scholarly journals Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball Pitchers

2002 ◽  
Vol 30 (4) ◽  
pp. 463-468 ◽  
Author(s):  
Stephen Lyman ◽  
Glenn S. Fleisig ◽  
James R. Andrews ◽  
E. David Osinski
Keyword(s):  
Cohort Study ◽  
Shoulder Pain ◽  
Joint Pain ◽  
Generalized Estimating Equations ◽  
Age Group ◽  
Elbow Pain ◽  
Increased Risk ◽  
Youth Baseball ◽  
Baseball Pitchers ◽  
And Performance

Background Joint pain is thought to be an early sign of injury to a pitcher. Objective To evaluate the association between pitch counts, pitch types, and pitching mechanics and shoulder and elbow pain in young pitchers. Study Design Prospective cohort study. Methods Four hundred and seventy-six young (ages 9 to 14 years) baseball pitchers were followed for one season. Data were collected from pre- and postseason questionnaires, injury and performance interviews after each game, pitch count logs, and video analysis of pitching mechanics. Generalized estimating equations and logistic regression analysis were used. Results Half of the subjects experienced elbow or shoulder pain during the season. The curveball was associated with a 52% increased risk of shoulder pain and the slider was associated with an 86% increased risk of elbow pain. There was a significant association between the number of pitches thrown in a game and during the season and the rate of elbow pain and shoulder pain. Conclusions Pitchers in this age group should be cautioned about throwing breaking pitches (curveballs and sliders) because of the increased risk of elbow and shoulder pain. Limitations on pitches thrown in a game and in a season can also reduce the risk of pain. Further evaluation of pain and pitching mechanics is necessary.

scholarly journals Limiting the Pitch Count in Youth Baseball Pitchers Decreases Elbow Pain

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712198910
Author(s):  
Tetsuya Matsuura ◽  
Yuki Takata ◽  
Toshiyuki Iwame ◽  
Jyoji Iwase ◽  
Kenji Yokoyama ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Stress Test ◽  
Daily Maximum ◽  
Test Results ◽  
Level Of Evidence ◽  
Valgus Stress ◽  
Radiographic Images ◽  
Elbow Pain ◽  
Youth Baseball ◽  
Baseball Pitchers

Background: Reducing the number of pitches thrown is regarded as the most effective way to prevent throwing injuries in youth baseball pitchers. However, few studies have compared the effectiveness of limiting the pitch count versus the limiting the number of innings pitched in terms of elbow injuries. Hypothesis: We hypothesized that, compared with inning limits, pitch count limits would lead to greater decreases in elbow pain, range of motion deficits, positive moving valgus stress test results, and the risk of capitellar osteochondritis dissecans (OCD). Study Design: Cohort study; Level of evidence, 3. Methods: This study retrospectively reviewed baseball pitchers aged 8 to 12 years in 2017 and 2018. Inning and pitch count limits in games were set to a daily maximum of 7 innings in 2017 and 70 pitches in 2018. Elbow pain, range of motion, and moving valgus stress test results were evaluated. The presence of capitellar OCD was assessed on ultrasonographic and radiographic images. Results: A total of 352 pitchers in 2017 and 367 pitchers in 2018 participated. The mean pitch count per game was lower in the pitch count limit (CL) group (52.5 ± 16.0) than in the inning limit (IL) group (98.2 ± 19.5) ( P < .001). Compared with the IL group, the CL group had significantly lower rates of elbow pain (40.9% vs 31.9%, respectively; P = .01) and reduced flexion (19.0% vs 10.6%, respectively; P = .001). Multivariate analysis revealed a significant association between elbow pain and age in both the IL and the CL groups ( P < .0001 and P = .02, respectively) and between OCD and elbow pain in the CL group ( P = .04). Conclusion: A pitch count limit of ≤70 pitches per day for baseball pitchers ≤12 years could be more protective against elbow pain and reduced flexion than a limit of ≤7 innings per day, but it may not be effective for reducing the risk of capitellar OCD.

Risk of Stroke in Nasopharyngeal Cancer Survivors: A National Registry-Based Population Cohort Study

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013058
Author(s):  
Teng Hwee Tan ◽  
Huili Zheng ◽  
Timothy Cheo ◽  
Jeremy Tey ◽  
Yu Yang Soon
Keyword(s):  
Cohort Study ◽  
General Population ◽  
Nasopharyngeal Cancer ◽  
Reference Population ◽  
National Registry ◽  
Age Group ◽  
Post Stroke ◽  
Risk Of Death ◽  
Increased Risk ◽  
Stage 1

