Increased Upper Arm Length and Loading Rate Identified as Potential Risk Factors for Injury in Youth Baseball Pitchers

2021 ◽  
pp. 036354652110285
Author(s):  
Jessica L. Downs ◽  
Kyle W. Wasserberger ◽  
Jeff W. Barfield ◽  
Michael G. Saper ◽  
Gretchen D. Oliver
Keyword(s):  
Injury Risk ◽  
Loading Rate ◽  
Tracking System ◽  
Limb Length ◽  
Upper Arm ◽  
Male Youth ◽  
Bony Landmarks ◽  
Youth Baseball ◽  
Baseball Pitchers ◽  
The Relationship

Background: In the throwing elbow, increased elbow torque has been correlated with increased injury risk. Additional insight into the relationships between anthropometric factors and elbow joint loading is warranted. Purpose: To investigate the relationship among physical limb length characteristics, elbow kinetics, and elbow kinematics in youth baseball pitchers and to examine the relationship between elbow varus loading rate and elbow kinetics. Design: Descriptive laboratory study. Methods: A total of 27 male youth baseball pitchers participated (mean ± SD: age, 15.8 ± 2.7 years; height, 176.3 ± 13.0 cm; weight, 71.7 ± 16.4 kg). Upper arm (UA) and forearm (FA) lengths were measured using a moveable sensor to digitize bony landmarks. Kinematic data were collected at 240 Hz using an electromagnetic tracking system. Participants threw 3 fastballs to a catcher at a regulation distance (60 ft 6 in), and the fastest velocity trial was used for analysis. Linear regression was used to determine the relationship among limb length characteristics, elbow kinetics, and elbow kinematics after accounting for the effects of body weight and height. Results: Pitchers with longer UA length experienced increased maximum elbow varus torque ( P = .005) and maximum net elbow force ( P = .001). Pitchers with an increased forearm to UA ratio had decreased elbow compression force ( P < .001) and exhibited a more flexed elbow at foot contact ( P = .001). Pitchers with greater maximum loading rates experienced greater elbow varus torque ( P = .002). Conclusion: In youth baseball pitchers, longer UA length and greater loading rate increase varus torque about the elbow during a fastball pitch. Clinical Relevance: Longer UA length and greater loading rate may place pitchers at risk of injury because of their relationship with kinetic values.

scholarly journals Increased Foot and Tibial Angles at Footstrike Decrease Vertical Loadrate in Runners

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0048
Author(s):  
Adam Tenforde ◽  
Haylee Donaghe Borgstrom ◽  
Steve Jamison ◽  
Irene Davis
Keyword(s):  
Injury Risk ◽  
Loading Rate ◽  
Sagittal Plane ◽  
Video Recording ◽  
Correlation Coefficients ◽  
Group Differences ◽  
P Values ◽  
Source Program ◽  
Running Injuries ◽  
The Relationship

Category: Sports Introduction/Purpose: It is well established that elevated vertical loadrates on footstrike are a risk factor for developing running injuries. Overstriding, or increased foot and tibial angles at footstrike, has been theorized to increase loading rate. Thus, it is often suggested that runners shorten their stride to reduce their injury risk. However, the relationship between landing alignment and loadrates has not been well established in current literature. Thus, we aimed to investigate the relationship between sagittal plane foot angle (FA) and tibial angle (TA) with vertical loadrates in both healthy and injured forefoot (FFS) and rearfoot strike (RFS) runners. It was hypothesized that as FA and TA increased, loadrate would increase for all runners. Methods: This is an ongoing study with 52 healthy runners (35 RFS, 17 FFS) and 24 injured runners (14 RFS, 10 FFS) for a total of 76 runners (51 M, 25 F; age34.3±11.4 yrs). Vertical average loadrate (VALR) and vertical instantaneous loadrate (VILR) were obtained while running at 2.68 m/s on an instrumented treadmill. All runners reported 0/10 pain during the assessment. Sagittal plane FA and TA at footstrike were measured from video recording using an open-source program. Positive FA designated RFS. Positive TA was defined as ankle anterior to the knee. Between-group differences were evaluated using paired two-tailed t-tests. Correlation coefficients (r) were computed for FA and TA with VALR and VILR (p=0.05; trend: p =0.10). Results: Healthy RFS - FA and TA were negatively correlated with VALR and VILR. Injured RFS – There was a trend toward negative correlation between TA and both VALR and VILR. Healthy FFS – TA was negatively correlated with both loadrates. Injured FFS – There were no significant correlations. Correlation coefficients, slopes, and p values are presented in Table 1. VALR and VILR were higher in RFS vs FFS runners (56±20 vs 40±10, 69±25 vs 54±12 BW/s, p<0.01), but were not significantly different for healthy vs injured runners (52±19 vs 56±26, 63±21 vs 67±27 BW/s, p=0.4). Conclusion: In contrast to current thought, preliminary results suggest that increasing FA and TA at footstrike are associated with decreasing vertical loadrates. This relationship was strongest for FA in the healthy RFS runners and weakest for FA in both the healthy and injured FFS runners. With increased FA, load attenuation may be due to increased eccentric activity of the tibialis anterior as well as increased knee flexion excursion and eccentric quadriceps activity with increased TA.

