A Comparison of Throwing Kinematics between Youth Baseball Players with and Without a History of Medical Elbow Pain

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.

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

The American Journal of Sports Medicine ◽

10.1177/0363546520914911 ◽

2020 ◽

Vol 48 (7) ◽

pp. 1601-1607 ◽

Cited By ~ 1

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.

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Elbow Injuries in Youth Baseball Players Without Prior Elbow Pain

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967113509948 ◽

2013 ◽

Vol 1 (5) ◽

pp. 232596711350994 ◽

Cited By ~ 26

Author(s):

Tetsuya Matsuura ◽

Naoto Suzue ◽

Shinji Kashiwaguchi ◽

Kokichi Arisawa ◽

Natsuo Yasui

Keyword(s):

Baseball Players ◽

Elbow Pain ◽

Youth Baseball ◽

Elbow Injuries

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

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967116s00121 ◽

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

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Risk factors for shoulder and elbow pain in youth baseball players

The Physician and Sportsmedicine ◽

10.1080/00913847.2017.1300505 ◽

2017 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Tetsuya Matsuura ◽

Toshiyuki Iwame ◽

Naoto Suzue ◽

Kokichi Arisawa ◽

Koichi Sairyo

Keyword(s):

Risk Factors ◽

Baseball Players ◽

Elbow Pain ◽

Youth Baseball

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Asymptomatic Medial Elbow Ultrasound Abnormality in Youth Baseball Players Is an Independent Risk Factor for Elbow Injury: A Prospective Cohort Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120986791 ◽

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.

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Scapula Kinematics of Youth Baseball Players

Journal of Human Kinetics ◽

10.1515/hukin-2015-0107 ◽

2015 ◽

Vol 49 (1) ◽

pp. 47-54 ◽

Cited By ~ 5

Author(s):

Gretchen Oliver ◽

Wendi Weimar

Keyword(s):

Internal Rotation ◽

External Rotation ◽

Body Height ◽

Baseball Players ◽

Overhead Athletes ◽

Scapular Kinematics ◽

Dynamic Movement ◽

Youth Baseball ◽

History Of ◽

Posterior Tilt

Abstract Literature has revealed the importance of quantifying resting scapular posture in overhead athletes as well as quantifying scapular kinematics during dynamic movement. Prior to this project much of the attention in throwing research had been focused on the position of the humerus without description of the positioning of the scapula. Therefore, it was the purpose of this study to present scapular kinematics during pitching in youth baseball players. Twenty-five youth baseball players (age 11.3 + 1.0 years; body height 152.4 + 9.0 cm; body mass 47.5 + 11.3 kg), with no history of injury, participated in the study. Scapular kinematics at the events of maximum humeral external rotation (MER) and maximum humeral internal rotation (MIR) during the pitching motion were assessed three-dimensionally while pitching fastballs for strikes. Results revealed that at the event of MER, the scapula was in a position of retraction, upward rotation and a posterior tilt. While at the event of MIR, the scapula was protracted, upward rotated and tilted anteriorly.

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