scholarly journals Prevention of Elbow Injuries in Young Baseball Players: A 6-year Longitudinal Study

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0012
Author(s):  
Yoshihiro Kotoura ◽  
Toru Morihara ◽  
Yoshikazu Kida ◽  
Tsuyoshi Sukenari ◽  
Ryuhei Furukawa ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Large Scale ◽  
Medial Epicondyle ◽  
Annual Incidence ◽  
Medical Screening ◽  
Baseball Players ◽  
Elbow Pain ◽  
Elbow Injury ◽  
Elbow Injuries ◽  
Prevention Project

Objectives: Injuries in young baseball players are on the rise. However, there are few large-scale related to injury prevention activities. We have continued an injury prevention project in Kyoto, Japan since 2010. The aim of this study was to verify the preventive effect of our project. Methods: We offered medical screening of elbow for elementary and junior high school players. We examined their elbow manually, performed ultrasonography and guided the players how to check their elbow themselves. Additionally, we instructed baseball coaches and parents regarding injury prevention annually. In this study, a cumulative total of 2624 baseball players (mean age 11.0±0.6) who participated in our injury prevention project (2010-2016) were enrolled. We asked them to answer the questionnaire to investigate the experience of elbow pain and evaluated the tenderness of humeral medial epicondyle and range of motion. Ultrasonography of humeral capitellum and medial epicondyle was examined. Subjects with abnormalities on ultrasonography were further examined through radiographic study and osteochondritis dissecans of the humeral capitellum (OCD) was diagnosed. Humeral medial epicondyle apophysitis was diagnosed with abnormalities of ultrasonography, and physical findings. The annual incidence were investigated and analyzed statistically. P < 0.05 was considered significant for all statistical analysis. Results: The mean prevalence rate of OCD was 1.1% and flexion restriction was 12.3%. There were no significant differences in annual incidence. However, the experience rate of elbow pain was 14.4% in 2010 and 4.4% in 2016, tenderness of humeral epicondyle was 32.2% and 5.8%, extension restriction was 12.5% and 6.9%, and humeral medial epicondyle apophysitis was 22.1% and 5.3%, respectively, that significantly reduced year by year (Table 1). Conclusion: There has been increasing recognition for the importance of preventing the overuse injuries among young baseball players. However, large-scale and longitudinal evaluation studies for preventing elbow injuries have not been reported. The prevalence rates of elbow injuries have generally reduced year by year, which indicates that annual medical screening and educational project for young baseball players, coaches and parents would be an effective approach for preventing elbow injury. [Table: see text]

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 Age-Specific Prevalence and Clinical Characteristics of Humeral Medial Epicondyle Apophysitis and Osteochondritis Dissecans: Ultrasonographic Assessment of 4249 Players

2017 ◽  
Vol 5 (5) ◽  
pp. 232596711770770 ◽  
Author(s):  
Kenichi Otoshi ◽  
Shinichi Kikuchi ◽  
Kinshi Kato ◽  
Ryohei Sato ◽  
Takahiro Igari ◽  
...  
Keyword(s):  
Osteochondritis Dissecans ◽  
Morphological Changes ◽  
Medial Epicondyle ◽  
Baseball Players ◽  
Elbow Pain ◽  
Elbow Injuries ◽  
Bony Healing ◽  
History Of ◽  
Study Participants ◽  
Ultrasonographic Assessment

Background: Traction apophysitis of medial epicondyle (MEC) lesions and osteochondritis dissecans (OCD) of the capitellum are common elbow injuries in adolescent baseball players. However, the age-specific prevalence of these pathologies and their influence on elbow pain remain unknown. Purpose: To investigate the age-specific prevalence of each MEC lesion and capitellar OCD and to identify the incidence of elbow pain in each condition. Study Design: Descriptive epidemiology study. Methods: Study participants consisted of 4249 baseball players aged 6 to 17 years. A questionnaire was used to assess history of elbow pain, and morphological changes of the elbow joint were assessed using ultrasonography. Results: Regarding MEC lesions, fragmented (FG) and irregular (IR) lesions both reached their greatest respective prevalence at 11 to 12 years of age. After 14 years of age, IR decreased sharply, whereas FG was maintained at approximately 10%. Hypertrophic (HT) lesions increased sharply, reaching over 50% at 16 years of age, while there was a decrease in IR and FG lesions in the same age group. The prevalence of capitellar OCD remained the same (approximately 2%) throughout all ages except for in players aged 7 to 8 years (>7%). Players with MEC lesions had significantly greater prevalence of a history of elbow pain compared with those without (68.0% vs 39.1%) and were at a significantly greater risk for FG lesions (odds ratio [OR], 4.04; 95% CI, 3.16-5.22) compared with IR (OR, 3.22; 95% CI, 2.44-4.27) and HT lesions (OR, 2.03; 95% CI, 1.75-2.36). Players with capitellar OCD also had a significantly greater risk of a history of elbow pain (OR, 2.34; 95% CI, 1.40-4.11). Conclusion: Controlling the amount of practice and its intensity according to the condition of each player in the preadolescent and adolescent periods may be important in accelerating bony healing and decreasing preventable elbow pain in adulthood.