BackgroundWe aim to determine the risk of stroke and death within 30 days post stroke in nasopharyngeal cancer (NPC) survivors.MethodsWe conducted a population-based cohort study of patients diagnosed with NPC from Jan 1, 2005 to Dec 31, 2017. Using the cancer and stroke disease registries and the Singapore general population as the reference population, we report the age-standardized incidence rate differences (SIRDs) ratios (SIRs) and the cumulative incidence of stroke and the standardized mortality rate differences (SMRDs) and ratios (SMRs) for all causes of death within 30 days post stroke for NPC survivors.FindingsAt a median follow up of 48.4 months (IQR 19.8 – 92.9) for 3849 patients diagnosed with NPC, 96 patients developed stroke. The overall SIRD and SIR for stroke was 3.12 (95% CI 2.09 – 4.15) and 2.54 (95% CI 2.08 – 3.10) respectively. The SIRD was highest for the age group 70 – 79 years old (8.84 cases per 1000 person-years (PY); 0.46 – 17.21) while the SIR was highest for the age group 30 – 39 years old (16.41; 6.01 – 35.82). The SIRD and SIR for stage 1 disease was (6.96 cases per 1000 PY; 2.16 – 11.77) and (4.15; 2.46 – 7.00) respectively. The SMRD and SMR for all cause deaths within 30 days of stroke was (3.20 cases per 100 persons; -3.87 – 10.28) and (1.34; 0.76 – 2.37) respectively.InterpretationThe overall risk of stroke was markedly elevated in survivors of NPC, especially in Stage 1 disease when compared to the general population. The risk of death within 30 days of stroke was not significantly higher for NPC survivors.Classification of EvidenceThis study provides Class II evidence of the increased risk of stroke in survivors of nasopharyngeal cancer compared to general population.

scholarly journals RELATIONSHIP BETWEEN PHYSICAL DEVELOPMENT AND PERFORMANCE IN YOUTH BASEBALL PITCHERS

2018 ◽  
Vol 67 (1) ◽  
pp. 76-76
Author(s):  
Dirkjan Veeger ◽  
Erik van der Graaff ◽  
Femke van Dis ◽  
Evert Verhagen ◽  
Marco Hoozemans
Keyword(s):  
Physical Development ◽  
Youth Baseball ◽  
Baseball Pitchers ◽  
And Performance

scholarly journals Exceeding Pitch Count Recommendations In Youth Baseball Increases The Elbow Injuries

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0012
Author(s):  
Tetsuya Matsuura ◽  
Toshiyuki Iwame ◽  
Koichi Sairyo
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Multivariate Analysis ◽  
Univariate Analysis ◽  
The United States ◽  
Injury Incidence ◽  
Elbow Pain ◽  
Increased Risk ◽  
Youth Baseball ◽  
Elbow Injuries

Objectives: With the incidence of Little League elbow increasing, pitch limit recommendations for preventing throwing injuries have been developed in the United States and Japan. In 1995, the Japanese Society of Clinical Sports Medicine announced limits of 50 pitches per day and 200 pitches per week to prevent throwing injuries in younger than 12 years old. However the relationship between pitch limit recommendation and elbow injuries among pitchers has not been adequately studied. The aim of our study was to evaluate the association between pitch counts and elbow injuries in youth pitchers. Methods: A total of 149 pitchers without prior elbow pain were observed prospectively for 1 season to study injury incidence in relation to specific risk factors. Average age was 10.1 years (range, 7-11 years). One year later, all pitchers were examined by questionnaire. Subjects were asked whether they had experienced any episodes of elbow pain during the season. The questionnaire was also used to gather data on pitch counts per day and per week, age, number of training days per week, and number of games per year. We investigated the following risk factors for elbow injury: pitch counts, age, position, number of training days per week, and number of games per year. Data were analyzed by multivariate logistic regression models and presented as odds ratio (OR) and profile likelihood 95% confidence interval (CI) values. The likelihood-ratio test was also performed. A two-tailed P value of less than .05 was considered significant. All analysis was done in the SAS software package (version 8.2). Results: Of the 149 subjects, 66 (44.3%) reported episodes of pain in the throwing elbow during the season. 1. Analysis for pitch count per day Univariate analysis showed that elbow pain was significantly associated with more than 50 pitches per day. Multivariate analysis showed that more than 50 pitches per day (OR, 2.44; 95% CI, 1.22-4.94), and more than 70 games per year (OR, 2.47; 95% CI, 1.24-5.02) were risk factors significantly associated with elbow pain. Age and number of training days per week were not significantly associated with elbow pain. 1. Analysis for pitch count per week Univariate analysis showed that elbow pain was significantly associated with more than 200 pitches per week. Multivariate analysis showed that more than 200 pitches per week (OR, 2.04; 95% CI, 1.03-4.10), and more than 70 games per year (OR, 2.41; 95% CI, 1.22-4.87) were risk factors significantly associated with elbow pain. Age was not significantly associated with elbow pain. Conclusion: A total of 44.3% of youth baseball pitchers had elbow pain during the season. Multivariable logistic regression revealed that elbow pain was associated with more than 50 pitches per day, more than 200 pitches per week, and more than 70 games per year. Previous studies have revealed the risk factor with the strongest association to injury is pitcher. Our data suggest that compliance with pitch limit recommendations including limits of 50 pitches per day and 200 pitches per week may be protective against elbow injuries. Those who played more than 70 games per year had a notably increased risk of injury. With increasing demand on youth pitchers to play more, there is less time for repair of bony and soft tissues in the elbow. In conclusion, among youth pitchers, limits of 50 pitches per day, 200 pitches per week, and limits of 70 games per year may protect elbow injuries.

