scholarly journals Relationship between tightness of the hip joint and shoulder/elbow injury in high school baseball pitchers: a prospective study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Noritaka Hamano ◽  
Hitoshi Shitara ◽  
Tsuyoshi Tajika ◽  
Tsuyoshi Ichinose ◽  
Tsuyoshi Sasaki ◽  
...  
Keyword(s):  
High School ◽  
Risk Factor ◽  
Lower Limb ◽  
External Rotation ◽  
Elbow Pain ◽  
Elbow Injury ◽  
Hip Range Of Motion ◽  
Baseball Pitchers ◽  
A Prospective Study ◽  
The Relationship

AbstractSome studies have reported that upper limb tightness is a risk factor for shoulder/elbow pain in high school baseball pitchers; but there has been insufficient research on the relationship between lower limb tightness and shoulder and elbow pain in pitchers. This study aimed to clarify the correlation among pre-season hip range of motion (ROM) and shoulder and elbow disorders in high school baseball pitchers. We surveyed 125 high school pitchers. Hip ROM was measured in the supine and prone positions. After the season, based on their answers to the self-recorded questionnaire, a “shoulder or elbow injury” was defined as any condition resulting in the pitcher being considered disabled for ≥ 8 days. An independent t-test and logistic regression analysis were used for statistical analysis. Eleven disabled pitchers (9%) were identified during the season. In the injured group, the ROM of the plant side hip with 90° flexed external rotation was smaller than that in the non-injured group. Preseason limited ROM in the plant side hip with 90° flexed external rotation was a risk factor for the occurrence of shoulder/elbow pain in the season.

scholarly journals Daily Players’ Satisfaction with Pitching Performance Could Predict Shoulder and Elbow Injuries in High-school Baseball Pitchers: A Prospective Time-to-event Study

2021 ◽  
Author(s):  
Hitoshi Shitara ◽  
Tsuyoshi Tajika ◽  
Takuro Kuboi ◽  
Tsuyoshi Ichinose ◽  
Tsuyoshi Sasaki ◽  
...  
Keyword(s):  
High School ◽  
Event Study ◽  
Operating Characteristics ◽  
Time To Event ◽  
Elbow Injury ◽  
Shoulder Range Of Motion ◽  
Elbow Injuries ◽  
Characteristics Analysis ◽  
Baseball Pitchers ◽  
The Relationship

Abstract The relationship between baseball pitchers’ satisfaction with their own performance and the incidence of shoulder and elbow injuries is unclear. We analyzed the relationship between daily satisfaction scores before injury and incidence of shoulder/elbow injury in high-school baseball pitchers in this prospective, time-to-event study. We collected baseline data on baseball experience, height, weight, elbow and shoulder range of motion, and shoulder muscle strength. The 108 enrolled participants aged 15-17 years were divided into satisfied (88) and unsatisfied (22) groups based on the Receiver operating characteristics analysis results that revealed the cutoff value to be 4 points. The incidence of injury was 10.2% and 50.0% in the satisfied and unsatisfied groups, respectively. We observed that high-school baseball pitchers with a low satisfaction significantly increased the risk of shoulder and elbow injuries: these players had a 7.3-times greater risk of injuries and a 1.9-times earlier occurrence of injuries than pitchers who are satisfied with their performance. High-school baseball pitchers who had low satisfaction with their pitching performance had higher risk of shoulder and elbow injuries and lower time to injury than satisfied pitchers. Daily evaluation of players’ self-satisfaction could predict shoulder and elbow injuries in high-school baseball pitchers.

scholarly journals Role of Rotational Kinematics in Minimizing Elbow Varus Torques for Professional Versus High School Pitchers

2018 ◽  
Vol 6 (3) ◽  
pp. 232596711876078 ◽  
Author(s):  
Micheal J. Luera ◽  
Brittany Dowling ◽  
Mitchel A. Magrini ◽  
Tyler W.D. Muddle ◽  
Ryan J. Colquhoun ◽  
...  
Keyword(s):  
High School ◽  
External Rotation ◽  
Ligament Injury ◽  
Trunk Rotation ◽  
Elbow Injury ◽  
Risk Of Injury ◽  
Increased Risk ◽  
Rotational Kinematics ◽  
Pelvis Rotation ◽  
Baseball Pitchers

Background: Elbow injury rates among baseball pitchers are rapidly rising. However, this increase has been most dramatic among high school (HS) pitchers. Purpose: To examine pitch velocity and the kinetic and kinematic characteristics of HS versus professional (PRO) pitchers to identify potential differences that may play a role in the increased risk of ulnar collateral ligament injury in youth pitchers. Study Design: Controlled laboratory study. Methods: A total of 37 HS (mean ± SD: age, 16 ± 1 years) and 40 PRO (age, 21 ± 2 years) baseball pitchers completed maximal-effort baseball pitches during a single testing session, from which pitch velocity (PV), absolute and normalized elbow varus torque (EVTA and EVTN, respectively) during arm cocking and at maximum shoulder external rotation (MER), and 8 other elbow and shoulder torques or forces and rotational kinematics of the pelvis and trunk were analyzed, recorded, and compared. Results: PV was greater in PRO than HS athletes; EVTA was greater in PRO than HS athletes during arm cocking and at MER; but EVTN was similar during arm cocking and greater in HS than PRO athletes at MER. In PRO athletes, PV was not related to EVTA during arm cocking or MER ( r = 0.01-0.05). Furthermore, in PRO athletes, EVTA during arm cocking and at MER were inversely related to upper trunk rotation at hand separation and foot contact and to pelvis rotation at elbow extension ( r = –0.30 to –0.33). In contrast, in HS athletes, PV was strongly related to EVTA during arm cocking and MER ( r = 0.76-0.77). Furthermore, in HS athletes, PV and EVTA during arm cocking and at MER were moderately or strongly related to the other elbow and shoulder torques and forces ( r = 0.424-0.991), and EVTA was not related to upper trunk rotation or pelvis rotation throughout the throwing motion ( r = –0.16 to 0.15). Conclusion: The kinetic and rotational kinematic differences observed between PRO and HS pitchers in this study may help explain the greater performance of PRO pitchers while allowing them to minimize EVT during pitching. HS pitchers, however, do not appear to be as capable of utilizing the forces generated by rotation of their trunk and pelvis to aid in pitching, and those who throw the hardest generate the greatest forces at the shoulder and elbow. As a result, they experience higher EVTs relative to their body size, which may place them at an increased risk of injury. Clinical Relevance: HS pitchers throw harder primarily by generating larger forces in the arm and shoulder. Thus, owing to the relative physical immaturity of HS versus PRO pitchers, these factors may place them at an increased risk of injury. Coaches may first wish to focus on improving the rotational kinematics of HS pitchers rather than first focusing on achieving greater pitch velocities.

scholarly journals Asymptomatic Medial Elbow Ultrasound Abnormality in Youth Baseball Players Is an Independent Risk Factor for Elbow Injury: A Prospective Cohort Study

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712098679
Author(s):  
Hitoshi Shitara ◽  
Tsuyoshi Tajika ◽  
Takuro Kuboi ◽  
Tsuyoshi Ichinose ◽  
Tsuyoshi Sasaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
External Rotation ◽  
Medial Epicondyle ◽  
Baseball Players ◽  
Elbow Pain ◽  
Elbow Injury ◽  
Youth Baseball ◽  
Elbow Injuries

Background: Youth baseball players who experience elbow pain during the season frequently exhibit radiographic elbow abnormalities. However, it is unknown whether asymptomatic elbow abnormalities are risk factors for in-season elbow injuries. Purpose: To determine whether the preseason presence of asymptomatic medial epicondyle apophysitis is a risk factor for in-season elbow injuries in youth baseball players. Study Design: Cohort study; Level of evidence, 2. Methods: Youth baseball players (N = 210; age range, 7-12 years) with no pain or history of injury in their throwing arms underwent preseason evaluations that included shoulder and elbow range of motion measurements, shoulder muscle strength testing, and ultrasound elbow scans with a multifrequency 13-MHz linear array transducer. Over 1 year of play, the players and their parents maintained daily elbow pain diaries. Elbow injuries were defined as medial elbow symptoms that prevented ball throwing for ≥8 days. Results: The preseason ultrasound evaluation revealed medial epicondyle apophysitis in 59 players. In the year following, elbow injuries occurred in 17 (28.8%) players with preseason medial epicondyle apophysitis and 18 (11.9%) players without apophysitis. Independent predictors of elbow injuries were preseason medial epicondyle apophysitis (odds ratio [OR], 2.488; 95% confidence interval [CI], 1.152-5.376; P = .02) and deficits of abduction (ABD) and external rotation of the dominant shoulder (OR, 0.963; 95% CI, 0.936-0.992; P = .012). Conclusion: Asymptomatic medial epicondyle apophysitis and ABD and external rotation deficits in the dominant shoulder were risk factors for elbow injuries in 7- to 12-year-old youth baseball players. These findings may aid in the design of programs to prevent elbow injuries in this population.

scholarly journals Relationship between upper limb injuries and hip range of motion and strength in high school baseball pitchers

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110033
Author(s):  
Noritaka Hamano ◽  
Hitoshi Shitara ◽  
Tsuyoshi Tajika ◽  
Tsuyoshi Ichinose ◽  
Tsuyoshi Sasaki ◽  
...  
Keyword(s):  
High School ◽  
Range Of Motion ◽  
Elbow Injury ◽  
The Past ◽  
Hip Range Of Motion ◽  
Limb Injuries ◽  
Hip Abduction ◽  
Baseball Pitchers ◽  
Abduction Strength ◽  
Dominant Side

We aimed to examine the relationship between hip range of motion (ROM) and abduction strength and throwing-related shoulder/elbow injuries in high school baseball pitchers. The study included 135 baseball pitchers. We asked them to fill out a questionnaire at the checkups, that included the dominant arm and the years of baseball experience. To avoid a confirmation bias, the examiners were blinded to the participants’ hand dominance. All players underwent physical function measurements, such as height, weight, shoulder and hip strength, and shoulder and hip ROM. Shoulder and elbow injury was defined as shoulder and elbow pain that the patient had been aware of in the past 3 years. The results of injured and non-injured pitchers were compared. Eighty-five pitchers had experienced a shoulder or elbow injury in the past 3 years. The shoulder ROM and strength in the injured and non-injured groups did not differ to a statistically significant extent. The hip external rotation ROM on the dominant side, the hip abduction strength on the non-dominant side, and the hip abduction strength on the dominant side were significantly lower in the injured group than in the non-injured group. The results may contribute to reducing the incidence of these injuries.

scholarly journals The Relationship between the Glenohumeral Joint Internal Rotation Deficit and the Trunk Compensation Movement in Baseball Pitchers

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 243
Author(s):  
Shih-Chung Cheng ◽  
Ting-Yu Wan ◽  
Chun-Hao Chang
Keyword(s):  
High School ◽  
Internal Rotation ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Senior High School ◽  
Control Group ◽  
Trunk Rotation ◽  
Baseball Pitchers ◽  
The Relationship ◽  
Dominant Side

Background and objectives: Glenohumeral joint internal rotation deficit (GIRD) is commonly observed in the dominant arm of baseball pitchers and is limited by horizontal adduction motions. We inferred that when pitchers’ generation of internal shoulder rotation and horizontal adduction activity is limited, they may generate compensation movements in other body parts. This study aims to investigate whether pitchers with GIRD generates trunk compensation during pitching where pitching targets were on the lower corner of their non-dominant side. Design: Case-control study. Setting: Elite senior high school baseball. Participants: Twenty-five senior high school baseball pitchers participated in this study. Twelve pitchers with GIRD were assigned to the experiment group, and the remaining 13 participants to the control group. Main outcome measures: Glenohumeral internal/external rotation of both arms and internal/external rotation of the bilateral hip joints were measured. The kinematic values of the trunk when pitching to a target were measured using high-speed infrared cameras. Results: Pitchers with GIRD exhibited significantly greater upper trunk rotation toward the non-dominant side when a baseball was released from their hand (27.39 ± 6.62 degrees), compared with non-GIRD pitchers (20.42 ± 5.97 degrees) (p < 0.05). The total rotation of the pivot leg of pitchers with GIRD (67.54 ± 7.84 degrees) was significantly smaller than that of pitchers without GIRD (74.00 ± 7.07 degrees) (p < 0.05). Conclusions: GIRD in the dominant arm affected upper trunk rotation during pitching and was associated with the hip range of motion. Future studies could conduct a longitudinal study regarding the relationship between GIRD and other joint injuries of the lower limbs.

scholarly journals A small number of daily pitches induces shoulder and elbow injuries among high school baseball pitchers: a prospective study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hitoshi Shitara ◽  
Tsuyoshi Tajika ◽  
Takuro Kuboi ◽  
Tsuyoshi Ichinose ◽  
Tsuyoshi Sasaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
High School ◽  
Prospective Study ◽  
Baseball Players ◽  
Arm Injuries ◽  
Elbow Injuries ◽  
Full Power ◽  
Baseball Pitchers ◽  
A Prospective Study ◽  
The Relationship

AbstractBaseball players frequently injure their shoulders and elbows. Preseason risk factors for such injuries have been relatively well studied, but in-season risk factors are less known, and the relationship between the number of pitches and the incidence of such injuries in baseball pitchers of any level is unclear. Identifying the risk factors related to the number of daily pitches is particularly important to prevent baseball-related arm injuries among young pitchers. Thus, we prospectively investigated the relationship between the number of daily full-power pitches in high school baseball pitchers and the incidence of shoulder and elbow injuries. We observed that a small number of daily full-power pitches, < 30 pitches per day, in high school baseball pitchers, significantly increased the risk of shoulder and elbow injuries: these players had a 2.3-times greater risk of injuries and a 45-day earlier occurrence of injuries than those pitching ≥ 30 pitches per day. Although unexpected, this was plausible as continuous daily pitching is required to maintain physical condition in growing and maturing high school pitchers. These findings may form the basis for establishing guidelines regarding the appropriate number of daily pitches required to prevent shoulder and elbow injuries in high school baseball pitchers.

scholarly journals The Relationship between Scapular Upward Rotation and Shoulder Internal and External Rotation Isokinetic Strength in Professional Baseball Pitchers

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 759
Author(s):  
Byung Gon Kim ◽  
Seung Kil Lim ◽  
Sunga Kong
Keyword(s):  
External Rotation ◽  
Professional Baseball ◽  
Isokinetic Strength ◽  
Strength Ratio ◽  
Shoulder Injury ◽  
Isokinetic Dynamometer ◽  
Normal Range ◽  
History Of ◽  
Baseball Pitchers ◽  
The Relationship

This study aims to assess the relationship between scapular upward rotation (SUR) across varying humeral-elevation angles (HEAs) and shoulder isokinetic strength and ratio in professional baseball pitchers. The subjects were professional baseball pitchers (n = 16) without a history of shoulder injury in the last six months. The subject’s SUR angles were measured with the humerus elevated at HEAs of 0° (at rest), 60°, 90°, and 120° to the scapular plane. Shoulder isokinetic strength was evaluated for shoulder internal rotation (IR) and external rotation (ER) strength (PT%BW and TW%BW), and the ER/IR strength ratios were determined at 60, 120 and 180°/s using an isokinetic dynamometer. The SUR angle at an HEA of 0° was positively correlated with IR strength at 120°/s (r = 0.535) and 180°/s (r = 0.522). The SUR angle at an HEA of 60° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.505) and 120°/s (r = −0.500). The SUR angle at an HEA of 90° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.574; r = −0.554) and 120°/s (r = −0.521; r = −0.589) as well as with ER strength at 180°/s (r = −0.591, r = −0.556). The SUR angle at an HEA of 120° was negatively correlated with ER strength at 60°/s (r = −0.558), 120°/s (r = −0.504; r = −0.524), and 180°/s (r = −0.543) and the ER/IR strength ratio at 60°/s (r = −0.517). In this study, we found that the ratio of isokinetic strength between ER and IR became closer to the normal range on increasing the SUR angle. In particular, an HEA of 90°, which resembles the pitching motion, showed a clear relationship between SUR, shoulder ER, and the ratio of ER/IR isokinetic strength in professional baseball pitchers.

Humeral Torsion as a Risk Factor for Shoulder and Elbow Injury in Professional Baseball Pitchers

2016 ◽  
Vol 44 (9) ◽  
pp. 2214-2219 ◽  
Author(s):  
Thomas J. Noonan ◽  
Charles A. Thigpen ◽  
Lane B. Bailey ◽  
Douglas J. Wyland ◽  
Michael Kissenberth ◽  
...  
Keyword(s):  
Risk Factor ◽  
Professional Baseball ◽  
Elbow Injury ◽  
Humeral Torsion ◽  
Baseball Pitchers

scholarly journals Hip Range of Motion and Strength and Energy Flow During Windmill Softball Pitching

