Every Pitch Should Count

MedicalResearch.com Interview with:
“Pitching Crop” by slgckgc is licensed under CC BY 2.0Jason L. Zaremski, MD, CAQSM, FACSM, FAAPMR

Assistant Professor│Divisions of PM&R, Sports Medicine, & Research
Department of Orthopaedics and Rehabilitation
Co-Medical Director Adolescent & High School Outreach Program
University of Florida College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Throwing injuries are common in baseball and can be caused by excessive pitch counts, year-round pitching, and pitching with arm pain and fatigue. Despite the evidence, pitching injuries among high school players have not decreased. With a multitude of research in overhead throwers, yet the volume of overuse throwing injuries not decreasing, our team suspected there was a missing workload factor in baseball pitchers. Therefore, our team conducted research to determine whether an important factor was being overlooked: volume of pitches thrown during warm-up between innings and bullpen activity in high school varsity baseball pitchers.

In the study, our team counted all pitches thrown off a mound during varsity high school baseball games played by 34 different high schools in North Central Florida during the 2017 season. After counting nearly 14,000 pitches in 115 pitch outings, our team found that 42% of the pitches thrown off a mound were not accounted for in the pitch counts, and that there is a large variability of bullpen pitches being thrown from pitcher to pitcher. Even with a greater focus on pitch counts as a way to prevent injuries, a substantial number of pitches are going unaccounted for in high school players as part of warm-up and bullpen activity.

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Snowboarders Have More Upper Body Injuries Than Skiiers

MedicalResearch.com Interview with:
“First day of snowboarding” by kaolin fire is licensed under CC BY 2.0
Dr. Brett D Owens, MD
Dr. Owens is currently Team Physician for the US Lacrosse National Men’s Team, and
Team Physician for Brown University
Professor at Uniformed Services University and Professor at Brown University
Alpert School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study is a review of the literature on ski and snowboarding injuries. We summarize findings by our group and others on the injuries seen with these snow sports and report an overall increase in injuries as participation continues to increase.

Snowboarders have a higher injury rate and there are different injury patterns with skiers experiencing more lower extremity injuries (knee) and snowboarders experiencing more upper extremity injuries (wrist, shoulder, etc.).  Continue reading

College Athletes Get Injured During Practice Not Just in Competition

Zachary Y. Kerr, PhD, MPH Sports Injury Epidemiologist Director, NCAA Injury Surveillance Program Datalys Center for Sports Injury Research and Prevention Indianapolis, IN 46202

Dr. Zachary Kerr

MedicalResearch.com Interview with:
Zachary Y. Kerr, PhD, MPH
Sports Injury Epidemiologist
Director, NCAA Injury Surveillance Program
Datalys Center for Sports Injury Research and Prevention
Indianapolis, IN 46202 

Medical Research: What is the background for this study? What are the main findings?

Dr. Kerr: The NCAA Injury Surveillance Program has been ongoing since 1982, but the Datalys Center for Sports Injury Research and Prevention began management in 2009.  We provide the NCAA sports and medical committees with evidence-based data they can use to make rule and policy decisions aimed at student-athlete health and safety.  However, among the research community, there lacks current injury incidence data across the collegiate student-athlete population.

The main findings of this study is that the rate of injury was higher in competitions than in practices.  However, the total number of injuries estimated in practices exceeds that of competition, which suggests that interventions should be aimed at reducing injury incidence in both practices and competitions.

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Which High School Sports Have Highest Risk of ACL Injury?

MedicalResearch.com Interview with:
Alex L. Gornitzky
Medical Student and
Theodore J. Ganley, M.D.
Director of Sports Medicine,
The Children’s Hospital of Philadelphia
Associate Professor of Orthopaedic Surgery,
The University of Pennsylvania School of Medicine

Medical Research: What is the background for this study?

