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Akiho S, Hashida R, Tagawa Y, Maeyama A, Kinoshita K, Kanazawa K, Matsuse H, Hara M, Yamamoto T. Bone morphology and physical characteristics of the pro-cyclist hip joint. INTERNATIONAL ORTHOPAEDICS 2024; 48:1879-1886. [PMID: 38700698 PMCID: PMC11176226 DOI: 10.1007/s00264-024-06196-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/19/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE This study aimed to investigate the radiographic findings for the hip joint and hip range of motion in professional cyclists, and to determine their bone morphology and physical characteristics. The effects of physical characteristics on athletic performance were examined in terms of metabolic efficiency using simulation analysis. METHODS We performed a case-control research study on 22 hips in 11 male professional cyclists (average age 28.5, height 1.73 m, weight 77.6 kg). Thirty hips in 15 healthy male volunteers were selected as controls. As radiographic evaluations, acetabular dysplasia was assessed on standardized radiographs. During physical evaluations, the hip range of motion was examined. We used simulation analysis to investigate the metabolic efficiency in the different cycling forms. RESULTS The radiographic evaluations showed a significant difference in the incidence of acetabular dysplasia (p = 0.01): 59% (13/22 hips) in the pro-cyclist group versus 10% (3/30 hips) in the control group. The physical evaluations revealed significant differences in the hip internal rotation angle (p = 0.01), with greater ranges of internal rotation in the pro-cyclist group versus the control group. The simulation analyses showed that metabolism was reduced in the cycling form with hip internal rotation, especially in the lower extremities. CONCLUSIONS Pro-cyclists showed a high frequency of acetabular dysplasia and superior hip internal rotation. According to the cycling model analyses, hip internal rotation allowed pedaling with reduced metabolic power.
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Affiliation(s)
- Shunsuke Akiho
- Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 810-0180, Japan.
- Orthopaedic Surgery, Fukuoka Seisyukai Hospital, 4-11-8 Chojyabarunishi, Kasuya-Machi, Kasuya-Gun, Fukuoka, 811-2316, Japan.
- Orthopaedic Surgery, Hisatsune Hospital, 152-1 Tadomiushimaru, Sime-Machi, Kasuya-Gun, Fukuoka, 811-2204, Japan.
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital, 67 Asahimachi, Kurume, 830-0011, Japan
- Department of Orthopaedic, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Japan
| | - Yoshihiko Tagawa
- Division of Rehabilitation, Kurume University Hospital, 67 Asahimachi, Kurume, 830-0011, Japan
| | - Akira Maeyama
- Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 810-0180, Japan
| | - Koichi Kinoshita
- Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 810-0180, Japan
| | - Kazuki Kanazawa
- Orthopaedic Surgery, Fukuoka Seisyukai Hospital, 4-11-8 Chojyabarunishi, Kasuya-Machi, Kasuya-Gun, Fukuoka, 811-2316, Japan
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital, 67 Asahimachi, Kurume, 830-0011, Japan
- Department of Orthopaedic, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Japan
| | - Masafumi Hara
- Orthopaedic Surgery, Hisatsune Hospital, 152-1 Tadomiushimaru, Sime-Machi, Kasuya-Gun, Fukuoka, 811-2204, Japan
| | - Takuaki Yamamoto
- Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 810-0180, Japan
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Yanagisawa O. Alterations in pitching biomechanics and performance with an increasing number of pitches in baseball pitchers: A narrative review. PM R 2024; 16:632-643. [PMID: 37574914 DOI: 10.1002/pmrj.13054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/09/2023] [Accepted: 07/28/2023] [Indexed: 08/15/2023]
Abstract
In baseball pitchers, the association of fatigue with overuse injury and decline in pitching performance has been discussed frequently, but the scientific data concerning their interrelationships have been inconsistently reported. The purpose of this narrative review is to summarize and explore the evidence regarding acute changes in pitching biomechanics and performance from repetitive throwing motions among baseball pitchers. Muscle fatigue from repetitive throwing not only decreases muscle output but also disturbs the kinetic chain of baseball pitching. In addition, repetitive throwing can impair the proprioceptive and kinesthetic functions needed for accurate joint position sense in the shoulder and elbow. Consequently, these changes negatively affect ball velocity and pitching accuracy, two critical aspects of overall pitching performance. Moreover, the cumulative loading caused by fatigue contributes to the high prevalence of overuse injuries, particularly in the elbow and shoulder joints. Thus it is important to comprehensively understand the relationships among changed pitching mechanics, deteriorated performance, and musculoskeletal injury originating from muscle fatigue due to repetitive pitching.