The Influence of Pitch Velocity on Medial Elbow Pain and Medial Epicondyle Abnormality Among Youth Baseball Players

2020 ◽  
Vol 48 (7) ◽  
pp. 1601-1607 ◽  
Author(s):  
Daisuke Kurokawa ◽  
Takayuki Muraki ◽  
Hiroaki Ishikawa ◽  
Kiyotsugu Shinagawa ◽  
Hideaki Nagamoto ◽  
...  
Keyword(s):  
Medial Epicondyle ◽  
Level Of Evidence ◽  
Baseball Players ◽  
Elbow Pain ◽  
The Past ◽  
Youth Baseball ◽  
Elbow Injuries ◽  
Internal Rotation Angle ◽  
Straight Leg Raise ◽  
The Relationship

Background: Pitch velocity is associated with elbow injuries among skillful baseball players. However, the relationship between pitch velocity and throwing elbow injuries among youth players has not yet been clarified. Purpose: To investigate the influence of pitch velocity on medial elbow pain and medial epicondyle abnormality among youth baseball players. Study Design: Cohort study; Level of evidence, 3. Methods: The participants consisted of 256 elementary school players (mean age, 11 ± 1 years; range, 9-12 years). The medial aspect of the elbow was evaluated using ultrasound imaging. A questionnaire was used to investigate past or present pain in the elbow, background of the players (age, height, body mass index, and years of baseball experience), and playing environment (number of days of practice in a week, experience as a pitcher, and cryotherapy of the shoulder and elbow after practice). Positioning of the scapula, range of motion in shoulder internal/external rotations and hip internal rotation, angle of the straight-leg raise, and heel-to-buttock distance were measured. The pitch velocity was recorded using a pitch velocity radar gun. The relationship between these variables and the presence of medial epicondyle abnormality, as well as past or present elbow pain, were statistically analyzed. Results: A medial epicondyle abnormality was observed in 130 players (51%), elbow pain in the past in 65 players (25%), and elbow pain during the examination in 14 players (5%). Sixty-nine players (27%) experienced elbow pain either in the past or during examination. Abnormality of the medial epicondyle had a relationship with the pitch velocity (odds ratio [OR], 1.1 for increase of 1 km/h; 95% CI, 1.1-1.2; P < .0001) and the number of practice days in a week (OR, 1.8 for increase of the practice days; 95% CI, 1.4-2.5; P < .0001). Pitch velocity was also significantly related with past pain, present pain, and past and/or present pain of the elbow (OR [km/h], 1.1, 1.1, 1.1; 95% CI, 1.0-1.1, 1.0-1.2, 1.1-1.2; P < .0001, P = .002, P < .0001, respectively). Conclusion: Pitch velocity was significantly associated with abnormality of the medial epicondyle and elbow pain. A 10-km/h increase in pitch velocity would increase the risk of medial epicondyle abnormality and medial elbow pain by 3 times.

Elbow Injuries in Professional Baseball: Epidemiological Findings From the Major League Baseball Injury Surveillance System

2017 ◽  
Vol 45 (10) ◽  
pp. 2319-2328 ◽  
Author(s):  
Michael G. Ciccotti ◽  
Keisha M. Pollack ◽  
Michael C. Ciccotti ◽  
John D’Angelo ◽  
Christopher S. Ahmad ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Surveillance System ◽  
Injury Surveillance ◽  
Professional Baseball ◽  
Injury Surveillance System ◽  
Baseball Players ◽  
Elbow Injury ◽  
Minor League ◽  
Major League ◽  
Elbow Injuries