scholarly journals Knee Pain Predicts Subsequent Shoulder Pain and the Association Is Mediated by Leg Weakness: Longitudinal Observational Data from the Osteoarthritis Initiative

2016 ◽  
Vol 43 (11) ◽  
pp. 2049-2055 ◽  
Author(s):  
Laura L. Laslett ◽  
Petr Otahal ◽  
Elizabeth M.A. Hensor ◽  
Sarah R. Kingsbury ◽  
Philip G. Conaghan
Keyword(s):  
Shoulder Pain ◽  
Knee Pain ◽  
Joint Pain ◽  
Depression Score ◽  
Persistent Pain ◽  
Increased Risk ◽  
Lower Limb Pain ◽  
Multinomial Modeling ◽  
Leg Weakness ◽  
Osteoarthritis Initiative

Objective.To assess whether the “spread” of joint pain is related to pain-associated muscle loss in 1 joint leading to increased loading and subsequent pain in other joints.Methods.Associations between persistent knee pain (pain in 1 or 2 knees over 0–3 years vs no persistent pain) and incident shoulder pain at Year 4 were examined in participants from the longitudinal National Institutes of Health Osteoarthritis Initiative. Associations were assessed using log multinomial modeling, adjusted for age, sex, body mass index, depression score, other lower limb pain, and baseline leg weakness (difficulty standing from a sitting position).Results.In older adults with clinically significant knee osteoarthritis (OA) or at risk of knee OA (n = 3486), the number of painful joints increased yearly, from 2.1 joints (95% CI 2.0–2.2) at baseline increasing by 5.2% (95% CI 2.2–8.3) at Year 4. Shoulders were the next most commonly affected joints after knees (28.5%). Persistent pain in 1 or 2 knees increased risk of bilateral shoulder pain at Year 4 [1 knee: relative risk (RR) 1.59, 95% CI 0.97–2.61; 2 knees: RR 2.02, 95% CI 1.17–3.49] after adjustment for confounders. Further adjustment for leg weakness attenuated effect sizes (1 knee: RR 1.13, 95% CI 0.60–2.11; 2 knees: RR 1.44, 95% CI 0.75–2.77), indicating mediation by functional leg weakness.Conclusion.Spread of joint pain is not random. Persistently painful knees predict new bilateral shoulder pain, which is likely mediated by leg weakness, suggesting that biomechanical factors influence the spread of pain.

scholarly journals The prevalence and impact of self-reported foot and ankle pain in the over 55 age group: a secondary data analysis from a large community sample

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Anne-Maree Keenan ◽  
Chris Drake ◽  
Philip G. Conaghan ◽  
Alan Tennant
Keyword(s):  
Ankle Joint ◽  
Joint Pain ◽  
Community Sample ◽  
Age Group ◽  
Foot Pain ◽  
Foot And Ankle ◽  
Ankle Pain ◽  
Large Community ◽  
Increased Risk ◽  
The Impact

Abstract Background While the prevalence and impact of musculoskeletal problems are high, most attention has been directed towards the back, knee and hip disorders. Foot pain is known to be common in older adults and accounts for a significant burden on health services. The aim of this study was to assess the impact of foot and ankle joint pain, considering age, presence of co-morbidities and other site joint pain, in a large community sample. Methods In the North Yorkshire Health study, 16,222 people over 55 years participated in a detailed survey of the prevalence and impact of lower limb joint problems. Self-assessment of overall body pain and functional activities of daily living were assessed. Participants indicated the presence of joint pain, stiffness or swelling during the last 3 months which had lasted for more than 6 weeks on a manikin: data were captured on the foot and the ankle. Results The prevalence of self-reported foot and ankle joint pain was substantial: 184.33 per 1000, second only to knee problems. While foot pain was common, it was mostly associated with joint pain at other sites; only 1 in 11 of those with foot and ankle pain reported it only in the foot. Logistic regression modeling revealed while established factors such as co-morbidities, knee and hip problems contributed to functional impairment, foot and ankle problems contributed to an additional increased risk of having difficulty standing and walking by two fold (OR = 2.314, 95%CI 2.061–2.598), going up and down stairs by 71% (OR = 1.711, 95%CI 1.478–1.980) and getting up from a seated position by 44% (OR = 1.438, 95%CI 1.197–1.729). Conclusion These results suggest that not only are foot problems in the over 55 age group extremely prevalent, they have a considerable impact on functional abilities.