scholarly journals Manifestations of muscle fatigue in baseball pitchers: a systematic review

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7390 ◽  
Author(s):  
Richard Birfer ◽  
Michael WL Sonne ◽  
Michael WR Holmes
Keyword(s):  
Injury Risk ◽  
Relevant Literature ◽  
Peripheral Fatigue ◽  
Future Research ◽  
Cochrane Database ◽  
Rest Time ◽  
Baseball Pitchers ◽  
And Performance ◽  
Conference Papers ◽  
The Relationship

Background Fatigue in baseball pitchers is a process linked to lowered physical and mental performance, injury, and changes in kinematics. Numerous studies have associated fatigue with overuse, high ball velocities, lack of rest time, poor mechanics, and degree of self-satisfaction. The aim of this study was to systematically review the literature to identify a theoretical framework for the relationship between outcomes and the manifestation of fatigue on baseball pitching. The synthesized data may identify areas requiring further research. Methodology This protocol was registered with PROSPERO (ID: CRD42018114194). SPORTDiscus, Medline, PubMed, Cochrane Database of Systematic Reviews, and Google Scholar were searched, using keywords such as fatigue in pitchers and changes in kinematics (e.g., pitching mechanics, valgus elbow torque), performance (e.g., pitch count, pitch type), and injury (e.g., pain, elbow, and shoulder soreness). Three reviewers independently screened the articles, selected relevant literature based on abstract eligibility, and assessed the methods described therein for final inclusion. Results A total of 31,860 articles were screened for eligibility and 25 articles were included for the review. The selected articles included epidemiological, longitudinal, experimental, conference papers, and crossover laboratory studies. Evidence extracted from the 25 studies demonstrates a relationship between fatigue in baseball pitching, and three overarching outcomes: changes in kinematics, a decrease in performance, and an increase in injury risk. Conclusions Findings show that a co-dependence between changes in kinematics and a decrease in performance, which stems from central and peripheral fatigue, is a contributing factor of injury in baseball pitchers. A large percentage of baseball pitchers exhibit pain or soreness in either their elbow or shoulder, or both at some point in a season. Initially, kinematic changes occur that could maintain performance, but may increase joint and tissue loading. Performance decreased with elevated pitch counts and innings thrown, and pitching further into games or the season. Evidence was found to be consistent across all studies; however, more work is needed in the area of fatigue as an injury mechanism during pitching. With a proof of concept established, the prevention of negative outcomes associated with fatigue must be the focus of future research and performance should not be the only criteria.

scholarly journals Sport Specialization and Increased Injury Frequency in Youth Baseball Players: A Prospective Study

2019 ◽  
Vol 54 (10) ◽  
pp. 1115-1122 ◽  
Author(s):  
Amanda J. Arnold ◽  
Charles A. Thigpen ◽  
Paul F. Beattie ◽  
Michael J. Kissenberth ◽  
John M. Tokish ◽  
...  
Keyword(s):  
South Carolina ◽  
Injury Risk ◽  
Physical Therapist ◽  
Injury Incidence ◽  
Baseball Players ◽  
Male Youth ◽  
Arm Injuries ◽  
Youth Baseball ◽  
Small Cohort ◽  
A Prospective Study

