Elbow Tendinopathy

CHICAGO, March 4, 2024 /PRNewswire/ -- Dr. Mark Cohen, hand, wrist and elbow surgeon at Midwest Orthopaedics at RUSH, and an official team physician for the Chicago White Sox, wants to warn parents about the epidemic he is seeing in his practice: youth baseball players experiencing overuse injuries in greater numbers. These injuries can range from arm pain to a torn ulnar collateral ligament (UCL) in the elbow. Some of these injuries require surgery, including UCL repair, also called 'Tommy John' surgery. "I'm a huge baseball fan and have enjoyed treating professional and youth players for many years," Dr. Cohen explains. "I love it when we can get a player back on the field. What concerns me is the rate at which Little Leaguers are experiencing big league conditions that may interfere with their body's normal function as they grow." Midwest Orthopaedics at RUSH physicians published a study in 2015 which revealed that the practice's fastest-growing segment of patients undergoing Tommy John surgery is 15 to 19-year-olds. "Ten years ago, Tommy John surgery was a treatment for Major League Baseball players," explains Dr. Cohen. "While my partners and I have been performing this surgery successfully on adults, I'm worried that the majority of patients are now under the of age 20. We are also seeing an increase in the prevalence of these elbow injuries in adolescents." Why? According to Dr. Cohen, the two primary reasons baseball players, especially pitchers, are seeking treatment at younger ages are because of the intensity of year-round play and single sport specialization. Unregulated pitch counts, weighted ball training, and pressure to increase velocity are also factors. All of these contribute to shoulder and elbow overuse injuries. He points to a 2023 study, in the Journal of Shoulder and Elbow Surgery, which showed that among 261 youth and high school pitchers followed over their playing careers, 25% experienced an injury to their arm -- and the rate of players undergoing surgery increased the longer they played. One sport played year-round For youth and high school pitchers, debate is on-going regarding the amount of time players should refrain from playing. Pitch Smart (a joint initiative between MLB and USA Baseball) recommends that 15 to 18-year-old take at least four months off from playing, including at least two to three continuous months off from any throwing. The rise in off-season programs and multiple leagues has made this difficult for some young athletes. Pitch counts hard to track With a goal to reduce stress on young players' shoulders and elbows, pitch counts were implemented several years ago by Little League International, MLB, and state high school associations. Like any well-intended guidelines, pitching restriction policies can be subject to interpretation, and gaps are often created, increasing injury risk. Velocity and weighted balls With MLB pitchers throwing an average of 94 mph today, emphasis has recently been placed on throwing velocity among youth players. Many players and parents see this as a way to advance to higher levels of baseball. Therefore, weighted ball velocity throwing programs have gained in popularity across all levels of the sport because some studies suggest that they increase pitch speed. However, experts think this trend has led to a greater rate of injury to the throwing shoulder and elbow. Recommendations Dr. Cohen has the following suggestions for parents of youth pitchers: - Be sure your athlete has received instruction on proper throwing mechanics and technique. - Understand your child's league pitch count rules and ensure they are being monitored and followed. - Consider the amount of time and number of teams your child is playing on. Is it too much? - Is your child tired much of the time? Consider making adjustments to allow for less playing time. - Allow your child to rest on non-playing days. - Encourage your child to play another sport, such as basketball, swimming, tennis, or cycling during the off season. - Talk with your child about his or her attitude about playing time. Do they think it is too much? - Never allow your child to play through pain. If you see he or she is in pain, alert a coach or manager immediately. - Seek treatment if pain is serious or persists after a day or two. About Midwest Orthopaedics at RUSH MOR is an international leader in musculoskeletal health consistently ranked among the top ten in the nation by U.S. News & World Report. MOR is comprised of renowned orthopedic and spine surgeons pioneering the latest advances in surgical techniques and non-surgical care. Its physicians are the designated team care providers for the Chicago Bulls, Chicago White Sox, Chicago Red Stars, Chicago Dogs, and Joffrey Ballet. MOR has seven full-service locations in Chicago, Joliet, Naperville, Oak Brook, Oak Park, Westchester, and Munster, IN. The group also has nine stand-alone physical therapy clinics in Bensenville, Chicago's South Loop, Geneva, Lincoln Park, Lockport, Orland Park, River Grove, Park Ridge, and Munster, IN. Visit for more information. SOURCE Midwest Orthopaedics at RUSH

DUBLIN--( BUSINESS WIRE )--The "United States MAXIGESIC IV Drug Insight and Market Forecast - 2032" drug pipelines has been added to ResearchAndMarkets.com's offering. This report provides comprehensive insights about MAXIGESIC IV for acute pain in the United States. A detailed picture of the MAXIGESIC IV for acute pain in the United States for the study period 2019 -2032 is provided in this report along with a detailed description of the MAXIGESIC IV for acute pain. The report provides insights about mechanism of action, dosage and administration, as well as research and development including regulatory milestones, along with other developmental activities. Further, it also consists of future market assessments inclusive of the MAXIGESIC IV market forecast analysis for acute pain in the US, SWOT, analysts' views, comprehensive overview of market competitors, and brief about other emerging therapies in acute pain. 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What is the clinical trial status of the study related to MAXIGESIC IV in acute pain and study completion date? What are the key collaborations, mergers and acquisitions, licensing and other activities related to the MAXIGESIC IV development? What are the key designations that have been granted to MAXIGESIC IV for acute pain? What is the forecasted market scenario of MAXIGESIC IV for acute pain? What are the forecasted sales of MAXIGESIC IV in the United States? What are the other emerging products available and how are these giving competition to MAXIGESIC IV for acute pain? Which are the late-stage emerging therapies under development for the treatment of acute pain? Key Topics Covered: 1. Report Introduction 2. MAXIGESIC IV Overview in Acute pain 2.1. Product Detail 2.2. Clinical Development 2.2.1. Clinical studies 2.2.2. Clinical trials information 2.2.3. Safety and efficacy 2.3. Regulatory Milestone 2.4. Other Developmental Activities 2.5. Product Profile 3. Competitive Landscape (Marketed Therapies) 4. Competitive Landscape (Late-stage Emerging Therapies) 5. MAXIGESIC IV Market Assessment 5.1. Market Outlook of MAXIGESIC IV in Acute pain 5.2. The United States Analysis 5.2.1. Market Size of MAXIGESIC IV in the United States for Acute pain 6. SWOT Analysis 7. Analysts' Views For more information about this drug pipelines report visit https://www.researchandmarkets.com/r/yk65yr About ResearchAndMarkets.com ResearchAndMarkets.com is the world's leading source for international market research reports and market data. We provide you with the latest data on international and regional markets, key industries, the top companies, new products and the latest trends.

