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

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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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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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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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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Role of Rotational Kinematics in Minimizing Elbow Varus Torques for Professional Versus High School Pitchers

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118760780 ◽

2018 ◽

Vol 6 (3) ◽

pp. 232596711876078 ◽

Cited By ~ 8

Author(s):

Micheal J. Luera ◽

Brittany Dowling ◽

Mitchel A. Magrini ◽

Tyler W.D. Muddle ◽

Ryan J. Colquhoun ◽

...

Keyword(s):

High School ◽

External Rotation ◽

Ligament Injury ◽

Trunk Rotation ◽

Elbow Injury ◽

Risk Of Injury ◽

Increased Risk ◽

Rotational Kinematics ◽

Pelvis Rotation ◽

Baseball Pitchers

Background: Elbow injury rates among baseball pitchers are rapidly rising. However, this increase has been most dramatic among high school (HS) pitchers. Purpose: To examine pitch velocity and the kinetic and kinematic characteristics of HS versus professional (PRO) pitchers to identify potential differences that may play a role in the increased risk of ulnar collateral ligament injury in youth pitchers. Study Design: Controlled laboratory study. Methods: A total of 37 HS (mean ± SD: age, 16 ± 1 years) and 40 PRO (age, 21 ± 2 years) baseball pitchers completed maximal-effort baseball pitches during a single testing session, from which pitch velocity (PV), absolute and normalized elbow varus torque (EVTA and EVTN, respectively) during arm cocking and at maximum shoulder external rotation (MER), and 8 other elbow and shoulder torques or forces and rotational kinematics of the pelvis and trunk were analyzed, recorded, and compared. Results: PV was greater in PRO than HS athletes; EVTA was greater in PRO than HS athletes during arm cocking and at MER; but EVTN was similar during arm cocking and greater in HS than PRO athletes at MER. In PRO athletes, PV was not related to EVTA during arm cocking or MER ( r = 0.01-0.05). Furthermore, in PRO athletes, EVTA during arm cocking and at MER were inversely related to upper trunk rotation at hand separation and foot contact and to pelvis rotation at elbow extension ( r = –0.30 to –0.33). In contrast, in HS athletes, PV was strongly related to EVTA during arm cocking and MER ( r = 0.76-0.77). Furthermore, in HS athletes, PV and EVTA during arm cocking and at MER were moderately or strongly related to the other elbow and shoulder torques and forces ( r = 0.424-0.991), and EVTA was not related to upper trunk rotation or pelvis rotation throughout the throwing motion ( r = –0.16 to 0.15). Conclusion: The kinetic and rotational kinematic differences observed between PRO and HS pitchers in this study may help explain the greater performance of PRO pitchers while allowing them to minimize EVT during pitching. HS pitchers, however, do not appear to be as capable of utilizing the forces generated by rotation of their trunk and pelvis to aid in pitching, and those who throw the hardest generate the greatest forces at the shoulder and elbow. As a result, they experience higher EVTs relative to their body size, which may place them at an increased risk of injury. Clinical Relevance: HS pitchers throw harder primarily by generating larger forces in the arm and shoulder. Thus, owing to the relative physical immaturity of HS versus PRO pitchers, these factors may place them at an increased risk of injury. Coaches may first wish to focus on improving the rotational kinematics of HS pitchers rather than first focusing on achieving greater pitch velocities.

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

Journal of Orthopaedic Surgery ◽

10.1177/23094990211003347 ◽

2021 ◽

Vol 29 (1) ◽

pp. 230949902110033

Author(s):

Noritaka Hamano ◽

Hitoshi Shitara ◽

Tsuyoshi Tajika ◽

Tsuyoshi Ichinose ◽

Tsuyoshi Sasaki ◽

...

Keyword(s):

High School ◽

Range Of Motion ◽

Elbow Injury ◽

The Past ◽

Hip Range Of Motion ◽

Limb Injuries ◽

Hip Abduction ◽

Baseball Pitchers ◽

Abduction Strength ◽

Dominant Side

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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Four-year trend in shoulder and elbow injuries in competitive level high school baseball pitchers: A repeated cross-sectional survey

JSES International ◽

10.1016/j.jseint.2021.04.006 ◽

2021 ◽

Author(s):

Tsuyoshi Sasaki ◽

Hitoshi Shitara ◽

Tsuyoshi Tajika ◽

Takuro Kuboi ◽

Tsuyoshi Ichinose ◽

...

Keyword(s):

High School ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Elbow Injuries ◽

Baseball Pitchers

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Decreased Lower Extremity Functional Movement Scores as a Predictor for Elbow Injury in Professional Baseball Pitchers

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2015.05.022 ◽

2015 ◽

Vol 24 (8) ◽

pp. e241-e242

Author(s):

Braden K. Mayer ◽

Ellen Shanley ◽

Charles A. Thigpen ◽

Thomas J. Noonan

Keyword(s):

Lower Extremity ◽

Professional Baseball ◽

Functional Movement ◽

Elbow Injury ◽

Baseball Pitchers

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An analysis of pre-season risk factors for low back injury in high-school baseball pitchers: a prospective study

Scientific Reports ◽

10.1038/s41598-021-90988-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kurumi Nakase ◽

Hitoshi Shitara ◽

Tsuyoshi Tajika ◽

Takuro Kuboi ◽

Tsuyoshi Ichinose ◽

...

Keyword(s):

High School ◽

Shoulder Function ◽

Whole Body ◽

Back Injury ◽

Low Back ◽

Shoulder Range Of Motion ◽

Low Back Injury ◽

Significant Independent Risk Factor ◽

Elbow Injuries ◽

Baseball Pitchers

AbstractPitching motion requires whole-body coordination; therefore, poor control of the lower extremities, pelvis and trunk may cause shoulder and elbow injuries. However, few studies have described the relationship between the shoulder joint function and low back injury in high-school baseball pitchers. A total of 128 healthy high school pitchers underwent pre-season medical checkups, where their shoulder range of motion and shoulder strength were measured. The participants completed a self-recorded daily questionnaire regarding the presence of low back pain. Pitchers were divided into injured and non-injured groups. Low back injury was observed in 13 participants (13.4%). In the injured group, horizontal adduction on the dominant shoulder was significantly less than in the non-injured group. A logistic regression analysis showed that horizontal adduction on the dominant side was a significant independent risk factor for low back injury during the season. It is important to recognize that restriction of the shoulder function not only causes shoulder and elbow injuries but can also risk low back injury.

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