Arterial Compression during Overhead Throwing: A Risk for Arterial Injury?

Stapleton, Claire H.; Elias, Jade; Green, Danny J.; Cable, N. Tim; George, Keith P.

doi:10.1016/j.ultrasmedbio.2010.05.002

« Previous Next »Ultrasound in Medicine and Biology
Volume 36, Issue 8 , Pages 1259-1266, August 2010

Arterial Compression during Overhead Throwing: A Risk for Arterial Injury?

Claire H. Stapleton
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- Address correspondence to: Claire Stapleton, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street Campus, Liverpool, Merseyside, L3 3AF.
Jade Elias
- English Institute of Sport, Sportcity, Rowsley Street, Manchester, United Kingdom
Danny J. Green
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia
N. Tim Cable
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
Keith P. George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom

Received 22 January 2010; received in revised form 17 March 2010; accepted 3 May 2010. published online 05 July 2010.

Abstract

Case studies reporting aneurysm formation in the axillary artery have been described in overhead throwing athletes, possibly due to repetitive arterial compression by the humeral head that has been transiently observed during sonographic diagnostic arm manoeuvres. Whether compression negatively alters arterial health has not been investigated and was the focus of this study. The throwing arm of elite overhead athletes was screened for inducible axillary artery compression. Compressors (COMP, n = 11, mean age: 20 (SD: 2) year, 7 male, 4 female) were age and sex matched with noncompressing (NONCOMP) athlete controls. Four indices of arterial health (flow mediated dilation [FMD], conduit artery vasodilatory capacity [CADC], glyceryl-trinitrate [GTN]-induced vasodilation and intima-media thickness [IMT]) were assessed with high-resolution ultrasound at the brachial and the axillary, artery. No significant between-group differences were observed at the brachial, or axillary, artery for FMD (brachial: COMP: mean (SD) 6.2 (3.1)%, NONCOMP: 6.1 (3.5)%, p = 0.967, axillary: COMP: 8.0 (5.5)%, NONCOMP: 9.0 (3.6)%, p = 0.602), CADC (brachial: COMP: 10.4 (3.4)%, NONCOMP: 10.4 (5.4)%, p = 0.999, axillary: COMP: 9.6 (4.2)%, NONCOMP: 8.5 (3.2)%, p = 0.492), GTN-induced vasodilation (brachial: COMP: 17.9 (5.1)%, NONCOMP:14.1 (7.2)%, p = 0.173, axillary: COMP: 9.5 (4.3)%, NONCOMP: 7.7 (3.1)%, p = 0.302) or IMT (brachial: p = 0.084, axillary: p = 0.581). These results suggest that transient arterial compression, observed during diagnostic arm manoeuvres in overhead throwing athletes, is not associated with abnormal indices of artery function or structure and that other mechanisms must be responsible for the published cases of aneurysm formation in elite athletes performing overhead throwing actions. (E-mail: c.stapleton@ljmu.ac.uk)

Key Words: Vascular compression, Endothelial function, Elite athletes, Overhead throwing, Flow mediated dilation, Intima media thickness