Risk Factors of Shoulder and Elbow Injuries in Baseball: A Scoping Review of 3 Types of Evidence

Background: Shoulder and elbow overuse injuries are the most common problems in baseball players. No scoping review has compared the findings from different types of evidence. Purpose: To map the broad evidence from 3 types of evidence (epidemiological, biomechanical, and narrative) on potential risk factors for shoulder and elbow injuries in baseball and identify gaps in the existing literature to guide future research. Study Design: Scoping review. Methods: Eight electronic databases were searched from inception to May 14, 2020. Any peer-reviewed papers that investigated or discussed potential risk factors for shoulder and elbow injuries in baseball were included. Results: A total of 302 studies (107 epidemiological studies, 85 biomechanical studies, and 110 narrative reviews) were included. Risk factors were categorized into 9 domains: sports profiles, physical characteristics/functions, pitching mechanics, performance, behavioral, psychosocial, biological and developmental, injury/sports profiles, and environmental factors. Studies were consistent in supporting limited shoulder range of motion (ROM) and player positions (pitchers or catchers) as risk factors for shoulder injuries. For elbow injuries, the majority of the included studies suggested that being pitchers or catchers and working with higher ball velocity can be risk factors. Conclusion: Findings were consistent in some risk factors, such as limited shoulder ROM and positions. However, findings were inconsistent or limited for most factors, and substantial research gaps were identified. Research assessing those factors with inconsistent or limited evidence in the current literature were recognized to be priorities for future studies.

Epidemiological Evaluation of Pediatric Elbow Injuries: A Retrospective Observational Single Center

Introduction Elbow fractures are the commonest fractures in the pediatric age group. The aim of this study is to evaluate the epidemiology of fresh and neglected pediatric elbow fractures in a hilly state of India with a limited health care facility. Materials and Methods This was a retrospective observational single-center study conducted between January 2019 and January 2021. Results Supracondylar was the most common fracture in 58.7% of patients followed by lateral condyle and proximal radius fracture. The highest number of fractures were reported in the age group of 5 to 8 years. In addition, 19% of patients presented with associated complications, 8% of patients had combination injuries of the ipsilateral upper limb, 16% of patients presented to the hospital 1 week after the trauma, 48% of patients had the first contact with a bonesetter/native practitioner. Conclusion Supracondylar fracture was the most common elbow fracture followed by lateral condyle. The most common involved age group was 5 to 8 years. A significant number of elbow fractures are mismanaged by native practitioners in rural India.

Injury prevention of student rock climbers based on the formation of rational technique of movements: a randomized control trial

Background and Study Aim. Students are often injured while playing sports. The main condition for preventing injuries is the correct technique of movements. In the literature, rock climbing has not been analyzed in terms of prevention of student injuries. Therefore, the development of programs to prevent injuries of students-rock climbers is relevant. Aim: to determine the impact of the use of exercises in a closed kinematic chain on the technical skill and the number of injuries to the elbows of student-rock climbers based on the analysis of the one-arm hang technique. Material and methods. First, to substantiate the correct technique in rock climbing, the technique of performing one-arm hang was analyzed by 20 leading male climbers of Ukraine and 20 students - novice male climbers. Then a randomized control study was conducted. The participants in the randomized control study were 40 male students-climbers in the intervention group and 44 male students-climbers in the control group aged 18-19 years. The one-arm hang technique was determined based on the angles between the shoulder and the collarbone during the movement. The experiment lasted 1 year. At the beginning and at the end of the experiment, the analysis of the one-arm hang technique was carried out. The number of elbow injuries in both groups was also recorded. Results. The main parameters of the one-arm hang technique for qualified and unskilled climbers have been substantiated. For qualified climbers, one-arm hang involves the muscles of the shoulder girdle, torso, and legs. In unskilled climbers, one-arm hang is provided only by the muscles of the arm. In a control randomized study, there was a significant improvement in the results of biomechanical analysis of the hang technique in athletes in the intervention group (p <0.001). The use of exercises in a closed kinematic chain significantly reduces the incidence rate of elbow injuries in student-climbers (p <0.05). The odds rate of mild elbow injuries in the control group was 4.625 times higher than the intervention one (95% CI: 1.198; 17.854), the odds rate of moderate injuries in the control group was 5.588 times higher than in the control group than the intervention one (95% CI: 1.143; 27.324). Conclusions. Exercises in closed kinematic chains are an effective means of improving climbing technique and injury preventing to university students during rock climbing.

Overuse-related instability of the elbow: the role of CT-arthrography

The elbow is a complex joint whose biomechanical function is granted by the interplay and synergy of various anatomical structures. Articular stability is achieved by both static and dynamic constraints, which consist of osseous as well as soft-tissue components. Injuries determining instability frequently involve several of these structures. Therefore, accurate knowledge of regional anatomy and imaging findings is fundamental for a precise diagnosis and an appropriate clinical management of elbow instability. This review focuses particularly on the varied appearance of overuse-related elbow injuries at CT-arthrography.

Is Workload Associated with Ulnar Collateral Ligament Tears in Professional Baseball Players? An Analysis of Days of Rest, Innings Pitched and Batters Faced (126)

Objectives: To determine if workload; as measured by number of days rest between outings, innings pitched, batters faced, and being a starting pitcher; associates with risk for sustaining a subsequent UCL tear in professional baseball players. Methods: All professional baseball pitchers who sustained a UCL tear between 2011-2017 were identified using the major league baseball (MLB) Health and Injury Tracking System (HITS). A separate player usage was used to determine workload . We then compared these variables between player-games 2, 6, 12, and >12 weeks prior to a documented UCL tear and player games from a non-UCL tear control group. In a paired analysis, we compared the acute workload (2, 6, 12 weeks) prior to injury and the injured player’s workload >12 weeks prior to injury. Results: There were 2,204 elbow injuries within MLB, 369 of which were unique UCL tears in pitchers. In all time periods, player-games with more days rest, more innings pitched, and more batters faced associated with a subsequent UCL tear. Players who pitched 4 of more innings per outing had a 1.78-fold increase in percent of players with a subsequent UCL tear as compared to players with one inning pitched. Being a starting pitcher carried a relative risk of 1.51 (p<0.001) of subsequent UCL injury. In a paired analysis there were significantly more innings pitched and batters faced in the player-games 2 weeks prior to UCL injury than in the player-games >12 weeks prior to UCL injury (p=0.028 and p=0.017). Conclusions: Being a starting pitcher, pitching more innings per game, and facing more batters per game increased the risk of a UCL tear. An increase in workload in the 2 weeks prior to injury over that player’s baseline also significantly increased the risk for injury.