Background: Elbow injuries cause significant disability for the throwing athlete. Scant data are available on the distribution and characteristics of these injuries in elite baseball players. No study exists that focuses solely on the epidemiological characteristics of elbow injuries in professional baseball players using a comprehensive injury surveillance system. Hypothesis: Professional baseball players have a high occurrence of elbow injuries influenced by factors including length of time playing, time period within the annual baseball season, and specific position played. Study Design: Descriptive epidemiological study. Methods: Data on elbow injuries occurring during the 2011-2014 seasons were collected from Major League Baseball’s Health Injury and Tracking System, a comprehensive injury surveillance system. Each specific type of elbow injury was evaluated with respect to overall injury rate, years as a professional player, mechanism of injury, treatment, average time lost, and return to play. Results: During the study period, 3185 elbow injuries (n = 430 Major League; n = 2755 Minor League) occurred. The mean number of days missed and percentage requiring surgery were similar between Major and Minor League players. Overall, 20.0% (650/3185) of the injuries required surgical treatment. Pitchers were the most likely to incur an elbow injury (40.0% of injured athletes were pitchers), were the most likely to require surgery (34.2% of injured pitchers required surgery), and had the greatest mean number of days missed when treated nonsurgically (33.2 days). Medial injuries composed 42.1% (1342/3185) of all elbow injuries. Of all elbow surgeries performed during the study period, the highest percentage involved ligaments (372/650; 57.2%). Conclusion: Elbow injuries are a considerable source of disability in professional baseball players. Pitchers are most likely to incur these injuries, are most likely to require surgery, and have the highest mean number of days missed when treated nonsurgically. The most common injuries involve the medial elbow, with ligament injuries most often requiring surgery. This study represents the only investigation to date using a comprehensive injury surveillance system to examine elbow injuries in professional baseball players. It provides a basis for injury prevention and treatment recommendations, establishes the most thorough framework for determining elbow injury risk, and focuses continued research on elbow injury prevention in the elite baseball player.

Epidemiology of Shoulder and Elbow Injuries Among United States High School Baseball Players: School Years 2005-2006 Through 2014-2015

2017 ◽  
Vol 46 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Michael G. Saper ◽  
Lauren A. Pierpoint ◽  
Wei Liu ◽  
R. Dawn Comstock ◽  
John D. Polousky ◽  
...  
Keyword(s):  
United States ◽  
High School ◽  
Injury Prevention ◽  
Rate Ratio ◽  
Injury Rate ◽  
Injury Surveillance ◽  
Shoulder Injuries ◽  
Baseball Players ◽  
Elbow Injury ◽  
Elbow Injuries

Background: Shoulder and elbow injuries are common in young athletes, especially high school baseball players. Understanding the risk factors associated with baseball injuries is an essential first step in the development of injury prevention strategies. Purpose: To provide a comprehensive understanding of the epidemiology of shoulder and elbow injuries among high school baseball players in the United States. Study Design: Descriptive epidemiological study. Methods: Baseball-related injury data were obtained from the National High School Sports-Related Injury Surveillance Study using High School RIO (Reporting Information Online), an Internet-based sports injury surveillance system. Athletic trainers from high schools across the country uploaded data regarding athlete-exposures (AEs) (defined as practice or game participation) and shoulder and elbow injuries from the school years 2005-2006 through 2014-2015. Results: A total of 241 shoulder injuries and 150 elbow injuries occurred during 1,734,198 AEs during the study period, for an overall shoulder injury rate of 1.39 per 10,000 AEs and an overall elbow injury rate of 0.86 per 10,000 AEs. The overall rates of injury were higher in competitions compared with practices for shoulders (rate ratio, 1.44; 95% CI, 1.11-1.85) and elbows (rate ratio, 2.15; 95% CI, 1.56-2.96). The majority of shoulder (39.6%) and elbow (56.9%) injuries were sustained by pitchers, and most injuries were chronic and caused by overuse. Position players were more likely to sustain injuries by contact with the playing surface or apparatus. For pitchers, muscle strains were the most common shoulder injuries (38.7%), while ligament sprains were the most common elbow injuries (42.7%). The majority of pitchers with shoulder (70.8%) and elbow (64.6%) injuries returned to play within 21 days. Among pitchers, a higher proportion of elbow injuries (11.4%) resulted in medical disqualification compared with shoulder injuries (5.6%). Among pitchers, the majority of shoulder (89.2%) and elbow (96.4%) injuries were managed nonsurgically. Conclusion: Shoulder and elbow injury rates and patterns in high school baseball players differed between field positions (pitchers vs position players) and by type of exposure (practice vs competition). This study suggests several areas of emphasis for targeted injury prevention interventions, most notably limiting fatigue and preventing overuse injuries.

