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

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.

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

Scientific Reports ◽

10.1038/s41598-020-76894-6 ◽

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.

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Association Between Passive Hip Range of Motion and Pitching Kinematics in High School Baseball Pitchers

International Journal of Sports Physical Therapy ◽

10.26603/001c.27625 ◽

2021 ◽

Author(s):

Hillary A. Plummer ◽

Nicole M. Bordelon ◽

Kyle W. Wasserberger ◽

Tyler J. Opitz ◽

Adam W. Anz ◽

...

Keyword(s):

High School ◽

Range Of Motion ◽

Hip Range Of Motion ◽

Baseball Pitchers

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Ulnar Collateral Ligament Laxity After Repetitive Pitching: Associated Factors in High School Baseball Pitchers

The American Journal of Sports Medicine ◽

10.1177/03635465211002507 ◽

2021 ◽

pp. 036354652110025

Author(s):

Hiroshi Hattori ◽

Kiyokazu Akasaka ◽

Takahiro Otsudo ◽

Toby Hall ◽

Katsunobu Sakaguchi ◽

...

Keyword(s):

High School ◽

Range Of Motion ◽

Ulnar Collateral Ligament ◽

Elbow Flexion ◽

Strain Ratio ◽

Collateral Ligament ◽

Change Rate ◽

Elbow Injury ◽

Specific Effects ◽

Baseball Pitchers

Background: Medial elbow injury is common in baseball pitchers, with evidence of elbow valgus instability after only 60 consecutive pitches. However, the tissue-specific effects of repetitive pitching on medial elbow stabilizers are largely unknown. Purpose/Hypothesis: This study aimed to investigate changes in the ulnar collateral ligament (UCL) and forearm flexor-pronator muscles (FPMs) during repetitive pitching and factors that relate to identified change. We hypothesized that repetitive pitching would increase elasticity of the medial elbow stabilizers and therefore induce laxity. Study Design: Descriptive laboratory study. Methods: A total of 30 high school baseball pitchers participated (mean ± SD age, 16.6 ± 0.5 years). Each participant pitched 100 times (5 blocks of 20 pitches). The strain ratio, indicating elasticity in the UCL and FPMs, was measured using ultrasound before pitching and after every 20-pitch block. Data for each pitch block were compared using analysis of variance. Multiple regression analysis was used to investigate factors related to the change rate of the strain ratio. Results: The strain ratio of the UCL after 100 pitches was significantly less than that before pitching (before pitching, 4.83 ± 1.70; after 100 pitches, 3.59 ± 1.35; P = .013), but this was not the case for the FPMs (before pitching, 0.57 ± 0.24; after 100 pitches, 0.43 ± 0.18; P = .07). The ratio of the strain ratio in the UCL and FPMs (UCL/FPMs) before pitching (β = −0.385; P = .031) and the elbow flexion range of motion before pitching (β = −0.352; P = .046) were significantly and independently correlated with the change rate of the UCL. Conclusion: Elasticity significantly increased for the UCL, indicating laxity, but not for the FPMs after 100 pitches. Furthermore, the ratio of elasticity (UCL/FPMs) and the elbow flexion range of motion before pitching were significantly related to the change rate of UCL elasticity. Clinical Relevance: To reduce laxity of the UCL, pitchers should be limited to <100 pitches per game. Sustaining a lower level of relative FPMs to UCL elasticity at rest and maintaining a large muscle volume to avoid excessive elbow flexion range of motion may prevent UCL laxity that develops during repetitive pitching.

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Relationship Between Upper Limb Injuries and Hip Range of Motion in Elementary and Junior High School Baseball Players

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120970916 ◽

2021 ◽

Vol 9 (2) ◽

pp. 232596712097091

Author(s):

Noritaka Hamano ◽

Hitoshi Shitara ◽

Tsuyoshi Tajika ◽

Takuro Kuboi ◽

Tsuyoshi Ichinose ◽

...

