Baseball

Question 1

What is the throwers paradox?

Answer 1

Balance btwn adequate laxity and sufficient stability

Throwers shoulder:

• Increased ER motion
• Increased IR strength
• Total arc of motion needs to be preserved (often demonstrate a significant loss in IR greater than ER)

Question 2

What ligament is the primary restraint in the late cocking phase of throwing?

Answer 2

IGHL:

- specifically anterior band of the IGHL

Question 3

What ligament is often strained with a SLAP lesion?

Answer 3

IGHL:

- specifically superior band of the IGHL

Question 4

What is “dead arm syndrome”?

What pathology may be present in pitchers?

Answer 4

• Painful shoulder w/ throwing and can no longer throw with pre-injury velocity
• SLAP lesion

Question 5

Describe the Peel Back Mechanism in a throwing athlete

Answer 5

Late cocking phase

Eccentric follow through stresses on bicep-labral complex
- Inc strain in the late cocking phase may contribute to the detachment of the labrum w/ the eccentric contraction of the biceps muscle that occurs with rapid extension of the elbow

Can create a SLAP lesion

Question 6

During what phase are the MOST forces imparted to the shoulder?

Answer 6

• deceleration phase

Question 7

What ossesous adpatation is associated with greater ER ROM and lesser IR ROM?

Answer 7

Greater humeral head retroversion

Question 8

What dx could cause a pitcher to report “loosing feeling” in his hand?

Answer 8

Cubital tunnel syndrome

• can minimal lateral epicondylitis
• greatest stress during late cocking phase

Question 9

What pitches generate the greatest forces & torque?

Answer 9

Fastball
Curveball
Slider
Change-Up

Question 10

What angle is the best to test UCL ligamentous stability?

Answer 10

20-40 deg

Question 11

What is the moving valgus stress test best for?

Answer 11

• More sensitive than standard valgus stress test

- Good for high-level athletes with a small partial tear of the UCL

Question 12

What portion of the UCL ligament is the primary restraint to stresses induced by baseball pitching?

Answer 12

Anterior bundle

• primary restraint from 30 - 120 deg of flexion
• subject to near failure tensile stresses during the acceleration phase of throwing

Question 13

Pitchers 16 years and younger, what are the appropriate number of rest days?
21-40 pitches = ___ rest days
41-60 pitches = ___ rest days
61+ pitches = ____ rest days

Answer 13

21-40 pitches = 1 rest day
41-60 pitches = 2 rest days
61+ pitches = 3 rest days

Question 14

Tests for SLAP lesions in overhead athletes should mimic the peel back mechanism:

What 5 tests best do this?

Answer 14

♣	Biceps load
♣	Biceps load II
♣	Pronated load
♣	Pain provocation
♣	Resisted supination ER

Question 15

What elbow angle is best to test ligamentous stability?

Answer 15

20-40 degrees

Question 16

During the late cocking phase of overhead throwing which muscle(s) display the greatest amount of EMG activity?

Answer 16

Subscapularis

• Eccentric load

Question 17

Hyper-external glenohumeral rotation is thought to directly contribute to the following injury(ies) in throwers:?

Answer 17

Anterior-inferior microinstability