction moment during pitching and ulnar collateral ligament appearance during magnetic resonance imaging evaluation

Wendy J Hurd et al. Am J Sports Med. 2011 Jun.

Abstract

Background: Medial elbow distraction during pitching as the primary mechanism contributing to adaptations in ulnar collateral ligament (UCL) appearance during magnetic resonance imaging (MRI) evaluation has not been established.

Hypothesis: Uninjured high school-aged pitchers with unilateral adaptations of the UCL exhibit a higher peak internal elbow adduction moment than those without UCL adaptations.

Study design: Cohort study (Prevalence); Level of evidence, 2.

Methods: Twenty uninjured, asymptomatic high school-aged pitchers underwent bilateral elbow MRI examinations. Three-dimensional motion analysis testing was performed to collect throwing arm biomechanics as participants pitched from an indoor mound. Nonparametric tests were performed to compare peak internal elbow adduction moment in uninjured participants with and without adaptations in UCL appearance and to determine the nature of the relationship between the peak internal adduction moment and UCL appearance.

Results: Uninjured participants with UCL thickening exhibited a higher peak internal elbow adduction moment of 53.3 ± 6.8 N·m compared with uninjured participants without adaptations in UCL appearance, 38.8 ± 10.9 N·m (P = .05), as higher moments were correlated with ligament thickening (correlation coefficient, 0.45) (P = .02).

Conclusion: This study establishes the association between medial elbow distraction captured by the internal adduction moment during pitching and UCL adaptations visible during MRI evaluation.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: Funding for this study was provided by Major League Baseball and the Kelly-Aircast Foundation; Dr Hurd’s salary support was provided by the National Institutes of Health (T-32 HD00447).

Figures

Figure 1
Figure 1
Dominant (A) and nondominant (B) MRI images for an uninjured participant without unilateral adaptations in ulnar collateral ligament (UCL) appearance. Arrows denote symmetrical UCL appearance.
Figure 2
Figure 2
Dominant (A) and nondominant (B) MRI images for an uninjured participant with unilateral adaptations in ulnar collateral ligament (UCL) appearance. Arrows denote asymmetrical UCL appearance.
See this image and copyright information in PMC

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