Sites of flexor-pronator muscle injury and relationship between ulnar collateral ligament injury and flexor-pronator muscle injury in baseball players: a retrospective cohort study

Relationship between Medial Elbow Pain, Flexor Pronator Muscles, and the Ulnar Nerve in Baseball Players Using Ultrasonography

We aimed to clarify changes cross-sectional area (CSA) in flexor pronator muscles and the ulnar nerve (UN) in players with medial elbow pain between pitching phases. Forty-two male baseball players with and without medial elbow pain during throwing were included in this study. The players were divided into maximum external rotation (MER) and ball release (BR) groups according to the pitching phase in which pain was reported. The imaged region was the flexor digital profundus, flexor carpi ulnaris (FCU), flexor digitorum superficialis, and pronator teres muscles, as well as the UN. CSA at rest and during contraction was assessed using the ultrasonography software tracing function. For statistical analysis, the CSA at rest and at contraction in the healthy group, MER group and BR group was compared using one-way analysis of variance. There was a significant difference in CSA only in the FCU between the healthy (95.4 ± 15.5%) and the MER group (76.6 ± 12.5%) at rest (p = 0.004). There were significant differences in the UN between the healthy (105.0 ± 27.7%) and MER groups (176.4 ± 53.5%), and between the healthy and BR groups (132.9±21.1%) (p = 0.001 and p = 0.038, respectively). Our results suggest that athletes with medial elbow pain during the MER of pitching have ulnar nerve swelling.