Longitudinal study of elbow and shoulder pain in youth baseball pitchers

2001 ◽  
Vol 33 (11) ◽  
pp. 1803-1810 ◽  
Author(s):  
STEPHEN LYMAN ◽  
GLENN S. FLEISIG ◽  
JOHN W. WATERBOR ◽  
ELLEN M. FUNKHOUSER ◽  
LEAVONNE PULLEY ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Shoulder Pain ◽  
Youth Baseball ◽  
Baseball Pitchers

scholarly journals Risk factors associated with failure of total ankle arthroplasty: a nationwide cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dong Hun Suh ◽  
Kyungdo Han ◽  
Jin Woo Lee ◽  
Hak Jun Kim ◽  
Bongsung Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Service Failure ◽  
Group Versus ◽  
Population Based ◽  
Total Ankle Arthroplasty ◽  
Age Group ◽  
Ankle Arthroplasty ◽  
Factors Associated ◽  
Increased Risk

AbstractWe conducted a nationwide population-based cohort study to identify the risk factors associated with failure of total ankle arthroplasty (TAA). We included 2,914 subjects who underwent primary TAA between January 1, 2010, and December 31, 2016, utilizing the database of the Korean National Health Insurance Service. Failure of TAA was defined as revision TAA or arthrodesis procedures. An increased risk of TAA failure was observed in the < 65 age group versus the ≥ 75 age group [adjusted hazard ratios (aHR) 2.273, 95% confidence interval (CI) 1.223–4.226 in the 60–64 age group; aHR 2.697, 95% CI 1.405–5.178 in the 55–59 age group; aHR 2.281, 95% CI 1.145–4.543 in the 50–54 age group; aHR 2.851, 95% CI 1.311–6.203 in the < 50 age group]. Conversely, the ≥ 65 age group displayed no increase in the risk of TAA failure. The risk of TAA failure was increased in the severely obese group with body mass index (BMI) of ≥ 30 kg/m2 versus the normal BMI group (aHR 1.632; 95% CI 1.036–2.570). This population-based longitudinal study demonstrated that age < 65 years and BMI of ≥ 30 kg/m2 were associated with increased risk of TAA failure.

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.

The Effect of Pitching Biomechanics on the Upper Extremity in Youth and Adolescent Baseball Pitchers

2009 ◽  
Vol 37 (8) ◽  
pp. 1484-1491 ◽  
Author(s):  
J.T. Davis ◽  
Orr Limpisvasti ◽  
Derrick Fluhme ◽  
Karen J. Mohr ◽  
Lewis A. Yocum ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Internal Rotation ◽  
Motion Analysis ◽  
High Speed ◽  
Elbow Pain ◽  
Correct Performance ◽  
Youth Baseball ◽  
Elbow Injuries ◽  
Baseball Pitchers ◽  
Analysis System

Background Increased pitch counts have been linked to increased complaints of shoulder and elbow pain in youth baseball pitchers. Improper pitching mechanics have not been shown to adversely affect the upper extremity in youth pitchers. Hypothesis The correct performance of 5 biomechanical pitching parameters correlates with lower humeral internal rotation torque and elbow valgus load, as well as higher pitching efficiency, in youth and adolescent pitchers. Study Design Descriptive laboratory study. Methods In sum, 169 baseball pitchers (aged 9-18) were analyzed using a quantitative motion analysis system and a high-speed video while throwing fastballs. The correct performance of 5 common pitching parameters was compared with each pitcher's age, humeral internal rotation torque, elbow valgus load, and calculated pitching efficiency. Results Motion analysis correlated with video analysis for all 5 parameters (P <. 05). Youth pitchers (aged 9-13) performing 3 or more parameters correctly showed lower humeral internal rotation torque, lower elbow valgus load, and higher pitching efficiency (P <. 05). Conclusions Youth pitchers with better pitching mechanics generate lower humeral internal rotation torque, lower elbow valgus load, and more efficiency than do those with improper mechanics. Proper pitching mechanics may help prevent shoulder and elbow injuries in youth pitchers. Clinical Relevance The parameters described in this study may be used to improve the pitching mechanics of youth pitchers and possibly reduce shoulder and elbow pain in youth baseball pitchers.

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