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Injury Prevention

Overuse Injuries and Training Year Around for One Sport

Dr. Larry W. McDaniel Ed. D. and Brian McLaughlin discuss injuries and the year around practice and participation in the same sport.

Introduction

One of the most common injuries in a baseball involves the Ulnar Collateral Ligament. These injuries may require Ulnar Collateral Ligament Reconstruction. This surgery is sometimes referred to as "Tommy Johns Surgery". In this process the damaged ligament is replaced by a ligament from somewhere else in the body. Presently more young people are at risk for this injury due to starting competition earlier in competitive sports and the increase in intensity that is present in most sports. "Specialization and year round training are absolutely the leading culprits for the surgery in our youth (Jarrett 2008, pg. 1)[3]."

Ulnar Collateral Ligament Reconstruction

In 1974, a pitcher for the Los Angeles Dodgers underwent Ulnar Collateral Ligament Reconstruction surgery. His name was Tommy John, and was the first professional pitcher to undergo the surgery. Back then, the odds for recovery were 1 in 100. He beat the odds and continued pitching for fifteen years. So what is the surgery? This surgery involves a process of removing a damaged ligament from the elbow and replacing it with another ligament from somewhere else in the body. "Often the ligament is taken from the forearm, hamstring, knee, or foot of the patient (McDaniel et al. 2009, pg. 1)[4]." The tendon is then harvested and woven into a figure eight pattern through tunnels that have been drilled into the bones of the elbow joint. The chances today of a full recovery after surgery are between eighty five and ninety percent. Full range of motion is recovered after two months, but full recovery takes approximately six to twelve months. During this time, weight training and exercises should be performed in order to progress through rehabilitation on time (McDaniel et al. 2009)[4].

Prevalence

Obviously since the first person to undergo this surgery was a baseball player, the athletes that most commonly require this surgery are baseball players. There are other sports that use similar movements, such as throwing a javelin, a quarterback in American football, and tennis players. These athletes are at risk for ligament damage, however those sports cannot compare to the repetition and damage of a baseball pitcher. Most major league pitchers throw a baseball upwards of ninety miles an hour over one hundred times a game. "At a major leaguer's release point, his arm is moving so fast that it could spin around 20 times in 1 second (McNeal 2004, pg. 1)[5]." In addition to those forces, the arm performs different contortions for each different pitch in the pitchers repertoire.

Anatomy of the elbow

Young Athletes

UCL surgery has become a popular trend for those participating in little league baseball. This surgery has become so accepted in this age group that common myths have become popular. One myth states that UCL surgery makes the arm stronger. This is the myth that has parents of little leaguers asking their doctors if they can perform the surgery on their son's perfectly healthy arm (Fraser 2007)[2]. UCL surgery should only be performed on damaged arms. This does not eliminate all youths from requiring the operation. Young athletes have become particularly vulnerable to Tommy John Surgery because of specialization in sports. Early specialization creates the symptoms by overuse and repetitive stress placed on the ligaments of the elbow. Young athletes have become more at risk due to the number of hazards involved in specialization in sports. The problem with specialization is that many experts agree that specialization falsely promotes the idea that athletes will reach elite status (Jarrett 2008)[3]. One way to control youth specialization is "periodization". There are a lot of adults who wish they had the energy of a twelve year old, but even twelve year olds need a break from competition. "The American Academy of Pediatrics' Council on Sports Medicine and Fitness recommends limiting one sporting activity to a maximum of five days per week with at least one day off from any organized physical activity" (Jarrett 2008, pg. 2)[3]. The above group also recommends that young athletes take at least two or more months off from completion each year.

Conclusions

Ulnar Collateral Ligament Reconstruction is a common injury among sports involving overhand throwing motions, most notably baseball pitchers. Although other sports such as javelin throwing, football, and tennis require some of the same movements they can't compare to the repetitions of a baseball pitcher. Presently, there is an increase in the number of youth athletes receiving the operation. This is due to the increase in the number of youth athletes specializing in one sport before puberty and the belief that the surgery will make the athletes throwing arm stronger. To resolve the problem of youth arm injuries it is important to use the concept of periodization. One of the cycles should involve a period of rest that exceeds two months.


References

  1. ANTHONY, R.A. and WARREN, R.F. (2006) Treating Shoulder Injuries in High-Impact Amateur and Professional Athletes. PR Newswire-2006
  2. FRASER, S. (2007) Myth Information. Current Science, 93 (5), p. 10-12.
  3. JARRETT, J. (2008) In a World of Hurt: Body of Evidence Says Specialization Puts Young Athletes at Risk. McClatchy - Tribune Business News - 2008.
  4. McDANIEL, L. et al. (2009) Ulnar Collateral Ligament Reconstruction. [WWW] Available from: https://www.brianmac.co.uk/articles/article045.htm
  5. McNEAL, S. (2004) An Ounce of Prevention. The Sporting News, 228 (27) p. 28

Page Reference

If you quote information from this page in your work then the reference for this page is:

  • McDANIEL, L. and McLAUGHLIN, B. (2009) Overuse Injuries and Training Year Around for One Sport [WWW] Available from: https://www.brianmac.co.uk/articles/article063.htm [Accessed

About the Authors

Larry W. McDaniel Ed.D. is an Associate Professor of Exercise Science at Dakota State University Madison, SD. USA. Dr. McDaniel was a First Team All-American football player (USA Football), a Hall of Fame Athlete, and Hall of Fame Wrestling Coach.

Brian McLaughlin is a student of Exercise Science at Dakota State University who is a former athlete who has competed in several sports including baseball.

Related Pages

The following Sports Coach pages provide additional information on this topic: