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Salamh PA, Entler K, Parks M, Vrbancic C, Usui T, Hegedus EJ, Cook CE, Bullock GS. Unaccounted for Pitch Volume Among Adolescent Baseball Pitchers During a Travel Baseball Season. Clin J Sport Med 2024:00042752-990000000-00197. [PMID: 38896543 DOI: 10.1097/jsm.0000000000001238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE The primary aim was to compare differences in live game pitch counts (LGPCs) with all pitch counts (APCs) over the course of a youth baseball season. DESIGN Prospective longitudinal study. SETTING Midwest youth travel baseball. PARTICIPANTS Ten male baseball players part of a youth baseball travel team. VARIABLES Demographic data, pitch counts (practice, game, warm-up, and bullpen), innings pitched, and recommended rest days. MAIN OUTCOME MEASURES Live pitch counts compared with APCs and the relationship to recommended rest days. RESULTS During the season, 7866 pitches were recorded among 9 pitchers. By using the LGPC method alone, 42.5% of the pitches were unaccounted for. When considering age-specific rest days suggested by Pitch Smart Guidelines (PSGs), there were 104 rest days unaccounted for by using the live game pitch method. CONCLUSION There is a high number of unaccounted for pitches and an underestimation of rest days per outing when using live game methods. Revisions to the PSGs that include all pitches should be considered to accurately reflect pitching volume, which may be associated with the rising rate of injuries among these athletes.
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Affiliation(s)
- Paul A Salamh
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, Indiana
| | - Kalie Entler
- Memorial Hermann Rockets Sports Medicine Institute, Houston, Texas
| | - Meredith Parks
- Riley Hospital at Indiana University Hospital, Indianapolis, Indiana
| | | | - Takumi Usui
- University of Chicago Medicine, Chicago, Illinois
| | - Eric J Hegedus
- Physical Therapy Program, Phoenix, Arizona
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, Massachusetts
| | - Chad E Cook
- Clinical Research, Doctor of Physical Therapy Program, Duke Clinical Research Institute, Department of Population Health, Duke University, Durham, North Carolina; and
| | - Garrett S Bullock
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Bowman Gray Center for Medical Education, Winston-Salem, North Carolina
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Bi AS, Lin CC, Anil U, Rokito AS, Jazrawi LM, Erickson BJ. Trends in Elbow Ulnar Collateral Ligament Repairs and Reconstructions and an Analysis Between Low- and High-Volume Surgical Centers: A 10-Year Study in New York State. Orthop J Sports Med 2024; 12:23259671241246811. [PMID: 38799547 PMCID: PMC11128166 DOI: 10.1177/23259671241246811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 10/29/2023] [Indexed: 05/29/2024] Open
Abstract
Background Elbow ulnar collateral ligament (UCL) reconstruction (UCLR) is the gold standard for operative treatment of UCL tears, with renewed interest in UCL repairs. Purpose To (1) assess trends in rates of UCLR and UCL repair and (2) identify predictors of complications by demographic, socioeconomic, or surgical center volume factors. Study Design Descriptive epidemiology study. Methods Patients who underwent UCLR or UCL repair at New York State health care facilities between 2010 and 2019 were retrospectively identified; concomitant ulnar nerve procedures among the cohort were also identified. Surgical center volumes were classified as low (<99th percentile) or high (≥99th percentile). Patient information, neighborhood socioeconomic status quantified using the Area Deprivation Index, and complications within 90 days were recorded. Poisson regression analysis was used to compare trends in UCLR versus UCL repair. Multivariable regression was used to determine whether center volume, demographic, or socioeconomic variables were independent predictors of complications. Results A total of 1448 UCL surgeries were performed, with 388 (26.8%) concomitant ulnar nerve procedures. UCLR (1084 procedures; 74.9%) was performed more commonly than UCL repair (364 procedures; 25.1%), with patients undergoing UCL repair more likely to be older, female, and not privately ensured and having undergone a concomitant ulnar nerve procedure (all P < .001). With each year, there was an increased incidence rate ratio for UCL repair versus UCLR (β = 1.12 [95% CI, 1.02-1.23]; P = .022). The authors identified 2 high-volume centers (720 UCL procedures; 49.7%) and 131 low-volume centers (728 UCL procedures; 50.3%). Patients undergoing UCL procedures at high-volume centers were more likely to be younger and male and receive workers' compensation (all P < .001). UCL repair and ulnar nerve-related procedures were both more commonly performed at low-volume centers (P < .001). There were no significant differences in 3-month infection, ulnar neuritis, instability, arthrofibrosis, heterotopic ossification, or all-cause complication rates between low- and high-volume centers. The only significant predictor for all-cause complication was Medicaid insurance (OR, 2.91 [95% CI, 1.20-6.33]; P = .011). Conclusion A rising incidence of UCL repair compared with UCLR was found in New York State, especially among female patients, older patients, and nonprivate payers. There were no differences in 3-month complication rates between high- and low-volume centers, and Medicaid insurance status was a predictor for overall complications within 90 days of operation.
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Affiliation(s)
- Andrew S. Bi
- Department of Sports Medicine, NYU Langone Health, New York, New York, USA
| | - Charles C. Lin
- Department of Sports Medicine, NYU Langone Health, New York, New York, USA
| | - Utkarsh Anil
- Department of Sports Medicine, NYU Langone Health, New York, New York, USA
| | - Andrew S. Rokito
- Department of Sports Medicine, NYU Langone Health, New York, New York, USA
| | - Laith M. Jazrawi
- Department of Sports Medicine, NYU Langone Health, New York, New York, USA
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Erickson BJ, Bowman EN, Camp C, Freehill MT, Smith MV, Serio N, Ishikawa H, Smith K, Chalmers PN. Characteristics Associated With Noncompliance of Current Pitch Smart Guidelines in High School Baseball Pitchers Throughout the United States. Orthop J Sports Med 2023; 11:23259671231199085. [PMID: 37781638 PMCID: PMC10536850 DOI: 10.1177/23259671231199085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/19/2023] [Indexed: 10/03/2023] Open
Abstract
Background Although pitch count and rest guidelines have been promoted for youth and adolescent baseball players for nearly 2 decades, compliance with guidelines remains poorly understood. Purpose/Hypothesis The purpose of this study was to determine the frequency of compliance with Major League Baseball (MLB) Pitch Smart guidelines as well as the association between compliance and range of motion (ROM), strength, velocity, injury, and pitcher utilization. It was hypothesized that pitchers in violation of current recommendations would have increased strength, velocity, and injury. Study Design Case-control study; Level of evidence, 3. Methods This was a prospective, multicenter study of 115 high school pitchers throughout the United States. Pitchers were surveyed about their compliance with current off-season, rest-related guidelines, and history of injury. During the preseason, pitchers underwent standardized physical examinations, and pitch velocity was measured. Pitch counts were collected during the baseball season that followed. Dynamometer strength testing of shoulder forward flexion, and external rotation as well as grip strength was recorded. We compared pitchers who were compliant with recommendations with those who were noncompliant using Student t and Mann-Whitney U tests. Results Based on preseason data, 84% of pitchers had violated current Pitch Smart guidelines. During the season, 14% had at least 1 violation of the Pitch Smart guidelines. Across both the preseason survey and in-season pitch counts, 89% of players had at least 1 violation of the Pitch Smart guidelines. While there were no significant differences in ROM or strength, the noncompliant group had higher maximum pitch velocity than the compliant group (74 ± 8 vs 69 ± 5 mph [119 ± 13 vs 111 ± 8 kph], respectively; P = .009). Players' self-reported velocity differed significantly from the direct measurement, for both peak velocity (80 ± 6 vs 73 ± 8 mph [129 ± 9 vs 117 ± 13 kph], respectively; P < .001) and mean velocity (73 ± 8 vs 53 ± 27 mph [117 ± 13 vs 85 ± 43 kph], respectively; P < .001). Conclusion Most high school pitchers were not fully compliant with current Pitch Smart guidelines, and they tended to overestimate their peak velocity by 7 mph (11 kph). Pitchers who threw with greater velocity were at higher risk for violating Pitch Smart recommendations.
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Affiliation(s)
- Brandon J. Erickson
- Rothman Institute, New York, New York, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - Eric N. Bowman
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christopher Camp
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael T. Freehill
- Department of Orthopaedic Surgery, Stanford University, Palo Alto, California, USA
| | - Matthew V. Smith
- Department of Orthopaedic Surgery, Washington University in Saint Louis, Missouri, USA
| | | | - Hiroaki Ishikawa
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Karch Smith
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Peter N. Chalmers
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA
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Kamarajugadda S, Italiano J, Horodyski M, Zaremski JL, Pazik M, Zeppieri G, Farmer KW, Brombacher-O’Connell S, Prine B, Smith MS. Caregiver Awareness of Safe Pitching Recommendations in Youth Fastpitch Softball Pitchers. Orthop J Sports Med 2023; 11:23259671231169947. [PMID: 37255943 PMCID: PMC10226313 DOI: 10.1177/23259671231169947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/24/2023] [Indexed: 06/01/2023] Open
Abstract
Background Although fastpitch softball participation continues to rise, there is a lack of established pitch count guidelines, potentially putting young female athletes at risk of overuse injuries. In addition to coaches, caregivers' ability to recognize and employ safe pitching guidelines plays an important role in athlete safety. Purpose/Hypothesis The purpose of this study was to assess caregivers' knowledge of their child's pitching practices and their familiarity with softball pitching recommendations. We hypothesized that caregivers would be unaware of safe pitching recommendations in youth fastpitch softball. Study Design Cross-sectional study. Methods A 30-question survey was distributed to caregivers of youth fastpitch softball pitchers in age groups 10U (ie, ≤10 years), 12U, 14U, 16U, and 18U. The survey included questions on the demographic characteristics of caregivers and athletes, caregivers' knowledge of safe pitching recommendations, and athletes' pitching background and throwing habits. Comparisons of responses between the age groups were conducted using the chi-square test, Fisher exact test, or 1-way analysis of variance, as appropriate. Results A total of 115 caregivers completed the survey. Of the respondents, 84% were between 31 and 50 years, and 81.7% had a degree beyond high school. Only 28.1% of caregivers reported participating in youth sports. When asked to estimate the number of pitches they considered a safe amount during a single outing, 28.7% of caregivers (n = 33) did not provide a limit, 4.3% (n = 5) stated no limit was needed, 32.2% (n = 37) suggested 25 to 80 pitches, 21.7% (n = 25) suggested 81 to 100 pitches, 12.2% (n = 14) suggested 100 to 150 pitches, and 0.9% (n = 1) suggested that >150 pitches were acceptable. These data emphasized that only 14.8% of the caregivers were aware of any pitching guidelines. However, 93% of caregivers acknowledged that they would adhere to recommendations if guidelines were made available. Conclusion The study findings demonstrated that a majority of caregivers are unaware of current youth fastpitch softball pitching recommendations.
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Affiliation(s)
| | - Jack Italiano
- Department of Community Health &
Family Medicine, University of Florida, Gainesville, Florida, USA
| | - MaryBeth Horodyski
- Department of Orthopaedic Surgery &
Sports Medicine, University of Florida, Gainesville, Florida, USA
| | - Jason L. Zaremski
- Department of Physical Medicine and
Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - Marissa Pazik
- Department of Orthopaedic Surgery &
Sports Medicine, University of Florida, Gainesville, Florida, USA
| | - Giorgio Zeppieri
- Department of Rehabilitation,
University of Florida, Gainesville, Florida, USA
| | - Kevin W. Farmer
- Department of Community Health &
Family Medicine, University of Florida, Gainesville, Florida, USA
| | | | - Bryan Prine
- Department of Community Health &
Family Medicine, University of Florida, Gainesville, Florida, USA
| | - Michael Seth Smith
- Department of Community Health &
Family Medicine, University of Florida, Gainesville, Florida, USA
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Kaizu Y, Oyama Y, Ishihara Y, Honma Y. Survey with Innovations to Increase Response Rate Reveals Low Compliance with Guidelines among Youth Baseball Coaches - Including a Survey of Differences between Cities. Int J Sports Phys Ther 2022; 17:409-419. [PMID: 35391872 PMCID: PMC8975573 DOI: 10.26603/001c.32978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 01/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background Compliance rates of youth baseball team coaches with guidelines regarding pitch count limits have been reported, but response rates from previous surveys have not been high, which may introduce substantial non-response bias. In addition, differences between cities in guideline compliance rates have remained unclear. Purpose The aim of the present study was to obtain data on coach compliance with guidelines for pitch count limits with a high survey response rate. Secondary aims were to determine compliance with guidelines other than pitch count limits, and to determine whether differences in compliance exists between cities. Methods A questionnaire was developed for coaches of youth baseball teams in Gunma to assess knowledge of and compliance with the Japan Softball Baseball Association's recommendations for preventing injuries. In the preparation, distribution, and collection of the questionnaire, four strategies were applied to increase the response rate. The questionnaire surveyed basic descriptive information about the team and coach and coaches compliance with guidelines. Survey items were compared between compliant and non-compliant groups for pitch count limits, and by city. Results Valid responses to the questionnaire were obtained from coaches of 58 of 62 teams surveyed for a response rate of 93.5%. Despite the fact that almost all coaches were aware of the recommendations regarding pitch count limits and felt these limits were needed, only 15.5% were compliant. For guidelines other than the pitch count limits, the recommended values were exceeded for practice time on holidays. Differences between cities were evident in the compliance rate with the pitch count limit, but no differences between cities in other items were observed. Conclusion The results of this research revealed that compliance with pitch count limits in this sample of youth baseball coaches was much lower than previously reported. Differences between cities were identified in rates of compliance with pitch count limits. These results suggest a need to increase compliance rates with guidelines for pitch count limits and to address differences between cities. Level of Evidence Cross-sectional survey study, 3b.
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Affiliation(s)
- Yoichi Kaizu
- Department of Rehabilitation Center, Hidaka Hospital, Takasaki, Gunma, Japan; Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
| | - Yuki Oyama
- Department of Rehabilitation Center, Hidaka Rehabilitation Hospital, Takasaki, Gunma, Japan
| | - Yamato Ishihara
- Department of Rehabilitation Center, Hidaka Hospital, Takasaki, Gunma, Japan
| | - Yusuke Honma
- Department of Rehabilitation Center, Hidaka Rehabilitation Hospital, Takasaki, Gunma, Japan
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Baron JE, Westermann RW, DeMik DE, An Q, Wolf BR. Trends in Medial Ulnar Collateral Ligament Repair and Reconstruction From 2007 to 2016: A Population-Based Study of a Large Private Insurance Database. HSS J 2022; 18:116-121. [PMID: 35087341 PMCID: PMC8753544 DOI: 10.1177/1556331621997810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 02/03/2023]
Abstract
Background: Ulnar collateral ligament (UCL) reconstruction and UCL repair of the elbow are commonly performed procedures, resulting in high return-to-play rates. Whether the incidence rate of UCL reconstruction vs UCL repair has changed over time is not currently known. Purpose/Questions: We sought to assess temporal trends in the incidence rates of UCL repair and UCL reconstruction and to identify factors associated with UCL reconstruction. We hypothesized that UCL repair would demonstrate an increased incidence overall in recent years with an associated decline in UCL reconstruction rates. Methods: Using the PearlDiver Research Program to query the Humana administrative claims database, we identified patients who had undergone UCL repair and/or reconstruction from 2007 to 2016. Patients were stratified by age (15-19; 20-29; 30-49 years), sex, and year (2007-2011 vs 2012-2016). Poisson regression analysis (continuous variables) was used to calculate the incidence risk ratio (IRR); chi-square tests were performed for categorical variables, and odds ratios were calculated with 95% confidence intervals (CI). Results: The incidence rate of UCL repair was greater in 2012-2016 than in 2007-2011 (IRR: 1.86, 95% CI: 1.16-2.96). The incidence rate of UCL reconstruction vs UCL repair was greater for patients aged 15 to 19 years (IRR: 3.37, 95% CI: 1.97-5.77) but not patients aged 20 to 29 years (IRR: 0.89, 95% CI: 0.49-1.59) as compared with patients aged 30 to 49. Males aged 19 years were more likely than females to undergo UCL reconstruction (IRR: 10.09, 95% CI: 1.37-3.45). Conclusion: While UCL procedures are becoming more popular, our retrospective analysis showed that young males are preferentially treated with UCL reconstruction, warranting further investigation into these trends.
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Affiliation(s)
- Jacqueline E. Baron
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA,Jacqueline E. Baron, MD, Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA 52246, USA.
| | - Robert W. Westermann
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - David E. DeMik
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - Qiang An
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - Brian R. Wolf
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
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Greiner JJ, Trotter CA, Walczak BE, Hetzel SJ, Baer GS. Pitching Behaviors in Youth Baseball: Comparison With the Pitch Smart Guidelines. Orthop J Sports Med 2021; 9:23259671211050127. [PMID: 34778475 PMCID: PMC8581780 DOI: 10.1177/23259671211050127] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022] Open
Abstract
Background The Pitch Smart guidelines aim to limit youth baseball pitching behaviors associated with overuse injuries. Despite many youth baseball leagues being compliant with the guidelines, during tournaments, pitch count restrictions or guidelines are often not followed. Purpose To perform a quantitative analysis of pitch counts in youth baseball players and evaluate compliance with regard to the Pitch Smart guidelines in the tournament setting. Study Design Cross-sectional study; Level of evidence, 3. Methods Included in the analysis were 100 youth baseball teams that competed in the 8-and-under to 14-and-under age divisions during the 2019 tournament season. Pitching data were compared with the Pitch Smart guidelines. Violations were identified as (1) exceeding maximum daily pitch count, (2) inadequate rest between pitching events, and (3) pitching more than 1 event on the same day. Pitcher and game factors were analyzed for possible relationships to guideline violations using mixed-effects negative binomial regression models, with comparisons of violations using rate ratios (RRs). Results Analysis included 1046 pitchers and 2439 games. There were 1866 total Pitch Smart guideline violations, with 48.6% of pitchers having at least 1 violation. Inadequate rest was the most common reason for violation, with noncompliance occurring in 43.3% of pitchers. The highest rate of any violation (0.32 per appearance) occurred in the 8-and-under age division. High-volume pitchers had increased violation rates in each category compared with low-volume pitchers (P < .001). Violation rates were increased more than twice the rate when pitchers participated in ≥5 consecutive games without a rest day when compared with a single game (RR, 2.48; P < .001). Conclusion Noncompliance with Pitch Smart guidelines in tournament settings occurred in more than 90% of teams and almost half of all pitchers. Factors associated with noncompliance included younger pitcher age, high-volume pitching, and pitching in multiple consecutive games. Education of tournament directors, coaches, parents, and athletes regarding pitching guidelines is warranted in order to limit the risk of injury.
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Affiliation(s)
- Justin J Greiner
- Department of Orthopedic Surgery, Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Cameron A Trotter
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Brian E Walczak
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Scott J Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Geoffrey S Baer
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Steinl GK, Padaki AS, Irvine JN, Popkin CA, Ahmad CS, Lynch TS. The prevalence of high school multi-sport participation in elite national football league athletes. PHYSICIAN SPORTSMED 2021; 49:476-479. [PMID: 33238784 DOI: 10.1080/00913847.2020.1856632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: Early youth specialization is increasingly being researched and identified as a risk factor for overuse injuries and burnout. This study aimed to characterize high school sport specialization in top National Football League (NFL) athletes and determine whether associations exist between single-sport specialization and future injury risk, performance, and longevity.Methods: For NFL first-round draft picks from 2008-2017, data on the number of games played in the NFL, overuse injuries causing athletes to miss one or more regular season games, Pro Bowl selections, and current status in the NFL were collected using publicly available information.Results: A total of 318 athletes were analyzed. Multi-sport athletes were highly prevalent (88%, n = 280), while only 12% (n = 38) of athletes were classified as single-sport. No difference between multi-sport and single-sport athletes was found regarding games missed to upper (p = 0.93) or lower extremity injuries (p = 0.49), total games played (p = 0.57), or NFL longevity (p = 0.97). There was no significant difference in the proportions of athletes reaching at least 1 Pro Bowl.Conclusion: The majority of NFL first-round draft picks were multi-sport athletes in high school. Single-sport football participation in high school does not appear to aid athletes in reaching or succeeding in the NFL.
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Affiliation(s)
- Gabrielle K Steinl
- Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Ajay S Padaki
- Columbia University Irving Medical Center, Department of Orthopedic Surgery, New York, NY, USA
| | - James N Irvine
- Columbia University Irving Medical Center, Department of Orthopedic Surgery, New York, NY, USA
| | - Charles A Popkin
- Columbia University Irving Medical Center, Department of Orthopedic Surgery, New York, NY, USA
| | - Christopher S Ahmad
- Columbia University Irving Medical Center, Department of Orthopedic Surgery, New York, NY, USA
| | - T Sean Lynch
- Columbia University Irving Medical Center, Department of Orthopedic Surgery, New York, NY, USA
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9
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Agel J, Post E. Early Sport Specialization. J Bone Joint Surg Am 2021; 103:1948-1957. [PMID: 34375322 DOI: 10.2106/jbjs.21.00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ Early sport specialization has been recognized as a potential factor in the relationship between physical activity and health since the early 1970s. ➤ There is no universally agreed-upon terminology or definition for early sport specialization, but early sport specialization typically encompasses preteen athletes who play 1 sport competitively throughout the year or play on several teams within 1 season, leading to intensive participation without variation in physical activity. ➤ There is a limited number of comprehensive long-term outcome studies that have identified a potential link between early sport specialization and musculoskeletal injury or burnout. ➤ Methodologically sound prospective research looking at chronologic age and years of participation by sports played will help to answer whether there is an impact from early sport specialization on the relationship with successful participation and injury occurrence.
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Affiliation(s)
- Julie Agel
- Department of Orthopedics and Sports Medicine, University of Washington, Harborview Medical Center, Seattle, Washington
| | - Eric Post
- Indiana State University, Terre Haute, Indiana
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Tajika T, Oya N, Kuboi T, Endo F, Ichinose T, Shimoyama D, Sasaki T, Hamano N, Omodaka T, Kobayashi H, Mieda T, Okamura K, Shitara H, Iizuka Y, Yamamoto A, Nakajima I, Kobayashi T, Sakamoto M, Takagishi K, Chikuda H. Risk Factors for Throwing-Related Shoulder and Elbow Pain in Adolescent Baseball Players: A Prospective Study of Physical and Developmental Factors. Orthop J Sports Med 2021; 9:23259671211017129. [PMID: 34552989 PMCID: PMC8450620 DOI: 10.1177/23259671211017129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 01/25/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Throwing-related shoulder and elbow pain continues to be reported among adolescent baseball players. Few prospective studies have specifically examined the association between throwing-related shoulder and elbow pain and physical and developmental changes. Purpose: To evaluate the changes in physical and developmental characteristics during 1 year with respect to throwing-related shoulder and elbow pain in adolescent baseball players. Study Design: Case-control study; Level of evidence, 3. Methods: This 1-year prospective follow-up study investigated 164 baseball players aged 7 to 13 years. Player data (age, height, weight, field position, and pitch count), lower extremity muscle tightness, and range of motion (ROM) of the shoulder, elbow, and hip joints were assessed during the 2016 and 2017 preseason medical examinations. After the 2016 season, the participants completed questionnaires related to throwing-related shoulder and elbow pain, defined as an inability to play for ≥1 week because of elbow or shoulder difficulties. For study participants with and without throwing-related shoulder or elbow pain during the 2016 season, we conducted univariate and multivariate logistic regression analysis to identify risk factors for throwing-related shoulder or elbow pain. Results: Overall, 21 players (12.8%) reported a shoulder pain episode, 56 players (34.1%) had an elbow pain episode, and 70 players (42.7%) reported having experienced shoulder and/or elbow pain during the 2016 season. In multivariate logistic regression analysis, (1) shoulder pain was associated with 2016 preseason height (odds ratio [OR], 1.06; 95% CI, 1.01-1.11; P = .01) and change in dominant-side elbow extension ROM from 2016 to 2017 (OR, 1.12; 95% CI, 1.02-1.24; P = .02); (2) elbow pain was associated with change in weight from 2016 to 2017 (OR, 1.21; 95% CI, 1.04-1.41; P = .014); and (3) throwing-related shoulder and/or elbow pain was associated with greater 2016 preseason height (OR, 1.04; 95% CI, 1.003-1.68; P = .03) and an increase in height from 2016 to 2017 (OR, 1.17; 95% CI, 1.01-1.35; P = .03). Conclusion: Our results indicated that adolescent baseball players who were taller in the preseason and those with an increase in height over the 1-year study period faced significant risks for developing throwing-related shoulder and/or elbow pain.
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Affiliation(s)
- Tsuyoshi Tajika
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Noboru Oya
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Takuro Kuboi
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Fumitaka Endo
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Tsuyoshi Ichinose
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Daisuke Shimoyama
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Tsuyoshi Sasaki
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Noritaka Hamano
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Takuya Omodaka
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hiroki Kobayashi
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Tokue Mieda
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Koichi Okamura
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hitoshi Shitara
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Yoichi Iizuka
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Atsushi Yamamoto
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Ichiro Nakajima
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Tsutomu Kobayashi
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Masaaki Sakamoto
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Kenji Takagishi
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hirotaka Chikuda
- Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
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11
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Painter DF, Dove JH, Monteiro K, Kriz PK, Owens BD. Medical Advisability of Youth Pitching Recommendations on the Internet. Orthop J Sports Med 2021; 9:23259671211036692. [PMID: 34514011 PMCID: PMC8427927 DOI: 10.1177/23259671211036692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/13/2021] [Indexed: 02/04/2023] Open
Abstract
Background: As the incidence of youth pitching injuries and surgical procedures attributed to overuse has drastically increased, there are quality concerns about popular internet resources regarding arm care for youth pitchers. Purpose/Hypothesis: To assess the medical advisability of online arm care recommendations for youth pitchers. It was hypothesized that websites contain misleading arm-care information that is discordant with medical advice. Study Design: Cross-sectional study. Methods: We reviewed the first 100 websites populated after a Google search for youth pitching recommendations. Websites were categorized by type (athletic organization, commercial, or educational) and content quality (medically advisable, discordant, or neutral), the latter with respect to the Pitch Smart guidelines used by Major League Baseball. Chi-square tests of independence and z tests of independent proportions were used to compare column proportions among categories of website content quality for each type of website source. Given the small sample sizes in some instances, the Fisher-Freeman-Halton exact test was performed to assess the relationship between website source type and quality of information. Results Of the 99 qualifying websites, 76 were categorized as medically advisable, 16 as discordant, and 7 as neutral. In addition, 92% of educational websites and 94.7% of athletic organization websites featured exclusively advisable content, whereas only 54.8% of commercial websites were advisable. Of the 16 discordant websites, 15 were commercial sites. Educational websites were significantly more advisable and neutral in content when compared with discordant information, while commercial websites were significantly predictive of discordant content. Among the first 50 websites populated according to Google, 42 (84%) were advisable, 6 (12%) discordant, and 2 (4%) neutral. The remaining websites (n = 49) featured 34 (69.4%) that were advisable, 10 (20.4%) discordant, and 5 (10.2%) neutral. Conclusion: Study findings indicated that websites of an educational nature are predictive of medically advisable content, while commercial websites (eg, blogs) are associated with discordant information. The abundance and availability of inaccurate internet information should be appreciated by medical professionals and parents/coaches of youth baseball players.
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Affiliation(s)
- David F. Painter
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - James H. Dove
- Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Kristina Monteiro
- Office of Medical Education, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Peter K. Kriz
- Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Brett D. Owens
- Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Brett D. Owens, MD, Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, 1 Kettle Point Avenue, East Providence, RI 02914, USA () (Twitter: @BrettOwensMD)
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12
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Matsel KA, Weiss EE, Butler RJ, Hoch MC, Westgate PM, Malone TR, Uhl TL. A Nation-Wide Survey of High School Baseball Coaches' Perceptions Indicates their Arm Care Programs Play a Role in Injury Prevention. Int J Sports Phys Ther 2021; 16:816-826. [PMID: 34123533 PMCID: PMC8169022 DOI: 10.26603/001c.24247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 11/26/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Arm care programs consisting of upper extremity strengthening and stretching have been recommended for injury prevention for pitchers of all ages. There has been no investigation into high school baseball coaches' usage and perceptions of arm care programs to mitigate physical impairments associated with injuries in baseball players. HYPOTHESIS/PURPOSE The purpose of this study was to investigate the current usage of arm care programs by high school baseball coaches. The primary objective was to determine if coaches use group-based or individualized arm care programs. The secondary objective sought to determine if the use of arm care programs is influenced by coaches' age, education, and experience level. Finally, this study explored the potential barriers to arm care implementation and high school baseball coaches' current awareness and beliefs of injury prevention. STUDY DESIGN Descriptive cross-sectional survey. METHODS A 29-item online survey was emailed to 18,500 high school baseball coaches throughout the United States. Data were collected for three months, and the response rate was 3.7%. RESULTS A total of 87.3% (n=571/654) of responding coaches use arm care programs with their players. Of coaches performing arm care, only 18.5% of 571 individualize their arm care exercises based on specific player needs. However, older and more experienced coaches are more likely to individualize their programs. Among the 12.7% (n=83/654) of coaches who do not use arm care programs, the two most commonly cited reasons for not implementing arm care were lack of observed benefit (41%) and insufficient staff (31%). Although 42% of 654 coaches recognized reduced shoulder mobility as a major contributor to injury, risk factors such as throwing with a fatigued arm, previous injury history, and throwing > 8 months per year were not consistently identified as primary risk factors. CONCLUSION The results of this study suggest that the majority high school baseball coaches implement group-based arm care exercise programs to prevent injury. Lack of confidence in the effectiveness and staffing limitations were major barriers to implementation of arm care programming. However, the responding coaches exhibited inconsistent risk factor awareness and dated injury prevention beliefs. Therefore, better educational collaboration between rehabilitation professionals and high school coaches regarding injury risk factors and preventative strategies is warranted. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- K A Matsel
- University of Kentucky; University of Evansville
| | | | - R J Butler
- Saint Louis Cardinals Baseball Organization
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13
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Rose MJ, McCollum KA, Freehill MT, Cain SM. Quantifying Throw Counts and Intensities Throughout a Season in Youth Baseball Players: A Pilot Study. J Biomech Eng 2021; 143:034502. [PMID: 33156351 DOI: 10.1115/1.4049025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Indexed: 07/25/2024]
Abstract
Overuse injuries in youth baseball players due to throwing are at an all-time high. Traditional methods of tracking player throwing load only count in-game pitches and therefore leave many throws unaccounted for. Miniature wearable inertial sensors can be used to capture motion data outside of the lab in a field setting. The objective of this study was to develop a protocol and algorithms to detect throws and classify throw intensity in youth baseball athletes using a single, upper arm-mounted inertial sensor. Eleven participants from a youth baseball team were recruited to participate in the study. Each participant was given an inertial measurement unit (IMU) and was instructed to wear the sensor during any baseball activity for the duration of a summer season of baseball. A throw identification algorithm was developed using data from a controlled data collection trial. In this report, we present the throw identification algorithm used to identify over 17,000 throws during the 2-month duration of the study. Data from a second controlled experiment were used to build a support vector machine model to classify throw intensity. Using this classification algorithm, throws from all participants were classified as being "low," "medium," or "high" intensity. The results demonstrate that there is value in using sensors to count every throw an athlete makes when assessing throwing load, not just in-game pitches.
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Affiliation(s)
- Michael J Rose
- Department of Mechanical Engineering, University of Michigan, 2350 Hayward Street, Ann Arbor, MI 48109
| | - Katherine A McCollum
- College of Literature, Science and the Arts, University of Michigan, 500 S. State Street, Ann Arbor, MI 48109
| | - Michael T Freehill
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, 450 Broadway, Redwood City, CA 94063
| | - Stephen M Cain
- Department of Mechanical Engineering, University of Michigan, 2350 Hayward Street, Ann Arbor, MI 48109
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14
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Dowling B, McNally MP, Chaudhari AMW, Oñate JA. A Review of Workload-Monitoring Considerations for Baseball Pitchers. J Athl Train 2021; 55:911-917. [PMID: 32991703 DOI: 10.4085/1062-6050-0511-19] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Because of the unique demands of a pitch, baseball players have the greatest percentage of injuries resulting in surgery among high school athletes, with a majority of these injuries affecting the shoulder and elbow due to overuse from throwing. These injuries are believed to occur because of repeated microtrauma to soft tissues caused by the repetitive mechanical strain of throwing. Researchers and practitioners have suggested that baseball pitchers' workloads are a significant risk factor for injury in adolescent players, resulting in lost time and slowing of performance development. The purpose of our review was to investigate the current research relative to monitoring workload in baseball throwers and discuss techniques for managing and regulating cumulative stress on the arm, with a focus on preventing injury and optimizing performance in adolescent baseball pitchers.
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Affiliation(s)
- Brittany Dowling
- Midwest Orthopaedics at Rush, Sports Performance Center, Oak Brook, IL
| | | | - Ajit M W Chaudhari
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - James A Oñate
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus.,Human Performance Collaborative, The Ohio State University, Columbus
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15
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Matsel KA, Butler RJ, Malone TR, Hoch MC, Westgate PM, Uhl TL. Current Concepts in Arm Care Exercise Programs and Injury Risk Reduction in Adolescent Baseball Players: A Clinical Review. Sports Health 2021; 13:245-250. [PMID: 33514287 DOI: 10.1177/1941738120976384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
CONTEXT Awareness of important injury risk factors associated with excessive pitching volume has been highlighted in the literature, but injury rates remain high. Shoulder pain in baseball players is associated with various changes in musculoskeletal movements, which presents as measurable impairments throughout the kinetic chain. Baseball coaches and rehabilitation professionals have utilized exercise programs targeting strength and flexibility of the throwing arm to prevent injuries. The purpose of this review is to summarize the current evidence regarding the effectiveness of arm care exercise programs in reducing upper extremity injury rates in adolescent baseball players. EVIDENCE ACQUISITION A search of electronic databases, including CINAHL with full text, MEDLINE, and SPORTDiscus was conducted to retrieve available articles in English from the years 2010 through 2020. The search terms injury prevention, exercise, and adolescent baseball were used. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 4. RESULTS Improving shoulder internal rotation range of motion by stretching the posterior shoulder muscles daily was associated with a 36% risk reduction of shoulder and elbow injuries. Group-based arm care exercise programs that target multiple musculoskeletal impairments demonstrated an approximately 50% reduced risk of elbow injury. CONCLUSION For adolescent baseball players, arm care injury prevention programs focusing on important musculoskeletal impairments are effective at reducing injury incidence rates. Multimodal injury prevention programs that improve multiple musculoskeletal impairments are more comprehensive and may result in better injury reduction than programs focusing on a singular impairment.
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Affiliation(s)
- Kyle A Matsel
- University of Kentucky, Lexington, Kentucky.,University of Evansville, Evansville, Indiana
| | - Robert J Butler
- Saint Louis Cardinals Baseball Organization, St Louis, Missouri
| | | | | | | | - Tim L Uhl
- University of Kentucky, Lexington, Kentucky
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16
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Injuries and associated risk factors of the shoulder and elbow among adolescent baseball pitchers: A systematic review and meta-analysis. Phys Ther Sport 2020; 43:108-119. [PMID: 32143085 DOI: 10.1016/j.ptsp.2020.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 01/21/2020] [Accepted: 02/24/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The purpose of this study was to perform a systematic review and meta-analysis of the current literature surrounding risk factors associated with shoulder and elbow injuries among adolescent baseball pitchers. METHODS Relevant studies were assessed for inclusion and retained from PubMed, EMBASE, SportDiscus, and CINAHL databases. Data was extracted from the retained studies and underwent methodological quality assessment and meta-analysis. RESULTS The search resulted in 1238 studies identified with 10 ultimately retained for systematic review. Five studies including one case-control, two prospective cohort, and two cross-sectional studies met inclusion criteria for meta-analysis. This meta-analysis revealed that playing with arm fatigue was a significant risk factor (pooled odds ratio = 13.32, 95% confidence interval: 3.22-55.09). The other three risk factors (long competitive season, pitching for more than one team or league, and playing catcher as a secondary position) were not statistically significant. CONCLUSION Pitching with arm fatigue is a significant risk factor for shoulder and elbow injuries among adolescent baseball pitchers. Future efforts in assessment and mitigation of pitching with arm fatigue among this population may help to reduce the risk of arm injuries. Furthermore, investigations of additional risk factors in a more homogeneous population of adolescent pitchers may be warranted.
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17
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Zaremski JL, Zeppieri G, Tripp BL. Sport Specialization and Overuse Injuries in Adolescent Throwing Athletes: A Narrative Review. J Athl Train 2020; 54:1030-1039. [PMID: 31633409 DOI: 10.4085/1062-6050-333-18] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A significant number of adolescent athletes throughout the world participate in various throwing-dominant sports, including but not limited to baseball, cricket, handball, softball, track and field throwing events, and water polo. Due to the unique stresses placed on the throwing arm and entire body in these sports, a robust volume of literature has highlighted concerns about sport specialization in these athletes and an associated increased risk of injury, particularly to the dominant shoulder and elbow, with sport specialization. This review will highlight the evidence-based literature for this athletic niche, focusing on risk factors for injury, national and international organizations' recommendations for limiting overuse injuries, principles of conditioning and rehabilitative programs, and potential future areas of research to curb the growing incidence of throwing-related injuries among adolescent throwing athletes.
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Affiliation(s)
- Jason L Zaremski
- Department of Orthopaedics and Rehabilitation, Divisions of Physical Medicine and Rehabilitation, Sports Medicine, & Research, College of Health and Human Performance, University of Florida, Gainesville
| | - Giorgio Zeppieri
- Orthopaedics and Sports Medicine Institute, Physical Therapy, College of Health and Human Performance, University of Florida, Gainesville
| | - Brady L Tripp
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville
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18
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Zabawa L, Alland JA. Association Between Parental Understanding of Pitch Smart Guidelines and Youth Baseball Player Injuries. Orthop J Sports Med 2019; 7:2325967119846314. [PMID: 31205967 PMCID: PMC6537076 DOI: 10.1177/2325967119846314] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Injuries continue to rise among youth baseball players despite extensive research into prevention and the availability of throwing guidelines such as Pitch Smart. More research is needed to understand whether adherence to the current guidelines decreases injuries. Purpose To understand the degree to which parents are aware of the Pitch Smart guidelines, whether parents adhere to the guidelines, and whether adherence results in decreased injuries in youth baseball players. Study Design Cross-sectional study. Methods An anonymous, internet-based survey consisting of 44 items was distributed to parents of adolescent baseball players affiliated with various youth baseball organizations across the midwestern United States; 15 items on the survey served as assessment questions of the Pitch Smart guidelines. Absolute and percentage correct scores were calculated and compared by use of a Student t test. A chi-square analysis was used to compare discrete data. A binary logistic regression analysis was conducted to determine whether showcase participation predicted player injury. Results A total of 853 parents completed the survey. The mean ± SD age of the players on whom parents reported was 11.37 ± 3.5 years (range, 6-20 years). Among the cohort, 422 players regularly pitched. Regarding Pitch Smart guidelines, the percentage of correct answers by parents was 55.44% ± 0.3% for a player with a reported injury history and 62.14% ± 0.2% for a player without an injury history (P = .012). The number of correct answers was 8.03 ± 4.0 for the group with an injury history and 9.17 ± 3.2 for the group with no history of injury (P = .004). Binary logistic regression analysis, which controlled for age, indicated that showcase participation (P = .001, β = 1.043 ± 0.026, R2 = 0.178) was a significant predictor of player injury. Conclusion Pitchers are at an increased risk of injury compared with nonpitchers. Parents who are knowledgeable about the Pitch Smart throwing guidelines and actively follow them are significantly less likely to have a child with an injury. Excessive showcase participation is predictive of player injury when the analysis controls for age.
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Affiliation(s)
- Luke Zabawa
- University of Illinois at Chicago Medical College, Chicago, Illinois, USA
| | - Jeremy A Alland
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, USA
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