BASEBALL PITCHING BIOMECHANICS AFTER SURGERY

Baseball pitchers with and without histories of elbow or shoulder surgery were tested with a 240 Hz automated 3D motion capture system. No differences were found between pitchers with history of UCL reconstruction and matched controls. Pitchers tested shortly after returning from UCL repair demonstrated reduced elbow extension, elbow velocity, and shoulder velocity compared to a control group, but it is unknown whether these few kinematic differences resolve with time. Pitchers with a history of SLAP repair produced less shoulder horizontal abduction, shoulder external rotation, and forward trunk tilt than matched controls. The Thoracic Outlet Syndrome case report demonstrated significantly more shoulder abduction after surgery. Thus the ability to return to normal pitching biomechanics after injury depends upon the type of surgery

Functional Return to Play after Surgical Treatment of Lower-Extremity Injuries using Global Positioning System Profiles in Elite College Football Players

Category: Sports Introduction/Purpose: Return to sport criteria after surgical treatment of lower extremity injuries are highly variable and without consensus. Thigh measurements assessing atrophy, single-leg hop testing and isokinetic strength measurements are commonly used metrics when considering return to sport after surgical treatment of lower-extremity injuries. Yet, these modalities are limited in scope, as they do not fully or accurately evaluate functional movements required in elite athletics. Alternatively, using new Global Positioning System (GPS) technology, a wide breadth of functional movements can be tracked for each athlete, which can be used as a comparative self-control in the event of an injury. This data proposes a more comprehensive, dynamic and longitudinal comparison of athlete performance, which may more accurately reflect functional return to sport in elite athletes after surgery. Methods: Over a three-year period, GPS data was collected on thirteen elite American College Football players at a single FBS Subdivision University. A total of 300 data points per athlete were collected for every practice, scrimmage and game starting in spring prep and extending through regular season, and post-season play. A total of 5.7 million data points including total distance traveled, average and maximum velocity, acceleration profiles, and explosive change of direction through inertial movement analysis were prospectively collected and analyzed. Individual pre-injury GPS functional profiles for each of the thirteen athletes were used as baseline, healthy comparisons, and functional recovery was determined prospectively during return to play progression after lower extremity surgery. Return to sport was allowed when post-operative GPS profiles demonstrated equivalence or superiority of all parameters compared to pre-injury measurements. Results: All thirteen players returned to sport after all measured parameters were equal to or greater than pre-injury levels. Conclusion: Modern GPS technology employed during preseason, regular season and post-season establishes an individualized, baseline, profile of lower-extremity function which allows for postoperative comparison and prospective assessment of safe return to play in elite football players

Mini-open Incision Sports Hernia Repair: A Surgical Technique for Core Muscle Injury

One cause of groin pain in highly active patients may be a core muscle injury, commonly referred to as sports hernia. When patients fail nonoperative management, there are a number of surgical options that may be pursued. Typically, they will involve the direct repair of the rectus abdominis back to the pubis. However, we believe that this repair can be further strengthened by the appropriate lengthening of the adductor longus from the conjoined tendon. Therefore, we present a surgical technique that involves both rectus abdominis repair and adductor longus lengthening in those who show a core muscle injury that is refractory to conservative management. We believe that this technique can be easily replicated by practitioners reading this Technical Note

CHARACTERIZATION OF FREE-LIVING STEP-BASED PHYSICAL ACTIVITY METRICS AMONG PATIENTS WITH FEMOROACETABULAR IMPINGEMENT SYNDROME

BACKGROUND: Femoroacetabular impingement syndrome (FAIS) is a hip-joint disorder characterized by abnormal bony morphology (femoral-sided, “cam”; or acetabular-sided, “pincer”). FAIS is a precursor to hip arthritis and is often associated with low physical activity (PA) due to pain. Previous studies have relied on self-report questionnaires to assess PA. Device-based measurement (e.g., accelerometry), specifically step-based metrics (e.g., steps/day and cadence indices), may offer a more comprehensive assessment of PA patterns in this population. METHODS: We recruited 25 participants with FAIS (age=31.0±9.2 years, 60% women, BMI=26.1±4.7 kg/m2) and 14 healthy controls (age=28.1±9.1 years, 64% women, BMI=26.3±3.4 kg/m2). Participants were categorized as Cam only, Combined (cam and pincer), or Healthy (controls). Participants wore a waist-mounted accelerometer (ActiGraph GT3X+, ActiGraph LLC, Pensacola, FL) for 7 days during waking hours. Step-based metrics were computed, including steps/day, peak 1- and 30-min cadence (PK1 and PK30; steps/min), and time spent in various cadence bands (1-19, 20-39, 40-59,⋯100-119 steps/min). One-way ANOVAs with post hoc testing were conducted to examine group differences. Effect sizes (eta squared; η2) were calculated and interpreted as small=0.01, medium=0.06, and large=0.14. RESULTS: We found significant group effects for PK1 and PK30 (p=0.02 and 0.05, η²=0.29 and 0.25, respectively). Post hoc tests showed lower PK1 and PK30 for Cam vs. Healthy (p=0.003 and 0.005, respectively) and Combined vs. Healthy (p=0.02 and 0.05, respectively). Similarly, there were main effects for time spent in slow, medium, and brisk cadence bands (60-79, 80-99, and 100-119 steps/min (p=0.004, 0.02, and 0.02; η²=0.27, 0.26, and 0.19, respectively). Post hoc tests indicated differences in time spent in these cadence bands for Cam vs. Healthy (p=0.007, 0.03, and 0.02, respectively), while Combined differed significantly from Healthy only for the slow and medium cadence bands (p=0.01 and 0.03, respectively). There was no main effect for steps/day between groups (p=0.06, η²=0.1). CONCLUSION: Although there was no main effect of group for steps/day, several cadence-based metrics were lower among the FAIS groups, particularly for Cam vs Healthy. Future studies are encouraged to examine step-based metrics in individuals with FAIS, as they appear to capture real-world differences in walking behaviors