Ultrasound Study of Season-Long Joint Changes to College Baseball Players
Condition: Complete Tear Ulnar Collateral Ligament
Study type: Observational [Patient Registry]

Summary: 
      The purpose of this study is to use ultrasound imaging to determine if there are certain
      frequencies, durations, and intensities of baseball pitching that expose a college baseball
      player to increased risk of injury to their ulnar collateral ligament of their elbow
      throughout one baseball season.
    

Detailed description: 
      This study aims to use ultrasound imaging to assess the health of the ulnar collateral
      ligament (UCL) of the elbow, which acts as a major stabilizer in overhead throwing athletes
      and is often injured in baseball pitchers. The health of the UCL will be assessed by measured
      the amount of laxity in the UCL, identified as the distance between the end of the humerus
      (arm bone) where the UCL originates and the beginning of the ulna (forearm bone) where the
      UCL ends. An increase in this distance indicates an increase in laxity of the ligament, which
      is a risk factor for injury/tearing of the ligament with repetitive throwing seen in baseball
      pitchers. Measurements will be made at rest and under 3 pounds of valgus stress at 30 degrees
      of elbow flexion where the UCL acts as the main stabilizer of the elbow. Valgus stress is
      necessary for this procedure because damage to the ligament will be most clearly seen in this
      position when compared to the measurement at rest.

      Measurements will be made to both the right and left elbows, as well as both the right and
      left knees. The purpose of including the knees in this protocol is so that the subjects are
      blinded to the true intention of the study. Due to the psychological harm that could occur if
      the subjects know the focus of the study is their UCL, the study will be presented to the
      subjects such that the research team is viewing all structures within the elbow and knee, and
      their overall flexibility, strength, and bony changes will be monitored throughout the season
      using ultrasound. Therefore, the ultrasound measurements of the knee will be sham
      measurements, and only measurements made at the elbow will be recorded.

      In addition to ultrasound, measurements of range of motion will be performed at each testing
      session. Motions to be tested will be: shoulder flexion, extension, abduction, internal
      rotation, and external rotation; elbow flexion and extension; wrist flexion and extension;
      hip flexion, extension, abduction, internal rotation, and external rotation; knee flexion and
      extension. Recent studies have found significant results for deficits in range of motion
      correlating to UCL tears, so this data will be used in conjunction with measurements of
      laxity of the UCL as seen with ultrasound.

      Ultrasound imaging and range of motion testing will be performed on the same 10 subjects four
      times throughout one baseball season: before the first game of the season, after 20 games
      have been played, after 40 games have been played, and after the last game of the season has
      been played. During this period, pitching data will be collected and recorded for each
      pitcher. Data to be collected includes number of pitches thrown, number of each type of pitch
      thrown, number of innings pitched, velocity of all pitches, time in days between pitching
      appearances.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Members of the CSU Northridge baseball team
      
Keywords: Baseball; Ulnar collateral ligament