Humeral Retroversion and Injury Risk After Proximal Humeral Epiphysiolysis (Little Leaguer’s Shoulder)

2019 ◽  
Vol 47 (13) ◽  
pp. 3100-3106 ◽  
Author(s):  
Atsushi Ito ◽  
Teruhisa Mihata ◽  
Yuji Hosokawa ◽  
Akihiko Hasegawa ◽  
Masashi Neo ◽  
...  
Keyword(s):  
High School ◽  
Junior High School ◽  
Junior High ◽  
Control Group ◽  
Baseball Players ◽  
Elbow Pain ◽  
Elbow Injury ◽  
Elbow Injuries ◽  
Little Leaguer’S Shoulder ◽  
Humeral Retroversion

Background: The increased humeral retroversion on the dominant side of throwing athletes is thought to result from repetitive throwing motion. Little Leaguer’s shoulder—a rotational stress fracture of the proximal humeral epiphyseal plate—may influence the risk of humeral retroversion and injury of the shoulder or elbow joint. Purpose: To investigate the effect of Little Leaguer’s shoulder on humeral retroversion and the rates of shoulder and elbow injuries. Study Design: Cohort study; Level of evidence, 3. Methods: 10 high school baseball players (average age, 16.6 years; range, 16-18 years) who had experienced Little Leaguer’s shoulder during elementary or junior high school (average age, 12.6 years; range, 11-15 years) were enrolled in the study. As a control group, 22 high school baseball players (average age, 16.9 years; range, 16-18 years) who had never had any shoulder or elbow injury during elementary and junior high school were included. Humeral retroversion on ultrasonographic measurement, shoulder range of motion, and rates of shoulder and elbow injuries were evaluated. Results: Humeral retroversion was significantly greater on the dominant side than on the nondominant side in both players with Little Leaguer’s shoulder (dominant, 104°± 8°; nondominant, 84°± 12°; P < .001) and controls (dominant, 91°± 13°; nondominant, 81°± 10°; P < .001). In the dominant shoulder, humeral retroversion was greater in the Little Leaguer’s shoulder group than in the control group ( P = .008). When the effects of humeral retroversion were excluded, maximal external rotation was significantly less in the dominant shoulder than in the nondominant shoulder in the Little Leaguer’s shoulder group (by 11°± 12°, P = .02), whereas no significant difference was found between dominant (110°± 11°) and nondominant (111°± 13°) shoulders in the control group ( P = .64). The rates of shoulder and elbow pain were significantly higher in the Little Leaguer’s shoulder group (shoulder pain 80%, elbow pain 70%) than in the control group (shoulder pain 9%, P < .001; elbow pain 32%, P = .04). Conclusion: Humeral retroversion was increased in baseball players without any history of shoulder or elbow injury during elementary and junior high school and was further increased in players who had had Little Leaguer’s shoulder. Increased humeral retroversion after Little Leaguer’s shoulder may be a risk factor for future shoulder or elbow injury.

scholarly journals Increasing Burden of Youth Baseball Elbow Injuries in US Emergency Departments

2019 ◽  
Vol 7 (5) ◽  
pp. 232596711984563 ◽  
Author(s):  
David P. Trofa ◽  
Kyle K. Obana ◽  
Hasani W. Swindell ◽  
Brian Shiu ◽  
Manish S. Noticewala ◽  
...  
Keyword(s):  
Linear Regression Analysis ◽  
Shoulder Injuries ◽  
Injury Surveillance System ◽  
Baseball Players ◽  
Elbow Injury ◽  
Youth Athletes ◽  
Increased Risk ◽  
Youth Baseball ◽  
Elbow Injuries ◽  
Over Time

