The Ulnar Collateral Ligament (UCL) Dilemma: Unpacking High School Athlete Arm Injuries and Enhancing Arm Health

The Ulnar Collateral Ligament (UCL) Dilemma: Unpacking High School Athlete Arm Injuries and Enhancing Arm Health

After revisiting all of our athletes' arm health scores over the course of the winter, spring,

summer, we had four major injuries occur. All four took place between march and april, let's take

a deeper dive into these guys and their injuries.

All four injuries were tears of the Ulnar Collateral Ligament. Interestingly enough all four guys

had their last arm care test between February 18th and March 4th. Leaving no tests between

March 4th and their dates of injury which are between March 21st and May 23rd.

When they left the building in the first week of march, three of the four had near perfect arm

care numbers all had above the recommended 85% Arm Score, Above 20% External rotation

and internal rotation strength compared to bodyweight. Above 15% in scaption strength and grip

strength in comparison to bodyweight. An ER/IR Ratio between .85 and 1.05 and Strength

Relative to velocity well above the ideal 1.6 or 160% of strength divided compared to velocity.

The outlier still had decent arm care numbers, he had a lower arm care score at 74% even

though anything above 70% is considered safe, we prefer our guys to be above 85% and he

also had slightly below ideal grip strength at 14% (above 15% is optimal).

It is also important to note that all four of these individuals had experienced previous arm

ailments or been previously diagnosed with injuries to the arm prior to this off-season.

This raises the question as to why they got hurt, because once they left for HS arm care

numbers were in a good place. Did they stop training? Too much volume in high school? Not

enough rest/recovery?

The honest answer is we will never know for sure because of the lack of monitoring.

If they were training with us in season and testing regularly, could we have prevented this?

The reality is if you throw a baseball above 85 MPH you are always at a risk of hurting your arm.

It is part of the sport and the sad truth is, it happens. We know these facts: the lack of weight

training and arm care work in-season puts you at a higher risk of injury, ramping up too quickly

puts you at a higher risk of injury, fatigue puts you at a higher risk of injury, and having a history

of injuries puts you at a higher risk of an injury. The ability to monitor and measure your arm

strength is vital for making educated decisions on your arm and could potentially save you from

a big injury. With regular testing in-season we are able to look at tests compared to your

baseline and strength retention from outing to outing. If these numbers decrease we know that

we are at a higher risk of injury and can utilize deloading, additional rest, additional arm care

work, additional mobility, etc. to help our arm care scores return to normal. This can make your

arm the healthiest it can be and give us a lower chance of getting hurt.

We had over ten high schoolers that constantly threw above 85 that regularly trained and tested

with us while in season and stayed healthy with over 70 innings of work.

Multiple of these hard throwing high schoolers we had to deload for a week or add some additional rest in between

starts by using information from our data collection. Obviously we are not stating this is the

singular reason as to why they did not acquire an injury. However, we can firmly say this

certainly helped to decrease their chances throughout the year.

The chance of injury will never be zero. With regular training and regular testing, both in and out

of season, we can drastically reduce that risk.

Key Take-Aways:

1. Injuries are much more common the harder you throw

2. Our only chance of hoping to minimize injury is through consistent tracking of:

a. Volume of throwing

b. The intensity of throwing

c. How the arm is responding to this throwing (strength testing)

3. Previous injuries or ailments to the arm make you significantly more likely to experience

a future injury

4. Maintaining baseline strength is pivotal in reducing the chance of injury as we compete

5. Having an off-season and pre-season approach to properly ramp you up is imperative to

reduce your chances of experiencing arm pain.