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Upper Extremity Blood Flow in Collegiate and High School Baseball Pitchers

A Preliminary Report

University of Southern California, School of Medicine, Department of Orthopaedic Surgery, University of Southern California, School of Medicine, Department of Orthopaedic Surgery

John R. Perry, MD

University of Southern California, School of Medicine, Department of Orthopaedic Surgery, University of Southern California, School of Medicine, Department of Orthopaedic Surgery

Roberta Poppiti, RVT

Department of Surgery, Los Angeles, California

C. Thomas Vangsness, MD

University of Southern California, School of Medicine, Department of Orthopaedic Surgery, University of Southern California, School of Medicine, Department of Orthopaedic Surgery

Fred A. Weaver, MD

Department of Surgery, Los Angeles, California

The arterial and venous volume blood flow in the dom inant and nondominant upper extremities of five male pitchers, ages 16 to 21, was measured using color flow duplex ultrasound. Blood-flow measurements were ob tained at baseline, after warmup, and after each se quence of 20 pitches until 100 pitches were thrown. Blood flow was additionally determined 1 hour after the last pitch. The velocity of each pitch was recorded with a speed gun. Anthropomorphic measurements of the upper extremity were obtained at baseline and imme diately after Pitch 100 using a standard measuring tape. The highest average arterial volume flow in the pitching arm occurred after 40 pitches, reaching a peak of 549 ml/min (56% increase from baseline). Thereaf ter, the average arterial blood flow steadily declined, reaching an average of 402 ml/min after the 100th pitch (14% increase from baseline). In contrast, the arterial blood flow in the nonpitching arm increased only slightly from baseline, reaching a maximal volume flow of 448 ml/min immediately after the warm-up period (10% increase from baseline). The volume flow then persistently fell to a level 30% below baseline after the 100th pitch. Although this small pilot study does not demonstrate causation between a decline in pitching performance and arterial blood flow, it suggests arterial flow in the dominant extremity falls as the pitch count increases.