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. 2024 May 20;12(5):23259671241246061.
doi: 10.1177/23259671241246061. eCollection 2024 May.

Psychological Impact and Posttraumatic Stress Disorder Symptomatology After Ulnar Collateral Ligament Injuries in Baseball Players

Frank J Alexander  1 , Michael A Mastroianni  1 , Matthew J J Anderson  1 , Kira Skaggs  1 , Hasani W Swindell  1 , Alan W Reynolds  1 , Christopher S Ahmad  1
Affiliations

Psychological Impact and Posttraumatic Stress Disorder Symptomatology After Ulnar Collateral Ligament Injuries in Baseball Players

Frank J Alexander et al. Orthop J Sports Med. .

Abstract

Background: Significant psychological impact and prevalence of posttraumatic stress disorder (PTSD) have been well documented in patients sustaining anterior cruciate ligament injury.

Purpose: To examine PTSD symptomatology in baseball players after sustaining elbow ulnar collateral ligament (UCL) injury.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: Male baseball players of various competition levels (high school through Minor League Baseball [MiLB]) who underwent surgery for a UCL injury between April 2019 and June 2022 participated in the study. Before surgery, patients completed the Impact of Event Scale-Revised (IES-R) to assess PTSD symptomatology. Subgroup analysis was conducted according to level of play and player position.

Results: A total of 104 male baseball players with a mean age of 19.4 years (range, 15-29 years) were included in the study; 32 players (30.8%) were in high school, 65 (62.5%) were in college, and 7 (6.7%) were in MiLB. There were 64 (61.5%) pitchers, 18 (17.3%) position players, and 22 (21.2%) 2-way players (both pitching and playing on the field). A total of 30 (28.8%) patients scored high enough on the IES-R to support PTSD as a probable diagnosis, and another 22 patients (21.2%) scored high enough to support PTSD as a clinical concern. Nineteen patients (18.3%) had potentially severe PTSD. Only 4 players (3.8%) were completely asymptomatic. Subgroup analysis revealed college players as significantly more symptomatic than high school players (P = .02), and 2-way players were found to be significantly less susceptible to developing symptoms of PTSD compared with pitchers (P = .04).

Conclusion: Nearly 30% of baseball players who sustained a UCL injury qualified for a probable diagnosis of PTSD based on the IES-R. Pitchers and college athletes were at increased risk for PTSD after UCL injury compared with 2-way players and high school athletes, respectively.

Keywords: Tommy John surgery; medial ulnar collateral ligament injury; posttraumatic stress disorder; rehabilitation; thrower’s elbow; ulnar collateral ligament injury.

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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: M.J.J.A. has received grant support from DJO, education payments from Smith + Nephew, and hospitality payments from Medical Device Business Services. H.W.S. has received education payments from Arthrex and Smith + Nephew, hospitality payments from Stryker, and honoraria from Encore Medical. A.W.R. has received education payments from Gotham Surgical and Mid-Atlantic Surgical Systems. C.S.A. has received consulting fees, nonconsulting fees, and royalties from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from Columbia University Medical Center (ref No. IRB-AAAS3704).

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