Context Sport specialization is thought to be a primary contributor to the throwing-related injury risk in youth baseball players. Objective To (1) establish arm-injury incidence in a cohort of male youth (9–12 years old) baseball players and (2) examine sport specialization and the frequency of arm injuries in the same cohort. Design Cohort study. Setting Greenville, South Carolina, youth baseball programs and tournaments. Patients or Other Participants A total of 159 asymptomatic youth baseball players (age = 11.1 ± 1.1 years) were physically assessed and then were prospectively followed for 6.7 ± 1.5 months. Main Outcome Measure(s) Athlete demographics and playing and injury histories were initially recorded. Athlete-exposures and presence of arm injury were prospectively tracked. All injuries were physically confirmed by a licensed physical therapist. Results Youth players demonstrated an arm-injury incidence rate of 2.22 per 1000 athlete-exposures. Parents and players underestimated sport-specialization status based on the standard research definition (self versus research based: 31% versus 83%, respectively; P = .001). The frequency of arm injuries was higher in specialized players (100%) than in nonspecialized players (80%, P = .03) but did not differ between pitchers and position players (13.2% each, P = 1.00). Conclusions Sport specialization was associated with throwing-related arm injuries in a small cohort of youth baseball players. It is concerning that 57.9% of parents and specialized players were unaware of the athletes' status. Larger studies with longer follow-up periods are needed to further evaluate injury-risk profiles in physically developing youth populations.

The Effect of Stride Length and Lateral Pelvic Tilt on Elbow Torque in Youth Baseball Pitchers

2017 ◽  
Vol 33 (5) ◽  
pp. 339-346 ◽  
Author(s):  
Noah X. Tocci ◽  
David R. Howell ◽  
Dai Sugimoto ◽  
Corey Dawkins ◽  
Amy Whited ◽  
...  
Keyword(s):  
Regression Models ◽  
Injury Risk ◽  
Stride Length ◽  
Pelvic Tilt ◽  
Release Point ◽  
Independent Variables ◽  
Youth Baseball ◽  
Ball Velocity ◽  
Baseball Pitchers ◽  
Point Distance

High elbow torque during a pitch may contribute to injury risk. Our objective was to determine the pitch mechanics associated with elbow varus torque in youth baseball pitchers. Eighteen male youth pitchers (age = 15.5 ± 1.6 years) threw 3 fastballs and 3 change-ups from a windup position while undergoing 3-dimensional kinematic analysis. Independent variables included ball release point distance, stride length, lateral pelvic tilt, and ball velocity. Two multiple regression models, separated by pitch type (fastball, change-up) were used to determine the association of independent variables with peak varus torque at the elbow. Fastball and change-up regression models indicated that stride length (β = 0.301, p = .015; β = 0.46, p < .001, respectively) and lateral pelvic tilt (β = −0.50, p < .001; β = −0.25, p = .04, respectively) were significantly associated with peak elbow varus torque. During fastballs, pitch velocity was significantly associated with peak elbow varus torque (β = 0.38, p = .002), while release point distance was significantly associated with peak elbow varus torque during change-ups (β = −0.33, p = .015). Youth pitchers with longer strides and less lateral pelvic tilt demonstrated greater elbow torque regardless of pitch type, while the association of ball velocity and release point to elbow varus torque was dependent on pitch type.

scholarly journals Pitch Volume and Glenohumeral and Hip Motion and Strength in Youth Baseball Pitchers

2018 ◽  
Vol 53 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Josie L. Harding ◽  
Kelsey J. Picha ◽  
Kellie C. Huxel Bliven
Keyword(s):  
Injury Risk ◽  
External Rotation ◽  
Cross Sectional Study ◽  
Hip Joints ◽  
Cross Sectional ◽  
Hip Range Of Motion ◽  
Youth Baseball ◽  
Hip Motion ◽  
Baseball Pitchers ◽  
Increased Strength