Response: Currently, more than half of all high school students participate in organized athletics, and with increasing participation the incidence of ACL injury and subsequent reconstruction are also rising. Furthermore, researchers also know that adolescent and high school athletes have a number of unique risk factors that differentially affect their ACL injury risk profile as compared to older and/or more experienced athletes. To our knowledge, however, no previous studies have described sport-specific seasonal risk for ACL tears in the high school athlete by gender and by sport. More specifically, parents and athletes currently have no available information to more accurately define what their personal risk is for such an important and devastating injury. Therefore, the purpose of our study was to pool data from across the literature in order to objectively quantify an average high school athlete’s risk for ACL injury per season across a variety of varsity-level sports. If a student is injured while playing sports and the school doesn’t deal with the injury correctly then it could make the issue worse. This is why it is important for schools to correctly identify is the player has suffered an ACL injury. If you have suffered an injury at school that wasn’t properly dealt with then you may want to check out someone like these new york personal injury lawyers to see if you can get compensation. This study will hopefully help students see the risk of them getting an injury meaning they can take measures to prevent one happening to them.

Medical Research: What are the main findings?

Response: Overall, there is an approximately 1.6 times greater rate of ACL tear per athletic exposure in high school female athletes as compared to males. On a per-season basis, the highest risk sports in females were soccer, basketball and lacrosse at 1.1%, 0.9% and 0.5% risk of ACL tear per athletic season. Comparatively, in males, the highest risk sports were football, lacrosse and soccer at 0.8%, 0.4% and 0.3% risk of ACL tear per athletic season. Looking further at the year-round, multi-sport athlete, this may correspond to either a 2.5% risk per-year or 10% risk per high school career for the female athlete who participates in soccer, basketball and lacrosse, or 1% and 4%, respectively, for the male athlete who plays football, basketball and baseball.

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Pitch Count May Not Be Best Predictor Of Injury In MLB Players

Thomas Karakolis Department of Kinesiology University of Waterloo Waterloo, Ontario, CanadaMedicalResearch.com Interview with:
Thomas Karakolis

Department of Kinesiology
University of Waterloo
Waterloo, Ontario, Canada

Medical Research: What is the background for this study? What are the main findings?

Response: Major League Baseball (MLB) pitchers have an injury rate approaching 1 in 4, depending on the study you look at. As an occupational injury rate, this number is extremely high. In fact, I think you would be hard pressed to find another industry where the injury rate is that high.

One way that coaches and managers in MLB are trying to lower the
injury rate is to restrict the total ‘workload’ on pitchers per
season. Particularly in young pitchers, many MLB organizations
restrict the number of innings a pitcher can pitch based upon the
number of innings they pitched the previous year. Essentially, they
are using innings pitched as a surrogate for workload.

If this is an effective strategy, you would expect a correlation
between the increase in number of innings pitched between successive
seasons and future injury. Our study found that no such correlation
exists. Innings pitched does not appear to be a sensitive enough
measure to asses the true workload a pitcher experiences throughout
the season.

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Lacrosse Injuries Differ By Sex and Type of Play

Lara B. McKenzie, PhD MA Center for Injury Research and Policy The Research Institute at Nationwide Children’s Hospital Columbus, OH 43205MedicalResearch.com Interview with:
Lara B. McKenzie, PhD MA
Center for Injury Research and Policy
The Research Institute at Nationwide Children’s Hospital
Columbus, OH 43205


Medical Research: What are the main findings of the study? 

Dr. McKenzie: Our main findings were that lacrosse injury rates and patterns are different by sex and by type of athletic activity. Boys’ lacrosse allows for some person-to-person contact, while girls’ lacrosse largely outlaws it. Boys had an overall injury rate of 2.26 per 1000 athletic exposures, and girls had an injury rate of 1.54 per 1000 athletic exposures. The overall injury rate was about 3 times higher in competition than in practice. We also found that sprains and strains were the most common injury diagnosis for boys and girls (boys: 35.6% of injuries; girls: 43.9%), but that concussions were a significant injury diagnosis (boys: 21.9% of injuries; girls: 22.7%).
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Best Way To Avoid Repeat ACL Injury Is To Avoid Cutting Activities

Christoher C. Kaeding M.D. Judson Wilson Professor, Department of Orthopaedics Executive Director, Sports Medicine Center Head Team Physician, Department of Athletics The Ohio State UniversityMedicalResearch.com Interview with:
Christoher C. Kaeding M.D.
Judson Wilson Professor, Department of Orthopaedics
Executive Director, Sports Medicine Center
Head Team Physician, Department of Athletics
The Ohio State University

MedicalResearch: What are the main findings of the study?
Dr. Kaeding:

  • Younger age and high activity level were predictors off another ACL injury after an ACL Reconstruction.
  • Allograft use in younger more active patients Had an increased risk of re-injury.

