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Resident PGY 1
Henry Ford Hospital
Background: Rehabilitation following elbow ulnar collateral ligament reconstruction (UCLR) in baseball pitchers relies on a progression of pitching activities to ensure protection and gradual strengthening of the reconstructed ligament. Typically, players rely on subjective, perceived effort during pitches instead of an objective assessment to guide pitch velocity progression. This reliance on subjective effort levels leaves the elbow vulnerable to early over-load.
Purpose: To determine the correlation between pitch velocity and elbow torque at successive subjective and objective partial effort throws.
Methods: High school and collegiate baseball pitchers were included in this study. Pitch parameters were collected using a wearable sensor. Participants threw five pitches at 50%, 75% and 100% subjective partial effort. Maximum pitch velocity was calculated according to the 100% effort throws. Pitchers then threw five pitches at 50% maximum velocity and 75% maximum velocity, as measured by radar gun. General linear models with post-hoc Tukey tests were performed to determine the effects of pitch type on pitch parameters.
Results: 37 pitchers completed this study. Pitches at 100% effort generated significantly more elbow torque when compared to pitches at 50% effort (48.9 Nm vs. 37.1 Nm, p < 0.001). Pitches at 50% subjective partial effort and 75% subjective partial effort were significantly faster and generated higher elbow torque than did pitches thrown at 50% velocity or 75% velocity, respectively (p < 0.001). Overall, pitch velocity was a strong predictor for elbow torque, such that a 10% decrease in percent of maximum velocity was associated with a 13% decrease in percent of maximum elbow torque (beta coefficient = 1.3, r2= 0.81, p < 0.001).Conclusion: Pitchers generate higher-than-intended forces when throwing at 50% and 75% effort during a subjective partial effort throwing protocol. Inclusion of radar gun improved the ability to pitch at desired partial effort levels. Our findings suggest that radar guns should be used throughout the rehabilitation process to limit elbow torque and protect the reconstructed ulnar collateral ligament during rehabilitation throwing maneuvers.
Lizzio, Vincent A; Smith, Grace; Jildeh, Toufic R; Gulledge, Caleb; Swantek, Alexander; Stephens, Jeffrey P; Schulz, Brian; and Makhni, Eric C, "Importance of Radar Gun Inclusion During Return-to-Throwing Rehabilitation Following Ulnar Collateral Ligament Reconstruction in Baseball Pitchers: A Simulation Study" (2019). Clinical Research. 20.