Context:  Increased pitch volume and altered glenohumeral (GH) and hip range of motion (ROM) and strength contribute to injury risk in baseball pitchers. Although these factors affect one another, whether they are related is unknown. Objective:  To examine relationships among cumulative and seasonal pitch volume, ROM, and strength of the GH and hip joints in youth baseball pitchers. Design:  Cross-sectional study. Setting:  Baseball practice facilities. Patients or Other Participants:  A total of 28 healthy baseball pitchers (age = 13.9 ± 2.9 years). Main Outcome Measure(s):  A demographic and pitching questionnaire was used to quantify pitch volume. Glenohumeral internal-rotation (IR) and external-rotation (ER) ROM and strength of the throwing arm; total arc of motion (IR + ER ROM); and bilateral hip IR, ER, and total arc of motion ROM and strength in IR, ER, and abduction were measured. A goniometer was used to assess ROM; a handheld dynamometer, to assess strength. Frequency analyses and bivariate correlations (age covariate) described data and identified relationships. Results:  Correlations between years of competitive play and increased strength in lead-leg hip IR (r = 0.52, P = .02) and abduction (r = 0.48, P = .04) and stance-leg hip IR (r = 0.45, P = .05) were fair to good. The number of months played in the last year had a fair correlation with decreased GH IR strength (r = −0.39, P = .04) and increased stance-leg hip IR strength (r = 0.44, P = .05). Limited pitch time had a fair correlation with increased GH ER ROM (r = 0.40, P = .04) and an excellent correlation with increased lead-leg hip IR ROM (r = 0.79, P &lt; .001). Increased innings pitched per game had a fair to good correlation with decreased GH IR strength (r = −0.41, P = .04) and stance-leg hip ER ROM (r = −0.53, P = .03). More pitches per game had a fair to good correlation with increased GH ER ROM (r = 0.44, P = .05) and decreased stance-leg hip ER ROM (r = −0.62, P = .008). Conclusions:  The significant relationships identified in this study suggest the need to further examine youth and adolescent cumulative and seasonal pitch guidelines.

Mid upper arm circumference as an alternative measure to assess the nutritional status of adolescents: a study in India based on NFHS-4 data

2021 ◽  
pp. 1-12
Author(s):  
Aparna Roy ◽  
T. V. Sekher
Keyword(s):  
Nutritional Status ◽  
Sensitivity And Specificity ◽  
Measurement Data ◽  
Anthropometric Measurement ◽  
Alternative Measure ◽  
Upper Arm ◽  
Male Adolescents ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference ◽  
The Relationship

Abstract Use of body mass index (BMI) to assess the nutritional status of adolescents requires many resources, especially for country-level assessment. This study aimed to determine the relationship between BMI and mid upper arm circumference (MUAC) among adolescent males and females in India and to examine whether MUAC effectively represents the nutritional status of adolescents. The study utilized anthropometric measurement data collected by India’s National Family Health Survey-4 (2015–16). The weighted sample for analysis included 91,315 female and 14,893 male adolescents. The BMI and MUAC measurements showed a positive correlation in both female and male adolescents. Using BMI-for-age Z-score classifications, 12.7% of the adolescents were undernourished. Using MUAC (in cm) as per NACS (Nutrition Assessment, Counselling, and Support) guidelines and Mramba et al. (2017) classified 22.9% and 3.7% of the adolescents as undernourished respectively. Finally, using the MUAC-for-age Z-score classification, 98.4% of adolescents were determined to be normal and 1.7% undernourished. Sensitivity and specificity tests of the MUAC cut-offs, in comparison with BMI cut-offs, showed that all three MUAC cut-off classifications had high specificity (NACS cut-off: 81.3%; Mramba et al. cut-off (cm): 97.7%; Mramba et al. cut-off (Z-score): 99.1%). The NACS cut-off had moderately high sensitivity (52.2%) but the Mramba et al. cut-offs had low sensitivity (13.3% for the centimetre cut-off and 6.6% for the Z-score cut-off). Sensitivity and specificity tests proved the relationship between BMI and MUAC, and that MUAC represents adolescent nutritional status with considerable efficiency. With further research, it may be established that MUAC is a better and promising measure of adolescent nutrition, having the advantage of needing fewer resources for data collection. The MUAC has the potential to offer a simple and low-resource alternative to BMI to assess nutritional status among adolescents in poor countries.