CHICAGO, Nov. 30, 2023 /PRNewswire/ -- Youth baseball players are prone to elbow pain and injuries, including repetitive overuse changes and fractures, based on the maturity of their bones, according to a new study being presented today at the annual meeting of the Radiological Society of North America (RSNA). The repetitive motion and force of throwing a baseball places a large amount of stress on the growing bones, joints and muscles of the elbows of baseball players. Youth baseball players who have not yet reached skeletal maturity might be especially vulnerable to elbow pain and injuries. "When we look at the forces that baseball players, even Little League baseball players, deal with during routine practice and games, it becomes apparent why elbow injuries are so common amongst this group," said study co-author Vandan Patel, B.S., a radiology-orthopedics research scholar at Children's Hospital of Philadelphia (CHOP) in Pennsylvania. Most recent estimates show that 20 to 40% of youth baseball players between the ages of nine and 12 complain of elbow pain at least once during the season. Skeletally immature children have growth plates, which are areas of bone that are made up of cartilage, a rubbery and flexible connective tissue, that allows the bones to grow and change in shape as a child ages. Growth plates are weaker than the surrounding muscles and bones and prone to injury that can lead to either reversible changes or permanent deformity. Skeletal maturity occurs when the growth plates have closed, and no more bone (or growth) is being made. This usually occurs at the end of puberty, typically around age 13 to 15 for girls and 15 to 17 for boys. In this retrospective study, the researchers reviewed elbow MRI exams from 130 youth players (18 years of age and younger) being evaluated for elbow pain. MRI is an ideal method for identifying joint problems, because it can non-invasively show cross-sectional details of soft tissues (cartilage, tendons and ligaments) and bone. "We conducted this study in order to better understand the patterns of injuries that can occur among youth baseball players with elbow pain," said senior author Jie C. Nguyen, M.D., M.S., director for the Section of Musculoskeletal Imaging in the Department of Radiology at CHOP. "Tissue vulnerability and, thus, sites at risk for injury, change with growth and maturation. A younger player injures differently than an older player. It is our hope that this data will help us continue to improve and individualize the care of current and future generations of youth baseball players." The average age of this study group of patients was 13.9 years, with 115 boys and 15 girls included. The frequency with which the patients played baseball varied from daily to recreationally. Two radiologists independently reviewed the MRI exams to categorize the skeletal maturity and different findings of each patient's elbow. They classified 85 patients as skeletally mature and 45 patients as skeletally immature. The most common MRI findings in skeletally immature players included fluid build-up around the joint, stress injuries near the growth plate, fractures, and osteochondritis dissecans (OCD) lesions, where a piece of bone and the overlying cartilage is injured and can detach, leading to reduced range of motion and risk for premature osteoarthritis in adulthood. Conversely, in skeletally mature players, the injury pattern shifts from the growth plates to the soft tissue. These players most often had triceps tendinosis—a condition in which the tendon connecting the triceps muscle to the elbow bone becomes strained, irritated or torn—and fluid build-up in the bony area of the elbow where the ulnar collateral ligament attaches. The ulnar collateral ligament runs on the inner side of the elbow and helps stabilize it. Injuries that required surgery included intra-articular bodies (small fragments inside the joint), and unstable OCD. "In terms of the skeletally immature children, 9 patients (11%) had intra-articular bodies, and 19 patients (22%) had OCD lesions," Patel said. The researchers hope that the results of this study will help to identify elbow injuries in children who play baseball and to individualize treatment based on skeletal maturity. "This information is critically important not only to physicians, but also to parents and team coaches, all of whom provide crucial support for these children, reducing injury and preventing permanent damage on and off the field," said co-author Theodore J. Ganley, M.D., director of Sports Medicine and Performance Center in the Division of Orthopaedics at CHOP. "As parents, caregivers and coaches, it is important to be aware of these findings in order to ensure that symptoms of pain are not overlooked during the baseball season." Although they did find that prevalence of injury was linked to prolonged play, the researchers said further studies are needed to identify exactly which injuries are more time dependent compared to others. "This does not mean that elbow injuries are inevitable in baseball," Patel said. "With proper technique and proper rest, these injuries could potentially be avoided." Additional co-authors are Shahwar M. Tariq, B.S., Liya Gendler, D.O., Apurva S. Shah, M.D., M.B.A., and Adam C. Zoga, M.D., M.B.A. Note: Copies of RSNA 2023 news releases and electronic images will be available online at RSNA.org/press23. RSNA is an association of radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Illinois. (RSNA.org) Editor's note: The data in these releases may differ from those in the published abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting. To ensure you are using the most up-to-date information, please call the RSNA Newsroom at 1-312-791-6610. For patient-friendly information on pediatric and musculoskeletal imaging, visit RadiologyInfo.org. SOURCE Radiological Society of North America (RSNA)