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Elbow Injuries in the female athlete

Elbow Injuries in the female athlete. James Penna,MD Assistant Professor of Orthopaedics Residency Program Director for Orthopaedic Surgery Co-Team Physician for Stony Brook Seawolves. vocabulary. UCL- Ulnar Collateral Ligament of the Elbow

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Elbow Injuries in the female athlete

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  1. Elbow Injuries in the female athlete James Penna,MD Assistant Professor of Orthopaedics Residency Program Director for Orthopaedic Surgery Co-Team Physician for Stony Brook Seawolves

  2. vocabulary • UCL- Ulnar Collateral Ligament of the Elbow • Tommy John Surgery- Surgical repair or reconstruction of the UCL • TOB- Top of backswing • End of Softball pitch phase 3 and beginning of 4

  3. Conceptualdifferences She is THE pitcher He is A pitcher

  4. Injury rates • 11% of injuries resulting in unplanned removal from competition occur in pitchers • Over 50% of surveyed NCAA softball pitchers described episodes of significant anterior shoulder pain during all or part of the season. • Over 70% admitted to some level of injury in the past year • Girls are at significantly higher risk for overuse problems than their male counterparts who sustain the majority of their injuries with contact/traumatic events. • Baseball research data has shown that shoulder fatigue is a major contributor to elbow injuries* • Majority of UCL injuries in Softball occur in NON-Pitchers • There is significant resistance to the establishment of pitch counts due to the notion that with good windmill mechanics there is little to no risk of injury

  5. TOB Gluts Gluts Gluts Scap Stabilizers Biceps Biceps Gluts Triceps

  6. Softball does have pitch count recs

  7. Softball Governing body

  8. Consequences

  9. Upper extremity stress fracture • Overuse • Poor nutrition • Body image issues • Oversight • Lactose avoidance • Glass of milk 300mg Ca++ • Ca recommendations for teen to 20s 1000-1500/day • WITH Vit D

  10. Overload problems

  11. Capitellar Necrosis

  12. Olecranon stress fx

  13. UCL tear/insufficiency

  14. interventions • Platelet Rich Plasma- Injection of platelet rich portion of blood to stimulate a healing response • Repair of ligament • Reconstruction of ligament • Tommy John Surgery • By Frank Jobe 1974 returned in 76 (out 19mos)

  15. Injection Therapy

  16. UCL Reconstruction

  17. What’s our role • Be vigilant for signs of fatigue • Continue to stay abreast of and even participate in risk reduction projects • Support cross-training and ‘relative’ rest • Do not ignore the often non-glamorous CORE work

  18. core • Hip and Pelvis rotation are most important elements of pitching cycle • CORE programs seem to improve function and reduce risk in most throwing/serving/racket sports • Limited truncal rotation and flexibility has been associated with increased risk for upper extremity injury

  19. Thank you

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