Sonoelastography on Supraspinatus Muscle-Tendon and Long Head of Biceps Tendon in Korean Professional Baseball Pitchers

Joo Han Oh; Joon Yub Kim; Do Hoon Kim; Yong Il Kim; Jae Ho Cho

doi:10.5763/kjsm.2016.34.1.28

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Oh, Kim, Kim, Kim, and Cho: Sonoelastography on Supraspinatus Muscle-Tendon and Long Head of Biceps Tendon in Korean Professional Baseball Pitchers

Clinical Article

Korean J Sports Med 2016;34(1):28-35.

Published online: 19 January 2016

DOI: https://doi.org/10.5763/kjsm.2016.34.1.28

Sonoelastography on Supraspinatus Muscle-Tendon and Long Head of Biceps Tendon in Korean Professional Baseball Pitchers

Joo Han Oh¹, Joon Yub Kim^2,, Do Hoon Kim³, Yong Il Kim⁴, Jae Ho Cho²

¹Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea

²Department of Orthopedic Surgery, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea

³Department of Orthopedic Surgery, Nalgae Hospital, Seoul, Korea

LG Twins Professional Baseball Club, Seoul, Korea

Correspondence: Joon Yub Kim Department of Orthopedic Surgery, Myongji Hospital, Seonam University College of Medicine, 55 Hwasu-ro 14 beon-gil, Deokyang-gu, Goyang 10475, Korea Tel: +82-31-810-5114, Fax: +82-31-969-0500 E-mail: doctoryub@naver.com

Received 2 March 2016 Revised 1 May 2016 Accepted 2 May 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aim of this study was to evaluate the change of supraspinatus muscle and tendon as well as biceps tendon after pitching in Korean professional baseball league pitchers by the application of sonoelastography. A total of 10 pitchers from Korean professional league were evaluated their supraspinatus muscle and tendon and long head of biceps tendon of dominant arm by sonoelastography at all-star break period. After one month later, re-evaluations were performed after pitching in the game. The strain ratio of supraspinatus muscle and tendon (red portion, soft; blue portion, hard), thickness of supraspinatus and long head of biceps tendons were evaluated. For the correlation analysis with pitching, numbers of pitches, maximal velocity, maximal difference of velocity and ratio of breaking balls among pitches were investigated. The strain ratios of supraspinatus muscle, thickness of supraspinatus and long head of biceps tendon were decreased but not statistically significant. However, the strain ratio of red portion in supraspinatus tendon was significantly increased. There were no correlations between sonoelastograpic findings and pitches.

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Keywords: Baseball, Supraspinatus, Biceps, Sonoelastography

REFERENCES

1.Klauser AS., Miyamoto H., Bellmann-Weiler R., Feuchtner GM., Wick MC., Jaschke WR. Sonoelastography: musculoskeletal applications. Radiology. 2014. 272:622–33.

2.Varghese T., Ophir J., Konofagou E., Kallel F., Righetti R. Tradeoffs in elastographic imaging. Ultrason Imaging. 2001. 23:216–48.

3.Itoh A., Ueno E., Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology. 2006. 239:341–50.

4.Lalitha P., Reddy MCB., Reddy KJ. Musculoskeletal applications of elastography: a pictorial essay of our initial experience. Korean J Radiol. 2011. 12:365–75.

5.De Zordo T., Chhem R., Smekal V, et al. Real-time sonoe-lastography: findings in patients with symptomatic achilles tendons and comparison to healthy volunteers. Ultraschall Med. 2010. 31:394–400.

6.Brandenburg JE., Eby SF., Song P, et al. Ultrasound elastography: the new frontier in direct measurement of muscle stiffness. Arch Phys Med Rehabil. 2014. 95:2207–19.

7.Yanagisawa O., Sakuma J., Kawakami Y., Suzuki K., Fukubayashi T. Effect of exercise-induced muscle damage on muscle hardness evaluated by ultrasound real-time tissue elastography. Springerplus. 2015. 4:308.

8.Moon WK., Chang SC., Huang CS., Chang RF. Breast tumor classification using fuzzy clustering for breast elastography. Ultrasound Med Biol. 2011. 37:700–8.

9.Park SH., Kim SJ., Kim EK., Kim MJ., Son EJ., Kwak JY. Interobserver agreement in assessing the sonographic and elastographic features of malignant thyroid nodules. AJR Am J Roentgenol. 2009. 193:W416–23.

10.Yoon JH., Kim MH., Kim EK., Moon HJ., Kwak JY., Kim MJ. Interobserver variability of ultrasound elastography: how it affects the diagnosis of breast lesions. AJR Am J Roentgenol. 2011. 196:730–6.

