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 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.

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 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.

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

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

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

scholarly journals 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 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 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.

High Thoracic Kyphosis and Backward Trunk Inclination Angles in the Single-Leg Standing Position Associate With Medial Elbow Injuries in Youth Baseball Players: A Cross-Sectional Study

2020 ◽  
pp. 1-8
Author(s):  
Akira Saito ◽  
Kyoji Okada ◽  
Hiromichi Sato ◽  
Kazuyuki Shibata ◽  
Tetsuaki Kamata
Keyword(s):  
Thoracic Kyphosis ◽  
Standing Position ◽  
Baseball Players ◽  
Elbow Injury ◽  
Joint Range Of Motion ◽  
Trunk Inclination ◽  
Youth Baseball ◽  
Elbow Injuries ◽  
Inclination Angles ◽  
Joint Range

Context: Baseball pitching is a coordinated movement involving the spine. A previous study indicated that increased thoracic kyphosis angle in a standing position was a risk factor for medial elbow injuries in youth baseball players. However, spinal alignments in single-leg standing and their relationships with medial elbow injuries, scapular alignment, or hip joint range of motion are unclear. Objective: To examine the difference in spinal alignment between standing and single-leg standing positions in youth baseball players and analyze their relationship with elbow injuries, scapular alignment, or hip joint range of motion. Design: Cross-sectional study. Setting: University laboratory. Participants: There were 51 youth baseball players with medial epicondylar fragmentation (medial elbow injury group) and 102 healthy youth baseball players (control group). Main Outcome Measures: Thoracic kyphosis, lumbar lordosis, and trunk inclination angles during standing and single-leg standing, forward scapular posture, and hip joint range of motion. Results: In the single-leg standing position, the thoracic kyphosis and backward trunk inclination angles were significantly higher in the medial elbow injury group than in the control group (P = .016 and P = .046, respectively). In the standing position, no significant difference was observed between both groups. The thoracic kyphosis angle in single-leg standing was positively correlated with the bilateral forward scapular posture in the medial elbow injury (P = .008 and P < .001 on the throwing and nonthrowing sides, respectively) and control (P = .010 and P = .032 on the throwing and nonthrowing sides, respectively) groups. Conclusions: High thoracic kyphosis and backward trunk inclination angles are characteristics during single-leg standing in youth baseball players with medial elbow injuries. Spinal alignment measurement in single-leg standing may be useful for identifying youth baseball players who are at risk for sustaining medial elbow injury.

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