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High School Basketball Injuries Top 2.5 Million

Lara McKenzie, Ph.D. MA Associate Professor of Pediatrics Center for Injury Research and Policy The Research Institute at Nationwide Children's Hospital Columbus, OhioMedicalResearch.com Interview with:
Lara McKenzie, Ph.D. MA
Associate Professor of Pediatrics
Center for Injury Research and Policy
The Research Institute at Nationwide Children’s Hospital
Columbus, Ohio

MedicalResearch.com: What are the main findings of the study?

Dr. McKenzie: Our study was the first to compare and describe epidemiological patterns of basketball-related injuries presenting for treatment to emergency departments and to the high school athletic training setting using surveillance data captured from large, nationally representative samples. Specifically, we compared estimated national incidence, rates of injury and body sites injured, and diagnoses. Nationally, an estimated 1,514,957 athletes with basketball-related injuries reported to the emergency department and 1,064,551 presented to the athletic training setting. Patterns of basketball-related injuries presenting to the emergency department differ from those presenting to the high school athletic training setting for treatment, with those presenting to the emergency department being more severe. In general, injuries that could be relatively quickly assessed and more easily diagnosed and treated, such as strains and/or sprains, presented more commonly to the athletic training setting, while injuries that required more extensive diagnostic or treatment procedures, such as fractures, were treated more commonly in the emergency department.

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Overuse Sports Injuries More Common In Children From High Income Families

MedicalResearch.com Interview with: Neeru Jayanthi, MD Associate Professor Medical Director, Primary Care Sports Medicine Loyola University Medical Center study MedicalResearch.com: What are the main findings of the study? Dr. Jayanthi: We surveyed a cohort of 1,190 athletes ages 7 to 18, including 1,121 for whom insurance status could be determined. Our main findings were: 1. The rate of serious overuse injuries in athletes who come from families that can afford private insurance is 68 percent higher than the rate in lower-income athletes who are on public insurance (Medicaid). 2. Privately insured young athletes are twice as likely as publicly insured athletes to be highly specialized in one sport.  MedicalResearch.com: Were any of the findings unexpected? Dr. Jayanthi: The findings confirmed our hypothesis that higher-income students would be more likely to specialize in one sport, and also more likely to suffer serious overuse injuries. MedicalResearch.com: What should clinicians and patients take away from your report?   Dr. Jayanthi: Specializing in one sport at an early age increases the risk of serious overuse injuries. Here are evidence-based tips to reduce the risk of overuse injuries: •	Increase the amount of unstructured free play, while limiting the amount of time spent in organized sports and specialized training. Do not spend more than twice as much time playing organized sports as you spend in unstructured play. •	Do not spend more hours per week than your age playing sports. For example, a 10-year-old should not spend more than 10 hours per week playing sports. •	Do not specialize in one sport before late adolescence. •	Do not play sports competitively year round. Take a break from competition for one to three months each year (not necessarily consecutively). •	Take at least one day off per week from sports training. MedicalResearch.com: What recommendations do you have for future research as a result of this study? Dr. Jayanthi: We are doing a pilot study this summer comparing parent/child dyads of high competitive young athletes and recreationally active children with parent dyad to see differences based on sports participation of child and adult, as well as based on socioeconomic status. This may lead to a much larger study.  Citation: Abstract presented at the American Medical Society for Sports Medicine Annual Meeting in New Orleans, LA.MedicalResearch.com Interview with:
Neeru Jayanthi, MD
Associate Professor
Medical Director, Primary Care Sports Medicine
Loyola University Medical Center study


MedicalResearch.com: What are the main findings of the study?

Dr. Jayanthi: We surveyed a cohort of 1,190 athletes ages 7 to 18, including 1,121 for whom insurance status could be determined. Our main findings were:

1. The rate of serious overuse injuries in athletes who come from families that can afford private insurance is 68 percent higher than the rate in lower-income athletes who are on public insurance (Medicaid).

2. Privately insured young athletes are twice as likely as publicly insured athletes to be highly specialized in one sport.
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