11.Muraki T., Ishikawa H., Morise S, et al. Ultrasound elastography-based assessment of the elasticity of the supraspinatus muscle and tendon during muscle contraction. J Shoulder Elbow Surg. 2015. 24:120–6.

12.Seo JB., Yoo JS., Ryu JW. Sonoelastography findings of supraspinatus tendon in rotator cuff tendinopathy without tear: comparison with magnetic resonance images and conventional ultrasonography. J Ultrasound. 2015. 18:143–9.

13.Kanematsu Y., Matsuura T., Kashiwaguchi S, et al. Epidemiology of shoulder injuries in young baseball players and grading of radiologic findings of Little Leaguer's shoulder. J Med Invest. 2015. 62:123–5.

14.Kinsella SD., Thomas SJ., Huffman GR., Kelly JD 4th. The thrower's shoulder. Orthop Clin North Am. 2014. 45:387–401.

15.Yang J., Mann BJ., Guettler JH, et al. Risk-prone pitching activities and injuries in youth baseball: findings from a national sample. Am J Sports Med. 2014. 42:1456–63.

16.Yanagisawa O., Niitsu M., Takahashi H., Itai Y. Magnetic resonance imaging of the rotator cuff muscles after baseball pitching. J Sports Med Phys Fitness. 2003. 43:493–9.

17.Polster JM., Lynch TS., Bullen JA, et al. Throwing-related injuries of the subscapularis in professional baseball players. Skeletal Radiol. 2016. 45:41–7.

18.Yeh ML., Lintner D., Luo ZP. Stress distribution in the superior labrum during throwing motion. Am J Sports Med. 2005. 33:395–401.

19.Keeley DW., McClary MA., Oliver GD., Dougherty CP. A pre-post performance comparison of the long head of the biceps brachii muscle oxygenation in young baseball pitchers. J Sports Med Phys Fitness. 2014. 54:118–23.

20.Miniaci A., Mascia AT., Salonen DC., Becker EJ. Magnetic resonance imaging of the shoulder in asymptomatic professional baseball pitchers. Am J Sports Med. 2002. 30:66–73.

21.Seo JB., Yoo JS., Ryu JW. The accuracy of sonoelastography in a fatty degeneration of supraspinatus: a comparison with magnetic resonance images through quantitative assessment. J Korean Orthop Assoc. 2014. 49:223–30.

22.Zanetti M., Hodler J. Imaging of degenerative and posttraumatic disease in the shoulder joint with ultrasound. Eur J Radiol. 2000. 35:119–25.

23.Tudisco C., Bisicchia S., Stefanini M., Antonicoli M., Masala S., Simonetti G. Tendon quality in small unilateral supraspinatus tendon tears: real-time sonoelastography correlates with clinical findings. Knee Surg Sports Traumatol Arthrosc. 2015. 23:393–8.

24.Thorpe CT., Riley GP., Birch HL., Clegg PD., Screen HR. Effect of fatigue loading on structure and functional behaviour of fascicles from energy-storing tendons. Acta Biomater. 2014. 10:3217–24.

25.Reyes AM., Jahr H., van Schie HT., Weinans H., Zadpoor AA. Prediction of the elastic strain limit of tendons. J Mech Behav Biomed Mater. 2014. 30:324–38.

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Fig. 1.

The subject was on chair with his dominant arm at side during the examination.

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Fig. 2.

Measurement of strain ratio of supraspinatus muscle. Reference box (rectangle box) was located at the subcutaneous fat layer (closed arrow) and the same size of target boxes were located at red portion of supraspinatus muscle (closed arrow with dashed line) and blue portion of supraspinatus muscle (open arrow).

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Fig. 3.

Measurement of strain ratio of supraspinatus tendon (A), thickness of suprasinatus tendon (B) and biceps long head tendon (C). As in the manners with the measurement of strain ratio in supraspinatus muscle, reference box was located at subcutaneous fat layer (closed arrow), and target boxes were located at red (closed arrow with dashed line) and blue portion of supraspinatus tendon (open arrow) (A). The thickness of supraspinatus tendon (yellow dashed line) was measured with highest thickness at superior facet of greater tuberosity (B) and thickness of biceps long head tendon (yellow dashed line) was measured in the long axis view (C).

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Fig. 4.

The change of strain ratio after pitching compared to all-star break period at red and blue portion of supraspinatus muscle and tendon. SS: supraspinatus.

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Fig. 5.