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.

scholarly journals The Relationship between Dynamic Balance and Jumping Tests among Adolescent Amateur Rugby Players. A Preliminary Study

2021 ◽  
Vol 18 (1) ◽  
pp. 312
Author(s):  
Bartosz Wilczyński ◽  
Jakub Hinca ◽  
Daniel Ślęzak ◽  
Katarzyna Zorena
Keyword(s):  
Injury Risk ◽  
Dynamic Balance ◽  
Study Data ◽  
Balance Test ◽  
Risk Of Injury ◽  
Counter Movement Jump ◽  
Increased Risk ◽  
Positive Correlations ◽  
The Relationship ◽  
Rugby Players

Rugby is a demanding contact sport. In light of research, poor balance, reduced jumping ability, muscle strength, and incorrect landing patterns might contribute to the increased risk of injury in athletes. Investigating the relationship between tests assessing these abilities might not only allow for the skillful programming of preventive training but also helps in assessing the risk of injury to athletes. Thus, the main purpose of this study was to investigate the relationship between dynamic balance, vertical and horizontal jumps, and jump-landings movement patterns. Thirty-one healthy amateur adolescent rugby players (age: 14.3 ± 1.6 years, height 171.4 ± 9.7 cm, body mass 80 ± 26 kg) participated in the study. Data were collected by the Y-balance Test (YBT), Counter Movement Jump (CMJ), Single Leg Hop for Distance (SLHD), and Landing Error Score System (LESS). Significant positive correlations were found between SLHD both legs (SLHDb) and YBT Composite both legs (COMb) (r = 0.51, p = 0.0037) and between SLHDb and CMJ (r = 0.72, p < 0.0001). A relationship was also observed between the CMJ and YBT COMb test (r = 0.51, p = 0.006). Moderate positive correlations were found between the dominant legs in SLHD and the posterolateral (r = 0.40, p = 0.027), posteromedial (r = 0.43, p = 0.014), and composite (r = 0.48, p = 0.006) directions of the YBT. These results indicate that variables that are dependent on each other can support in the assessment of injury-risk and in enhancing sports performance of young athletes.

Musculoskeletal injury profiles in professional Women’s Tennis Association players

2017 ◽  
Vol 52 (11) ◽  
pp. 723-729 ◽  
Author(s):  
Jodie G Dakic ◽  
Belinda Smith ◽  
Cameron M Gosling ◽  
Luke G Perraton
Keyword(s):  
Injury Risk ◽  
Musculoskeletal Injury ◽  
Risk Identification ◽  
Injury Incidence ◽  
Tennis Players ◽  
Exposure Data ◽  
Prevention Programmes ◽  
Professional Tennis ◽  
Type Of Injury ◽  
The Relationship

ObjectiveThe physical demands of professional tennis combined with high training/match loads can contribute to musculoskeletal injury. The objectives of this study were to (1) describe the type, location and severity of injuries sustained during a 12-month tennis season in a cohort of professional female tennis players on the Women’s Tennis Association (WTA) tour and (2) prospectively investigate associations between training/match loads and injury.Methods52 WTA players competing at the Australian Open (2015) consented to participate. Injuries reported to WTA medical staff were classified using tennis-specific guidelines. Individual match exposure data were collected for all matches played at international level in 2015 and expressed per 1000 hours of WTA competition matchplay (MP) and 1000 match exposures (MEs). Variables associated with the number of injuries in the season and loss of time from competition were identified with regression analysis.ResultsThe injury incidence rate (IR) was 56.6 (95% CI: 49.5 to 64.6) per 1000 hours of MP or 62.7 (95% CI: 54.8 to 71.6) per 1000 MEs, although the IR of injuries resulting in loss of time from competition was lower (12.8 per 1000 hours of MP, 92 injuries/100 players). Lower limb (51%) and muscle/tendon (50%) injuries were the most common site and type of injury. Common specific injury site subcategories were the thigh, shoulder/clavicle, ankle and knee in order of frequency. Various measures of match load were significantly associated with injury.ConclusionThis study prospectively analysed injury profiles, including severity across an entire season of professional tennis, and investigated the relationship between training/match loads and injury. These data may help medical professionals develop injury risk identification and prevention programmes.

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.

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