Keyword(s):

High School ◽

Range Of Motion ◽

Junior High School ◽

Junior High ◽

Baseball Players ◽

Hip Range Of Motion ◽

Elbow Injuries ◽

Hip Flexion ◽

The Relationship ◽

Dominant Side

Background: Shoulder and elbow injuries are major problems in baseball players. Tightness of the upper extremities has been reported as a risk factor for shoulder and elbow injuries in elementary and junior high school baseball players. However, few studies have been conducted on the relationship between decreased hip range of motion (ROM) and shoulder and elbow injuries. Purpose/Hypothesis: This study aimed to prospectively examine the relationship between hip ROM and throwing-related shoulder and elbow injuries in elementary and junior high school baseball players. The hypothesis was that players with unrestricted ROM in the hip would have a reduced risk of upper extremity injuries. Methods: The study included 263 baseball players (mean ± SD age, 10.5 ± 1.3 years; range, 7-14 years). The following physical parameters were assessed: (1) hip flexion ROM measured in the supine position and (2) hip internal and external rotation in the prone position. After the season, players completed questionnaires regarding shoulder and/or elbow injuries. For comparison, the players were classified as injured (not able to play for ≥8 days because of shoulder and/or elbow problems) or noninjured. Results: During the season, 52 players had shoulder and/or elbow injuries. When the injured and noninjured groups were compared, hip flexion on the dominant side (121.5° ± 12.0° vs 126.7° ± 9.8°, respectively; P < .01), hip flexion on the nondominant side (119.6° ± 11.7° vs 126.0° ± 9.9°, respectively; P < .01), and internal rotation on the dominant side (52.5° ± 11.3° vs 56.8° ± 10.8°, respectively; P = .01) were significantly reduced in the injured group. Conclusion: We identified preseason decreases in flexion bilaterally and internal rotation on the dominant side as risk factors for shoulder and elbow injuries in elementary and junior high school baseball players. Further studies are required to prevent disabilities in elementary and junior high school baseball players through development of prevention and intervention programs.

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

10.21203/rs.3.rs-163670/v1 ◽

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.

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Association Between Pitching Volume And Shoulder And Elbow Injury In High School Baseball Pitchers

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000322500.33651.09 ◽

2008 ◽

Vol 40 (Supplement) ◽

pp. S233

Author(s):

Johna K. Register-Mihalik ◽

Stephen W. Marshall ◽

Frederick O. Mueller

Keyword(s):

High School ◽

Elbow Injury ◽

Baseball Pitchers

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Hip, Trunk, and Shoulder Rotational Range of Motion in Healthy Japanese Youth and High-school Baseball Pitchers

Progress in Rehabilitation Medicine ◽

10.2490/prm.20190009 ◽

2019 ◽

Vol 4 (0) ◽

pp. n/a

Author(s):

Machiko Hiramoto ◽

Toru Morihara ◽

Yoshikazu Kida ◽

Tomoyuki Matsui ◽

Yoshikazu Azuma ◽

...

Keyword(s):

High School ◽

Range Of Motion ◽

Baseball Pitchers ◽

Japanese Youth

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Rate of Upper Extremity Injury in High School Baseball Pitchers Who Played Catcher as a Secondary Position

Journal of Athletic Training ◽

10.4085/1062-6050-322-16 ◽

2018 ◽

Vol 53 (5) ◽

pp. 510-513 ◽

Cited By ~ 3

Author(s):

Elizabeth E. Hibberd ◽

Sakiko Oyama ◽

Joseph B. Myers

Keyword(s):

High School ◽

Upper Extremity ◽

The Other ◽

Elbow Injury ◽

Demographic Questionnaire ◽

Male High School ◽

Upper Extremity Injury ◽

Physical Examinations ◽

Baseball Pitchers ◽

Extremity Injuries

Context: Many high school pitchers play another position after they have finished pitching for the day or on their rest days from pitching. Because of the cumulative demands on the arm, pitchers who also play catcher may have a greater risk of developing a throwing-related shoulder or elbow injury. Objective: To compare the rate of throwing-related upper extremity injuries between high school baseball pitchers who also played catcher as a secondary position and those who did not play catcher. Design: Prospective cohort study. Setting: Field laboratory. Patients or Other Participants: A total of 384 male high school baseball pitchers were recruited from 51 high school teams. Pitchers who reported their secondary position as catcher were classified into the pitcher/catcher group and those who did not report playing catcher as a secondary position were classified into the other group. Main Outcome Measure(s): Participants completed a demographic questionnaire preseason and then athlete participation and injury status were tracked during the subsequent season. Athlete-exposures were monitored and the shoulder and elbow injury proportion rates were calculated. Results: Athlete-exposures did not differ between groups (P = .488). The pitcher/catcher group's risk of shoulder or elbow injury was 2.9 times greater than that of the other pitchers (15% versus 5%; injury proportion rate = 2.9; 95% confidence interval = 1.03, 8.12). Conclusions: Pitchers who reported also playing catcher were at a greater risk of sustaining a throwing-related shoulder or elbow injury than the other pitchers. These findings suggest that pitchers should consider not playing catcher as their secondary position in order to allow adequate time for recovery and to decrease their overall throwing load. Serial physical examinations of pitchers/catchers during the season may be useful in determining if their physical characteristics are changing during the season because of the cumulative throwing load.