The change of thickness of supraspinatus tendon and biceps long head tendon after pitching compared to all-star break period. SS: supraspinatus, Bc: biceps brachii.

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Table 1.

Demographic characteristics of pitchers and basic data of the study

Player	Role	Career (yr)	Shoulder disease	Mesure-ment	Age (yr)	Height (cm)	Weight (kg)	Red portion of SSM	Blue portion of SSM	Red portion of SST	Blue portion of SST	Thickness of SST (mm)	Thickness of long head of Bc (mm)	Throw (n)	Proportion of breaking ball	Highest of velocity (km/hr)	Lowest of velocity (km/hr)
1	Starting	20	Bennett lesion, scapular dyskinesia	At resting	30	184	75	4.00	1.49	2.63	0.80	0.80	5.31	0	-	-	-
1	Starting	20	Bennett lesion, scapular dyskinesia	After pitching				2.63	1.04	5.88	1.96	1.96	4.29	89	71.9	141	35
2	Starting	22	SLAP, partial rotator cuff tear, posterior instability	At resting	32	190	105	6.25	3.57	4.55	1.69	1.69	5.06	0	-	-	-
2	Starting	22	SLAP, partial rotator cuff tear, posterior instability	After pitching				8.33	1.27	5.88	1.05	1.05	4.29	106	54.7	149	35
3	Middle	14	Bennett lesion, internal impingement	At resting	24	183	77	8.33	1.12	7.14	2.08	2.08	6.75	0	-	-	-
3	Middle	14	Bennett lesion, internal impingement	After pitching				5.26	1.47	5.00	0.88	0.88	5.81	10	70.0	149	29
4	Middle	22	SLAP	At resting	32	193	100	4.55	1.72	1.69	0.63	0.63	4.45	0	-	-	-
4	Middle	22	SLAP	After pitching				10.00	2.08	4.55	1.67	1.67	4.29	72	52.8	144	22
5	Middle	17	SLAP, internal impingement	At resting	27	180	75	12.50	2.86	5.56	1.18	1.18	3.18	0	-	-	-
5	Middle	17	SLAP, internal impingement	After pitching				4.00	1.00	3.70	0.85	0.85	3.1	9	44.4	139	8
6	Starting	14	SLAP surgery (2008)	At resting	30	189	91	7.69	1.23	5.88	2.08	2.08	5.66	0	-	-	-
6	Starting	14	SLAP surgery (2008)	After pitching				4.55	0.96	8.33	1.05	1.05	4.38	106	73.6	151	25
7	Middle	14	Subscapularis tendinitis, internal impingement	At resting	24	181	92	4.35	1.05	3.70	0.78	0.78	5.72	0	-	-	-
7	Middle	14	Subscapularis tendinitis, internal impingement	After pitching				2.50	0.78	10.00	1.41	1.41	4.65	18	16.7	145	18
8	Middle	17	Internal impingement	At resting	27	177	81	16.67	1.67	3.57	1.28	1.28	5.71	0	-	-	-
8	Middle	17	Internal impingement	After pitching				4.35	0.91	7.69	2.13	2.13	5.01	18	16.7	148	22
9	Starting	18	GIRD, SLAP	At resting	30	186	95	6.67	1.59	4.35	1.45	1.45	4.61	0	-	-	-
9	Starting	18	GIRD, SLAP	After pitching				4.76	2.22	7.69	1.96	1.96	4.97	104	44.2	158	33
10	Starting	25	SLAP surgery, supraspinatus repair (2014)	At resting	35	190	98	12.50	3.85	2.94	1.06	1.06	3.57	0	-	-	-
10	Starting	25	SLAP surgery, supraspinatus repair (2014)	pitching After				10.00	2.63	4.17	1.19	1.19	5.16	19	57.9	146	21

SSM: supraspinatus muscle, SST: supraspinatus tendon, Bc: Biceps brachii, SLAP: superior labrum anterior to posterior, GIRD: glenohumeral internal rotation deficit.

Table 2.

Comparisons between strain ratios of supraspinatus muscle and tendon at red and blue portion at all-star break and after pitching

Variable	Supraspinatus muscle (SD)	Supraspinatus tendon (SD)	p-value
Red portion at all-star break	8.35 (4.23)	4.20 (1.65)	0.013
Blue portion at all-star break	2.02 (2.02)	1.30 (0.52)	0.090
Red portion after pitching	5.64 (2.80)	6.29 (2.06)	0.644
Blue portion after pitching	1.44 (0.65)	1.42 (0.48)	0.934

SD: standard deviation.

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