A Systematic Review of the Orthopaedic Literature on Truncal and Lower Extremity Injuries in Major League Baseball Players

Background: Although lower extremity biomechanics has been correlated with traditional metrics among baseball players, its association with advanced statistical metrics has not been evaluated. Purpose: To establish normative biomechanical parameters during the countermovement jump (CMJ) among Major League Baseball (MLB) players and evaluate the relationship between CMJ-developed algorithms and advanced statistical metrics. Study Design: Cohort study; Level of evidence, 3. Methods: MLB players in 2 professional organizations performed the CMJ at the beginning of each baseball season from 2013 to 2017. We collected ground-reaction force data including the eccentric rate of force development (“load”), concentric vertical force (“explode”), and concentric vertical impulse (“drive”) as well as the Sparta Score. The advanced statistical metrics from each baseball season (eg, fielding independent pitching [FIP], weighted stolen base runs [wSB], and weighted on-base average) were also gathered for the study participants. The minimal detectable change (MDC) was calculated for each CMJ variable to establish normative parameters. Pearson coefficient analysis and regression trees were used to evaluate associations between CMJ data and advanced statistical metrics for the players. Results: A total of 151 pitchers and 138 batters were included in the final analysis. The MDC for “load,” “explode,” “drive,” and the Sparta Score was 10.3, 8.1, 8.7, and 4.6, respectively, and all demonstrated good reliability (intraclass correlation coefficient > 0.75). There was a weak but statistically significant correlation between the Sparta Score and wSB ( r = 0.23; P = .007); however, there were no significant correlations with any other advanced metrics. Regression trees demonstrated superior FIP with higher Sparta Scores in older pitchers compared with younger pitchers. Conclusion: There was a positive but weak correlation between the Sparta Score and base-stealing performance among professional baseball players. Additionally, older pitchers with a higher Sparta Score had statistically superior FIP compared with younger pitchers with a similar Sparta Score after adjusting for age.

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Epidemiology of Pediatric Baseball and Softball Player Injuries

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211052585 ◽

2021 ◽

Vol 9 (12) ◽

pp. 232596712110525

Author(s):

Ali S. Farooqi ◽

Alexander Lee ◽

Eric Abreu ◽

Divya Talwar ◽

Kathleen J. Maguire

Keyword(s):

Lower Extremity ◽

Sports Injuries ◽

The United States ◽

Injury Surveillance System ◽

Baseball Players ◽

Injury Rates ◽

Lower Extremity Injuries ◽

Youth Baseball ◽

Extremity Injuries ◽

Head Neck

Background: Baseball and softball are popular sports in the United States and are responsible for a large number of youth sports injuries each year. Purpose: To investigate recent differences in youth baseball and softball injuries evaluated in nationwide emergency departments. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System (NEISS) database was examined for softball and baseball injuries in pediatric patients (age, 7-21 years) from 2010 through 2019. Patients were classified as children (age, 7-13 years), adolescents (age, 14-18 years), or young adults (age, 19-21 years). Case narratives were used to categorize injuries as contact injuries (hit by bat or ball), field injuries (sliding into base, collision with another player, catching, or running), throwing injuries, or other. Results: An unweighted total of 24,717 baseball injuries and 13,162 softball injuries were recorded. A nationwide estimate of 861,456 baseball injuries and 511,117 softball injuries were sustained during the studied time period, with estimated respective injury rates of 86,146 and 51,112 per year. Injured softball players were most commonly adolescent (47%) and female (92%), while injured baseball players were most commonly children (54%) and male (90%). There was a greater proportion of baseball-related injuries involving the head/neck (41%) as compared with softball-related injuries (30%) ( P < .01). Conversely, a greater proportion of softball-related injuries involved the lower extremity (32%) as compared with baseball-related injuries (19%) ( P < .01). When comparing diagnosis, softball injuries were more often sprains/strains (28%) than baseball injuries (18%) ( P < .01). When comparing mechanisms of injury, baseball athletes were more likely to be evaluated with contact injuries than were softball athletes (49% vs 40%, P < .01). Conclusion: Youth baseball athletes were more likely to be injured through contact mechanisms and had a higher proportion of injuries related to the head/neck/face, whereas softball injuries more frequently involved the lower extremity and resulted in a sprain/strain. League guidelines should focus on reducing contact injuries within youth baseball, and injury-prevention programs should focus on reducing lower extremity injuries in youth softball.