2021 ◽  
Author(s):  
Gretchen D. Oliver ◽  
Kyle Wasserberger ◽  
Anne de Swart ◽  
Kenzie Friesen ◽  
Jessica Downs ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Energy Flow ◽  
Injury Risk ◽  
External Rotation ◽  
Whole Body ◽  
Net Energy ◽  
Acceleration Phase ◽  
Hip Range Of Motion ◽  
Flow Through ◽  
The Relationship

Context Inadequate hip range of motion (ROM) and isometric strength (ISO) may interfere with energy flow through the kinetic chain and result in increased injury susceptibility. Objective To examine the relationship of hip ROM and ISO with energy flow through the trunk and pitching-arm segments during the windmill softball pitch in youth athletes. A subsequent purpose was to examine the relationship between energy flow and pitch speed. Design Descriptive laboratory study. Setting University research laboratory. Patients or Other Participants A sample of 29 youth softball pitchers (age = 11.2 ± 1.3 years, height = 155.0 ± 10.4 cm, mass = 53.2 ± 12.6 kg). Main Outcome Measure(s) Bilateral hip internal-rotation and external-rotation (ER) ROM and ISO were measured. Net energy outflow and peak rates of energy outflow from the distal ends of the trunk, humerus, and forearm were calculated for the acceleration phase of the windmill softball pitch, and pitch speed was measured. Results Regression analysis revealed an effect of drive-hip ER ISO on the net energy flow out of the distal ends of the trunk (P = .045) and humerus (P = .002). Specifically, increased drive-hip ER ISO was associated with increased net energy outflow from the trunk to the humerus and from the humerus to the forearm. No significant effects of hip ROM or other hip ISO measures were observed. Additionally, pitchers who achieved higher peak rates of distal outflow tended to achieve higher pitch speeds. Conclusions An association was present between drive-hip ER ISO and the net energy flow out of the distal ends of the trunk and humerus during the acceleration phase of the windmill softball pitch, emphasizing the importance of hip and lower body strength in executing the whole-body windmill pitch. Overall, energy-flow analysis is an interesting new way to analyze pitching mechanics and will aid in furthering our understanding of performance and injury risk in windmill softball pitching.

Effects of Hip Range of Motion and Isometric Strength on Energy Flow during Windmill Softball Pitching

2021 ◽  
Author(s):  
Gretchen D. Oliver ◽  
Kyle Wasserberger ◽  
Anne de Swart ◽  
Kenzie Friesen ◽  
Jessica Downs ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Energy Flow ◽  
External Rotation ◽  
Isometric Strength ◽  
Whole Body ◽  
Net Energy ◽  
Acceleration Phase ◽  
Hip Range Of Motion ◽  
Flow Through ◽  
The Relationship

Abstract Context:Inadequate hip range of motion (ROM) and isometric strength (ISO) may interfere with energy flow through the kinetic chain and result in increased injury susceptibility. Objective:To examine the relationship of hip ROM and ISO with energy flow through the trunk and pitching arm segments during the windmill softball pitch in youth athletes. A subsequent purpose was to examine the relationship between energy flow and pitch speed. Design:Descriptive laboratory study. Setting:University research laboratory. Participants:A sample of 29 youth softball pitchers (11.2±1.3 yrs.; 155.0±10.4 cm; 53.2±12.6 kg). Main Outcome Measure(s):Bilateral hip internal rotation (IR) and external rotation (ER) ROM and ISO were measured. Net energy outflow and peak rates of energy outflow from the distal ends of the trunk, humerus, and forearm were calculated for the acceleration phase of the windmill softball pitch, and pitch speed was measured. Results:Regression analysis revealed a significant effect of drive hip ER ISO on the net energy flow out of the distal ends of the trunk (p=0.045) and humerus (p=0.002). Specifically, increased drive hip ER ISO was associated with increased net energy outflow from the trunk to the humerus and from the humerus to the forearm. No significant effects of hip ROM or other hip ISO measures were observed. Additionally, pitchers who achieved higher peak rates of distal outflow tended to also achieve higher pitch speeds. Conclusions:There is an association between drive hip ER ISO and the net energy flow out of the distal ends of the trunk and humerus during the acceleration phase of the windmill softball pitch, emphasizing the importance of hip and lower body strength in the execution of the whole-body windmill pitch. Overall, energy flow analysis is an interesting new way to analyze pitching mechanics and will aid in further understanding of performance and injury risk in windmill softball pitching.

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