Baseball players and fans call it Tommy John surgery, after the pitcher who was the first to have the surgery 29 years ago. By any designation, it is one of the major advancements in sports medicine in the last quarter century. Technically it is a ulnar collateral ligament replacements procedure.
Pitching overhand is a particularly stressful motion; the strain it puts on a player's joint is commonly injurious. Pitchers such as Kerry Wood, Matt Morris, John Smoltz, Mariano Rivera, Tom Gordon, and Eric Gagne all have a four inch scar on their pitching arms as evidence of this career saving surgery.
These players typically perform as well, if not better, after the operation and have stronger arms, with radar gun readings to match. "It felt so good when I came back, I said I recommend it to everybody ... regardless what your ligament looks like," Chicago White Sox reliever Billy Koch says jokingly. He blew out his elbow in his third professional appearance, in 1997. A torn elbow ligament once was a pitcher's sentence to the broadcast booth or the monthly autograph show at the local Holiday Inn. No longer.
Tommy John surgery--technically an ulnar collateral ligament replacement procedure--has saved the careers of hundreds of Major League players. It may one day make the Hall of Fame case for its inventor, surgeon Frank Jobe (who was Hollywood enough to trademark the name "Tommy John procedure"). Thirty years after Jobe invented this surgery, baseball players are still using it.
The elbow is a hinge joint, moving in only one dimension (flex or extend), making it relatively simple from an architectural and functional standpoint. The humerus bone in the upper arm connects to the two bones of the forearm by means of various connective tissues. For a pitcher, one of the most important of these connections is the unlar collaterial ligament (UCL). The UCL offers much of the stability that is necessary for the elbow to withstand the extreme stresses created by throwing a baseball at high velocity. Its function is to stabilize against lateral forces and to keep the arm connected across the joint space.
Sometimes the UCL will weaken and stretch (technically a sprain), making it incompetent. Other times a catastrophic stress will cause the structure to "pop" or blow out. The injury isn't tremendously painful, and it can be incredibly diffic...
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... It is not completely clear how it is that a tendon becomes a ligament, although Dr. Akizuki thinks that range of motion exercises help the tendon learn that it is being used as a ligament now and that it needs to adopt. Surgeons don't go back in to biopsy the repaired elbow to see how the tissue has changed, but follow-up MRIs show that the new tissue is acting as a ligament should.
That's basically it. A surgery that baseball players and fans have grown to appreciate, and one of the more scientific breakthroughs in modern sports medicine. And after doing this report I’m fascinated by the modern science and how a tendon in your wrist can be used as a ligament.
Works Cited
1. www.usatoday.com/sports/baseba///2003-07-28-cover-tommy-john_x.htm
2. http://espn.go.com/trainingroom/s/2000/0215/427112.html
3. http://www.baseballprospectus.com/article.php?articleid=3486
4. www.wired.com
5. http://bonsecourshamptonroads.greystone.net/images/ei_0153.jpg
6. http://www.dartmouth.edu/~anatomy/assets/surface/wrist-hand?surface3.gif
Albert G. Spalding created the first major league baseball glove. “Wearing a glove just wasn’t manly” said Smithsonian. It used to be that the strongest player on the field was whoever had the most broken fingers or blisters, but after a while, players realised they
Witvrouw, E., Mahieu, N., Roosen, P., & McNair, P. (2007). The role of stretching in tendon injuries. British journal of Sports Medicine , 224-226.
...itchers who started out by only being allowed to throw under hand and now presently they are able to about five to ten different types of pitches overhand. Several records also have been broken like Mark McGwire breaking Roger Maris's thirty seven year old homerun record.
In spite of this the rate of ACL injury is almost equal through all levels of sports, from beginner, to recreational, to professional athletes. The most widely publicized incident of ACL damage has come from Theresa Edwards who was a top female athlete. She was a basketball player who went to the limit with sports. She went beyond her capability and her ligament couldn’t withstand the pressure and snapped. She is not the only but just one example of many who have suffered this same problem. As female athletes continue to become more competitive and aggressive, ACL damage continues to rise.
This case involved a 53 year old man who sustained a significant tear of his rotator cuff while playing baseball. He underwent surgical repair and was given a referral for physical therapy. The referral was to begin passive ROM 3 times per week for 2 weeks then initiate a supervised home program of active exercise for 2 weeks, and elastic resistance exercises for internal and external rotation every other day for a month. 2 weeks after surgery, he had his first PT visit in a sports medicine clinic that was managed by an athletic trainer (ATC).”