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Is core stability a risk factor for lower extremity injuries in an athletic population? A systematic review

Physical Therapy in Sport ◽

10.1016/j.ptsp.2017.08.076 ◽

2018 ◽

Vol 30 ◽

pp. 48-56 ◽

Cited By ~ 26

Author(s):

Cedric De Blaiser ◽

Philip Roosen ◽

Tine Willems ◽

Lieven Danneels ◽

Luc Vanden Bossche ◽

...

Keyword(s):

Systematic Review ◽

Risk Factor ◽

Lower Extremity ◽

Core Stability ◽

Lower Extremity Injuries ◽

Athletic Population ◽

Extremity Injuries

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The Prevalence of Lower Extremity Injuries in Running and Associated Risk Factors: A Systematic Review

Physical Activity and Health ◽

10.5334/paah.109 ◽

2021 ◽

Vol 5 (1) ◽

pp. 133-145

Author(s):

Jade Dempster ◽

Frédéric Dutheil ◽

Ukadike Chris Ugbolue

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Lower Extremity ◽

Lower Extremity Injuries ◽

Associated Risk Factors ◽

Extremity Injuries

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Although the injury rate of yoga is low, nearly two-thirds of musculoskeletal injuries in yoga affect the lower extremity: a systematic review

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine ◽

10.1136/jisakos-2017-000149 ◽

2018 ◽

Vol 3 (4) ◽

pp. 229-234

Author(s):

Arya Bekhradi ◽

Daniel Wong ◽

Brayden J Gerrie ◽

Patrick C McCulloch ◽

Kevin E Varner ◽

...

Keyword(s):

Systematic Review ◽

Lower Extremity ◽

Injury Rate ◽

Musculoskeletal Injuries ◽

Injury Incidence ◽

Time Duration ◽

Lower Extremity Injuries ◽

Level I ◽

Extremity Injuries ◽

Yoga Practitioners

ImportanceYoga is a very popular sporting activity across the world. There is limited information on the epidemiology and characteristics of yoga-related injuries.ObjectiveTo determine the incidence and prevalence of musculoskeletal injuries sustained in yoga.Evidence reviewA systematic review was registered with PROSPERO and performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and checklist. Level I–IV evidence studies reporting the incidence and prevalence of musculoskeletal injuries in male and female yoga practitioners were eligible for inclusion. The number and types of injuries were extracted from each study. Duplicate patient populations within separate distinct publications were analysed and reported only once. Injury rates were recorded and calculated on the basis of gender and nature of injury. Incidence was defined as the number of injuries sustained over a specific time duration. Prevalence was defined as the proportion of subjects with an injury at a given point in time.FindingsFive studies were analysed that reported injury incidence or prevalence in yoga (7453 subjects). In four of these studies, the type of yoga was not specified, but Mikkonenet alfocused solely on Ashtanga Vinyasa practitioners. There were 6544 female (88%) and 909 male (12%) yoga practitioners analysed (49.1±13.6 years of age). The incidence of injury among yoga practitioners was 1.18 injuries per 1000 yoga hours. Only four studies provided prevalence data, displaying 6.6% injury prevalence in 7415 yoga practitioners overall (up to 62% in Ashtanga Vinyasa). Overall, lower extremity injuries comprised 64% of total injuries; specifically the hip, hamstring, knee, ankle, feet and toe. The upper extremity and head and trunk injuries account for 13% and 23%, respectively.Conclusions and relevanceThere is limited quantity heterogeneous evidence reporting the characteristics of yoga injuries. The overall injury incidence is 1.18 injuries per 1000 yoga hours. The prevalence of injury is poorly characterised. However, the weighted mean prevalence is 7%. The majority of yoga injuries are lower extremity injuries.Level of evidenceLevel IV, a systematic review of level I–IV studies.

