Baseball: The effect of balance on elbow health, is there a relationship?

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Baseball Players Diagnosed with Ulnar Collateral Ligament Tears Demonstrate Decreased Balance Compared to Healthy Controls. Journal of Orthopaedic & Sports Physical Therapy 10-2013.  J. Craig Garrison, Amanda Arnold, Michael J. Macko, John E. Conway


The ulnar collateral ligament (UCL) is commonly injured in many baseball players, and is the ligament repaired during Tommy John surgery.  Sadly, many of the ballplayers receiving the surgery are under the age of 20.  There are many myths regarding the effects of Tommy John surgery, and due to its high success rate it has lead many players and parents to ignore the warning signs associated with the pathology.  Dr. James Andrews is at the forefront of sports medicine surgery and research, he is steadfast in promoting prevention of UCL tears, not surgical intervention for improved performance.  There are many contributing factors to arm and elbow health, this study focused on single leg balance and its relationship with UCL injuries.

Study: 30 baseball players diagnosed with a UCL tear compared to 30 healthy controls of similar age and competition level.  Subjects were tested on the Y Balance Test for both the stance and landing leg of the pitching motion.  The Y Balance Test has been found to be both reliable and valid in its prediction for injury risk in the athletic population.  The authors found that players with UCL tears had significantly lower Y balance scores than the healthy controls, and concluded that poor balance can be included as a risk factor for possible UCL injury.

Clinical Application: This study provides support to consider the inclusion of single leg balance, stability and strength measurements in baseball pre-season physicals, and physical therapy clinical evaluations for baseball players presenting with medial elbow pain.  Additionally,  the study strengthens the notion to include single leg exercises in any baseball training or rehab program, preferably ones that will provide carryover onto the field or mound.  The task of throwing a baseball takes place in sequential single leg stances, so it stands to reason that balance and single leg strength should help stabilize the throwing motion.

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