July 14, 2008

Elbow Injuries on Rise Among Young Athletes

MONDAY, July 14 (HealthDay News) -- One of the country's leading sports doctors reports that he's performing more surgeries on sprained elbows in young athletes, a fact that reflects higher numbers of children focusing on just one sport.

The findings suggest that more young athletes are specializing only in baseball and putting their arms at risk, said co-author Dr. E. Lyle Cain, fellowship director for the American Sports Medicine Institute at the Andrews Sports Medicine & Orthopaedic Center, in Birmingham, Ala.

"Sports specialization at a young age encourages overuse," Cain said. "The bodies of athletes have no chance to rest and recover."

The good news: The surgeon who did the study, Dr. James Andrews, reported that 83 percent of his patients who underwent surgery recovered well enough to return to playing sports.

At issue are injuries to the ulnar collateral ligament, or UCL. It's a tiny ligament -- just a half-inch long -- that's crucial to keeping the elbow stable when a person throws something, Cain said.

In some cases, the ligament tears or becomes stretched out. "The patient generally has pain, and they lose the ability to throw, lose velocity," Cain explained.

The injury strikes baseball pitchers and other athletes who throw or swing their arms, such as tennis players, javelin throwers, quarterbacks and weightlifters.

"It's pretty common," said Dr. Robert Gotlin, director of Sports Rehabilitation with Beth Israel Medical Center in New York City. "Any particular league anywhere in the country is going to see injuries to the UCL but not necessarily requiring surgery."

Before the mid-1970s, the injuries ended athletic careers if they didn't heal. But a form of reconstructive surgery first performed on Hall of Fame baseball pitcher Tommy John has allowed many athletes to continue playing.

Surgeons typically replace the damaged ligament with ligament from another part of the arm or the leg, Cain said.

In the new study, released Saturday at the American Orthopaedic Society for Sports Medicine annual meeting, in Orlando, Fla., researchers looked at athletes treated by Andrews between 1988 and 2006. The study, said to be the largest of its kind, focused on 743 patients who were followed for at least two years after their surgeries; almost all were baseball players. Eighty-three percent were able to return to the same level of play or higher.

The researchers also found that surgeries on athletes 18 and younger are becoming more common. They made up 12 of 97 patients before 1997, according to Cain. But high school students made up 62 of 188 operations in 2005.

"There's no question that this comes from specialization in single sports" in recent years, Cain said. "Even 10 to 15 years ago, it was uncommon for a young athlete to pick one sport at a young age and focus on that sport."

Gotlin said the study is useful, but he cautioned that "in the best of all worlds, we're talking about a 75 to 80 percent success rate."

What to do? "We should encourage young kids and athletes to cross train," Cain said. "There's no good reason for an 8-year-old child to play baseball year-round and specialize in baseball."

More information

For more about UCL injuries, try the American Sports Medicine Institute.

SOURCES: E. Lyle Cain, M.D., fellowship director, American Sports Medicine Institute, Andrews Sports Medicine & Orthopaedic Center, Birmingham, Ala.; Robert Gotlin, D.O., director, Sports Rehabilitation, Beth Israel Medical Center, New York City; July 12, 2008, American Orthopaedic Society for Sports Medicine annual meeting, Orlando, Fla.
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