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Outcomes With a Focus on Return to Play for Revision Ulnar Collateral Ligament Surgery Among Elite-Level Baseball Players: A Systematic Review

The American Journal of Sports Medicine ◽

10.1177/0363546518816960 ◽

2018 ◽

Vol 47 (11) ◽

pp. 2759-2763 ◽

Cited By ~ 3

Author(s):

Georgina Glogovac ◽

Brian M. Grawe

Keyword(s):

Systematic Review ◽

Major League Baseball ◽

Return To Sport ◽

Ulnar Collateral Ligament ◽

Rate Of Return ◽

Secondary Outcome ◽

Collateral Ligament ◽

Baseball Players ◽

Major League ◽

Elite Level

Background: Ulnar collateral ligament (UCL) reconstruction is commonly performed among overhead throwing athletes. Previous studies demonstrated relatively high rates of return to sport after primary reconstruction. Outcomes after revision UCL reconstruction have not been widely studied. Purpose: To report the rate of return to sport after revision UCL reconstruction among elite-level baseball players. Study Design: Systematic review. Methods: A systematic review of the literature following the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines was performed for high-level baseball players undergoing revision UCL reconstruction. Study bias was assessed with the Methodological Index for Non-Randomized Studies scoring system. The primary outcome measure was whether the study participants were able to return to sport after revision UCL reconstruction. Secondary outcome measures included career length after revision and pitching performance statistics. Data were summarized with ranges, tables, and weighted averages. A subjective analysis was performed. Results: A total of 5 studies met inclusion criteria. The rate of return to sport at preinjury level was 62.8%. Among Major League Baseball pitchers, the rate of return to sport at the preinjury level was 68.8%. The rate of return to sport at the same level or lower (Major League Baseball, minor league, collegiate) was 78.1%. Time to return to sport ranged from 1.3 to 1.7 years. Mean earned run average after revision ranged from 4.87 to 5.04. Mean number of innings pitched per season after revision ranged from 36.95 to 50.5. Conclusion: This systematic review demonstrated a limited rate of return to preinjury level of sport among elite-level baseball players who underwent revision UCL reconstruction. Pitching durability and career longevity were inferior to results that were reported for players who underwent primary UCL reconstruction alone. This study suggests that outcomes after revision UCL reconstruction are not reliable and elite-level players should be counseled accordingly.

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Early Sports Specialization Is Associated With Upper Extremity Injuries in Throwers and Fewer Games Played in Major League Baseball

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119861101 ◽

2019 ◽

Vol 7 (7) ◽

pp. 232596711986110 ◽

Cited By ~ 5

Author(s):

Jamie Confino ◽

James N. Irvine ◽

Michaela O’Connor ◽

Christopher S. Ahmad ◽

T. Sean Lynch

Keyword(s):

High School ◽

Upper Extremity ◽

Major League Baseball ◽

Professional Baseball ◽

Baseball Players ◽

Minor League ◽

Major League ◽

Elbow Injuries ◽

The Disabled ◽

Extremity Injuries

Background: Single-sport athletes who specialize in baseball at a young age may have a greater predisposition to overuse injury, burnout, and decreased career longevity when compared with multiple-sport athletes. The effect of sport specialization has not been studied in professional baseball players. Hypothesis: Major League Baseball (MLB) players who played multiple sports in high school would experience fewer injuries, spend less time on the disabled list, play more games, and have a longer career than athletes who played only baseball in high school. Study Design: Descriptive epidemiology study. Methods: First- and second-round MLB draft picks from 2008 to 2016 who played in at least 1 professional game were included in this study. Athletes who participated in 1 or more sports in addition to baseball during high school were considered multisport athletes, and athletes who participated in only baseball were considered single-sport athletes. For each athlete, participation in high school sports, injuries sustained in MLB and Minor League Baseball, number of days on the disabled list for each injury, number of games played in both leagues, and whether the athlete was still active were collected from publicly available records. Results: A total of 746 athletes were included in this study: 240 (32%) multisport and 506 (68%) single sport. Multisport athletes played in significantly more mean total games (362.8 vs 300.8; P < .01) as well as more mean MLB games (95.9 vs 71.6; P = .04) than single-sport athletes. There was no difference in the mean number of seasons played in the major leagues (1.8 vs 1.6; P = .15) or minor league (5.25 vs 5.20; P = .23) between multisport and single-sport athletes. Single-sport athletes had a significantly higher prevalence of upper extremity injuries compared with multisport athletes (136 [63%] vs 55 [50%]; P = .009). Single-sport pitchers also had a higher prevalence of shoulder and elbow injuries (86 vs 27; P = .008) and were more likely to have recurrent elbow injuries (33% vs 17% recurrence; P = .002) compared with multisport pitchers. Conclusion: Professional baseball players who participated in multiple sports in high school played in more major league games and experienced lower rates of upper and lower extremity injuries than players who played only baseball in high school.

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