All in all, injuring the ACL is a devastating blow to the knee. The ACL, which plays a major role in the support of the knee, must be protected during full-contact activities. Even simple activities such as running and jumping can lead to ACL injuries. It is important to follow the proper technique so that the body can stay healthy and continue to do what one does with it.
Pitching puts a large amount of stress on the pitcher’s body, especially the elbow and arm. The reason for this is that the act of pitching contains so many unnatural body movements. The body is not made to make the jerky movements that are involved in pitching. Some of the forces that affect the body during pitching include gravitational force and the resistance of the ball. Even though the ball is small and you wouldn’t think the resistance force is very high, you would be surprised at how large of a difference it makes and how much it actually affects your body.
When comparing rotator cuff tears from the common people and athletes, they are much more common when a person is physically active in sports. An injury in the rotator ...
In November of 2010, I was playing basketball in the fifth game of my senior season. It was just like any other game. However, I would soon find out otherwise. It was late in the game; I drove into the lane and got fouled hard. I was knocked so off-balance that I speared the floor with my knee. As soon as my knee hit the floor I heard a “snap” that I will never forget for the rest of my life. Little did I know at the time, that would be the last shot of my high school basketball career. Not long after my injury, I consulted a doctor. After getting an x-ray and an MRI, the doctor informed me that I had completely torn my ACL and would need to have surgery. An ACL tear can be a very devastating injury. The anterior cruciate ligament (ACL) is one of the four major ligaments within the knee. The ACL is one of the most commonly injured ligaments, injured by an estimated 200,000 patients each year. Of the 200,000 annual ACL injuries, surgery is performed in approximately 100,000 cases. There are many types of reconstructive surgery on the ACL. However, there is an alternative to surgery in the form of physical therapy.
Black D. 2010. Treatment of knee arthrofibrosis and quadriceps insufficiency after patellar tendon repair: a case report including use of the graston technique. International journal of therapeutic massage and bodywork. Volume 3, Issue 2:14-21
For example, "Little League Elbow" describes overuse injuries in kids who are repetitively throwing the ball. Kids are sustaining severe injuries to their growth plates, neck and spinal cord that could end their career in pro-sports before it begins....
The surfaces of the joint are organised to allow only back and forth motion such as bending and straightening. This type of joint can be found between your upper arm and your lower arm, in the elbow. This type of joint is incredibly important as it allows an up and down movement, without this type of joint, we wouldn’t be able to move our arm up and down. Muscles are attached to this type of joint by tendons to allow it to contract and relax and be able to move the bone within this joint. Ligaments attach the bones in a hinge joint together, for example, the humerus and the tibia are joined by ligaments but they also have antagonist muscle pairs attached to them by tendons which allow the bone to move by contraction and relaxation of the muscles.
Ligaments are tough, non-stretchable fibers that hold bones together. Damage to cruciate ligaments, which crisscross the knee to give it stability, is one of the most common sports injuries. The “tear” occurs from changing direction rapidly, slowing down from running, or landing from a jump improperly. The A.C.L tear is one injury that worries athletes in all sports at all levels because of its devastating effects. People ages 15-25 that participate in basketball and other sports that require pivoting are especially at risk.
There are many injuries in general, but sports injuries? Sprains and Strains are the most common injuries in sports. “Sprains are injuries to ligaments, the tough bands connecting in a joint. Suddenly stretching ligaments past their limits deforms or tears them” (Hoffman 1). Ligaments are like springs in a sense that when you stretch a spring, it will return to it’s normal state unless they are
The solution to this problem is located in the lab. Researchers across the country are working day in and day out to come up with a solution to accelerate the healing of soft tissues. They have come up with many solutions, from vibration therapy, to personalized rehab plans, but none of these are yielding truly significant results. I believe the solution lies at the molecular level. I believe that we can observe the healing of these soft connective tissues and learn from it. Then we can design a method from the observations to accelerate the production of the fibrils and collagen that will go on to make up the soft connective tissue. I have begun to take the beginning steps in solving this problem through my mentorship with Dr. Weinhold. Our research goals go hand in hand, which has led us to beginning research on the release of an angiogenic growth factor through a gelatin that will coat sutures. In theory, this angiogenic growth factor, once released from the crosslinking with the gelatin will stimulate the development of blood vessels around the recently repaired collagenous tissue. This, in turn, will allow the tendon/ligament to have a better oxygen supply and allow for quicker