Background: Youth athletes are starting sports earlier and training harder. Intense, year-round demands are encouraging early sports specialization under the perception that it will improve the odds of future elite performance. Unfortunately, there is growing evidence that early specialization is associated with increased risk of injury and burnout. This is especially true of pediatric and adolescent baseball players. Purpose/Hypothesis: The purpose of this investigation was to analyze national injury trends of youth baseball players. We hypothesized that while the total number of baseball injuries diagnosed over the past decade would decrease, there would be an increase in adolescent elbow injuries seen nationally. A further hypothesis was that this trend would be significantly greater than other injuries to the upper extremity and major joints. Study Design: Descriptive epidemiology study. Methods: Injury data from the National Electronic Injury Surveillance System, a United States Consumer Product Safety Commission database, were analyzed between January 1, 2006, and December 31, 2016, for baseball players aged ≤18 years. Data were collected on the location of injury, diagnosis, and mechanism of injury. Results: Between 2006 and 2016, an estimated 665,133 baseball injuries occurred nationally. The mean age of the injured players was 11.5 years. The most common injuries diagnosed included contusions (26.8%), fractures (23.6%), and strains and sprains (18.7%). Among major joints, the ankle (25.6%) was most commonly injured, followed by the knee (21.3%), wrist (19.2%), elbow (17.7%), and shoulder (16.2%). The incidence of the ankle, knee, wrist, and shoulder injuries decreased over time, while only the incidence of elbow injuries increased. A linear regression analysis demonstrated that the increasing incidence of elbow injuries was statistically significant against the decreasing trend for all baseball injury diagnoses, as well as ankle, knee, wrist, hand, and finger injuries ( P < .05). Additionally, the only elbow injury mechanism that increased substantially over time was throwing. Conclusion: The current investigation found that while the incidence of baseball injuries sustained by youth players is decreasing, elbow pathology is becoming more prevalent and is more commonly being caused by throwing. Given that the majority of elbow injuries among adolescent baseball players are overuse injuries, these findings underscore the importance of developing strategies to continue to ensure the safety of these youth athletes.

scholarly journals Elbow Injuries in Youth Baseball Players Without Prior Elbow Pain

2013 ◽  
Vol 1 (5) ◽  
pp. 232596711350994 ◽  
Author(s):  
Tetsuya Matsuura ◽  
Naoto Suzue ◽  
Shinji Kashiwaguchi ◽  
Kokichi Arisawa ◽  
Natsuo Yasui
Keyword(s):  
Baseball Players ◽  
Elbow Pain ◽  
Youth Baseball ◽  
Elbow Injuries

scholarly journals Experience Rate of Elbow Pain and Morphological Abnormality of Humeral Medial Epicondyle among Youth Baseball Players

2016 ◽  
Vol 4 (7_suppl4) ◽  
pp. 2325967116S0012
Author(s):  
Yoshihiro Kotoura ◽  
Toru Morihara ◽  
Yoshikazu Kida ◽  
Tsuyoshi Sukenari ◽  
Ryuhei Furukawa ◽  
...  
Keyword(s):  
Medial Epicondyle ◽  
Morphological Abnormality ◽  
Baseball Players ◽  
Elbow Pain ◽  
Youth Baseball

Regional Interdependence and the Role of the Lower Body in Elbow Injury in Baseball Players: A Systematic Review

2020 ◽  
Vol 48 (14) ◽  
pp. 3652-3660
Author(s):  
Matthew Jordan Deal ◽  
Bradley P. Richey ◽  
Cyrus Anthony Pumilia ◽  
Ibrahim Mamdouh Zeini ◽  
Charles Wolf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Lower Extremity ◽  
Lower Extremity Injury ◽  
Lower Body ◽  
Extremity Injury ◽  
Baseball Players ◽  
Elbow Pain ◽  
Elbow Injury

Background: Elbow injuries are exceedingly common in baseball players. Previous studies have identified that upper extremity strength and range of motion deficits pose a risk for these injuries, but few studies have examined the effect of lower extremity deficits. Given the role of the lower extremity in the kinetic chain of the baseball throwing motion, lower body deficits may affect the kinematics of the upper extremity and play a role in the elbow injury of baseball players. Purpose: To systematically review the current literature investigating the association of trunk and lower extremity deficits with elbow pain or injury in baseball players. Study Design: Systematic review. Methods: A systematic review of the literature was performed according to the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines to identify and analyze all previous studies focused on the association of elbow pain and/or injury with functional deficits of the trunk and lower extremities. Results: A total of 14 studies met inclusion criteria, examining a range of baseball players extending from youth to professional athletes. One of the 14 studies examined other types of overhead throwing athletes alongside baseball players. Lower extremity–related risk factors for elbow pain and injury in these athletes were found and stratified per level of play. Factors included specific hip range of motion, lower extremity injury or pain, balance, and foot arch posture. Associations were also found with lower extremity injury and noncompliance with primary prevention programs. Conclusion: Specific lower extremity deficits were found to be independent risk factors for elbow pain and injury in throwing athletes at certain levels of play. Additionally, prevention programs designed to correct deficits in identified risk factors were effective in reducing the incidence of elbow injury in youth athletes. These results highlight the potential of screening and subsequent intervention to reduce the incidence of elbow injury in certain subsets of baseball players.

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