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A Profile of Glenohumeral Internal and External Rotation Motion in the Uninjured High School Baseball Pitcher, Part I: Motion

Journal of Athletic Training ◽

10.4085/1062-6050-46.3.282 ◽

2011 ◽

Vol 46 (3) ◽

pp. 282-288 ◽

Cited By ~ 27

Author(s):

Wendy J. Hurd ◽

Kevin M. Kaplan ◽

Neal S. ElAttrache ◽

Frank W. Jobe ◽

Bernard F. Morrey ◽

...

Keyword(s):

High School ◽

Range Of Motion ◽

External Rotation ◽

Group Analysis ◽

Playing Field ◽

Male High School ◽

Thrower’S Shoulder ◽

Baseball Pitchers ◽

Motion Characteristics ◽

Rotation Motion

Context: The magnitude of motion that is normal for the throwing shoulder in uninjured baseball pitchers has not been established. Chronologic factors contributing to adaptations in motion present in the thrower's shoulder also have not been established.Objectives: To develop a normative profile of glenohumeral rotation motion in uninjured high school baseball pitchers and to evaluate the effect of chronologic characteristics on the development of adaptations in shoulder rotation motion.Design: Cohort study.Setting: Baseball playing field.Patients or Other Participants: A total of 210 uninjured male high school baseball pitchers (age = 16±1.1 years, height = 1.8 + 0.1 m, mass = 77.5±11.2 kg, pitching experience = 6±2.3 years).Intervention(s): Using standard goniometric techniques, we measured passive rotational glenohumeral range of motion bilaterally with participants in the supine position.Main Outcome Measure(s): Paired t tests were performed to identify differences in motion between limbs for the group. Analysis of variance and post hoc Tukey tests were conducted to identify differences in motion by age. Linear regressions were performed to determine the influence of chronologic factors on limb motion.Results: Rotation motion characteristics for the population were established. We found no difference between sides for external rotation (ER) at 0° of abduction (t209 = 0.658, P = .51), but we found side-to-side differences in ER (t209 = −13.012, P<.001) and internal rotation (t209 = 15.304, P<.001) at 90° of abduction. Age at the time of testing was a significant negative predictor of ER motion for the dominant shoulder (R2 = 0.019, P = .049) because less ER motion occurred at the dominant shoulder with advancing age. We found no differences in rotation motion in the dominant shoulder across ages (F4,205 range, 0.451–1.730, P>.05).Conclusions: This range-of-motion profile might be used to assist with the interpretation of normal and atypical shoulder rotation motion in this population. Chronologic characteristics of athletes had no influence on range-of-motion adaptations in the thrower's shoulder.

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Do hip-abduction braces work?—A biomechanical evaluation of a commercially available hip brace

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03989-8 ◽

2021 ◽

Author(s):

Roman Michalik ◽

Katrin Essing ◽

Ben Rohof ◽

Matthias Gatz ◽

Filippo Migliorini ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Range Of Motion ◽

Hip Joint ◽

Inertial Sensor ◽

Hip Range Of Motion ◽

Hip Abduction ◽

Hip Motion ◽

Biomechanical Evaluation ◽

Set Up ◽

Hip Flexion

Abstract Introduction Dislocations of the hip joint are a common and clinically relevant complication following total hip arthroplasty (THA). Hip-abduction braces are currently used following operative or non-operative treatment of THA dislocations to prevent re-dislocations. However, the clinical and biomechanical effectiveness of such braces is still controversial. Material and methods A total of 30 volunteers were measured during standing and during sitting up and down from a chair task wearing a hip brace set at 70°, 90° or no hip flexion limitation. Range of motion of the hip joint was measured in all directions by an inertial sensor system. Further it has been evaluated if the range of motion would be reduced by the additional use of an arthrodesis cushion. Results The use of a hip brace set up with flexion limitation did reduce hip ROM in all directions significantly compared to unhinged brace (p < 0.001–0.035). Performing the “sit down and stand-up task” the brace set up at 70° flexion limitation did reduce maximum hip flexion significantly (p = 0.008). However, in most cases the measured hip flexion angles were greater than the settings of the hip brace should have allowed. The additional use of a cushion can further limit hip motion while sitting up and down from a chair. Conclusion This study has demonstrated that hip-abduction braces reduce hip range of motion. However, we also found that to achieve a flexion limitation of the hip to 90°, the hip brace should be set at a 70° hip flexion limitation.

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