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Affiliation(s)
- Osamu Yanagisawa
- Faculty of Business Information Sciences, Jobu University, Isesaki, Japan
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Kouno C, Onishi M, Kawabe R, Doi N, Tahu Y, Nagai-Tanima M, Aoyama T. Incidence and Characteristics of Elbow Injury in Japanese Youth Baseball Players: Comparison Between 2011 and 2021. Orthop J Sports Med 2023; 11:23259671231200844. [PMID: 37846314 PMCID: PMC10576929 DOI: 10.1177/23259671231200844] [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: 04/09/2023] [Accepted: 05/03/2023] [Indexed: 10/18/2023] Open
Abstract
Background Little League elbow, including humeral epicondylitis and osteochondritis dissecans, is a severe throwing injury in school-aged pitchers. Recent rule revisions have been implemented, and thus, prevention awareness may have increased. Purpose To compare the incidence of elbow injury in 2011 from a previous study with that in 2021 and examine changes in the incidence and characteristics of players with elbow injuries. Study Design Cross-sectional study; Level of evidence, 3. Methods A survey based on the 2011 survey was conducted from September 1 to December 31, 2021, among 4060 third- to sixth-grade Little League players belonging to 203 teams in Kyoto, Japan. This survey included a 23-item checklist on physical condition and injury. The participants were classified into 2 groups according to the presence or absence of an elbow injury in the dominant arm during the season. The Wilcoxon rank-sum test was conducted to compare differences in basic information between the 2 groups. We also compared the differences in the 23 checklist items between the 2 groups using the chi-square or Fisher exact probability test. Results Overall, 98 teams (1335 players; age range, 8-12 years) returned the questionnaires (collection rate, 32.9%). The final analysis population (excluding incomplete questionnaires) was 678 (mean age, 10.6 ± 1.1 years). Elbow injuries accounted for 30.7% of all injury sites in the players. Overall, 61 players (9.0%) reported elbow injuries in 2021 compared with 19.1% of the players in the 2011 survey (P < .01) A significantly higher percentage of players with elbow injuries had elbow pain in extension (item 2 on the survey checklist, P < .001) and flexion (item 4, P < .0024), were regular players (item 5, P = .0288), played baseball under fatigue (item 8, P = .0028), and had lower and upper limb inflexibility (item 17, P = .0379; item 18, P = .0146; and item 22, P = .0085). Conclusion Study findings indicated that the incidence of elbow injuries has decreased significantly over the past 10 years, although the elbow joint still accounted for almost one-third of all injuries in Japanese youth baseball players.
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Affiliation(s)
- Chika Kouno
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Miyu Onishi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Rika Kawabe
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoki Doi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yukinobu Tahu
- Kyoto Prefecture Sports Little League Baseball Association, Kyoto, Japan
| | - Momoko Nagai-Tanima
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Aoyama
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Murakami S, Takeuchi S, Okamoto H, Muramatsu N, Sakurai H, Wada I, Goto H. Stand-up test could be a helpful adjunct for screening elbow disorders in Little League baseball players. J Orthop Sci 2023; 28:352-357. [PMID: 34916132 DOI: 10.1016/j.jos.2021.11.019] [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: 10/09/2020] [Revised: 11/08/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The purpose of this study is to justify the result of the modified Stand-Up test (MSUT) in Little League baseball players and to clarify the association with sports related disorders in the elbow. METHODS A total of 245 (240 boys and 5 girls) Little League baseball players aged 9 to 12 underwent physical examination, elbow ultrasonography and questionnaires during a routine medical checkup. In addition, the MSUT, based on the Japanese Orthopaedic Association (JOA)'s original Stand-Up test to evaluate the risk of Locomotive syndrome, was performed. RESULTS Seventeen osteochondritis dissecans (OCD) of capitellum and 4 medial epicondylar fragmentation (MEF) cases were diagnosed with ultrasonography in 242 players. Based on the MSUT, five boys could not stand up from 40 cm platform with the single leg stance, two of whom complained of current elbow pain, three of whom diagnosed with a positive finding with ultrasonography. Odds ratio (95% confidence limits) of risk factors for failing to the 40 cm-MSUT with the single leg stance were: incidence of current elbow pain 5.7 (0.9-35.5); OCD (Grade 1b and 2) 8.2 (0.8-83); and MEF 19.5 (1.7-230). CONCLUSION Two percent of Little League baseball players were unable to stand up from a 40 cm high platform/stool with the single leg stance by the MSUT and it was associated with an increase in MEF or OCD diagnosis by ultrasonography and presence of elbow pain. These results suggest that players who failed to the 40 cm-MSUT with the single leg stance are at risk of elbow disorders. Also, these results are consistent with previous research on throwing injuries that have associated poor control in the legs or trunk with pain and injury involving the upper extremities. MSUT, a relatively simple procedure, may be a helpful adjunct for screening to estimate readiness for resuming general physical activity in Little League baseball players.
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Affiliation(s)
- Satona Murakami
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan; Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
| | - Satoshi Takeuchi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan; Department of Orthopaedic Surgery, National Hospital Organization Toyohashi Medical Center, Toyohashi, Japan
| | - Hideki Okamoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Naoko Muramatsu
- Department of Rehabilitation, Nagoya City University Hospital, Nagoya, Japan
| | - Haruka Sakurai
- Department of Rehabilitation, Nagoya City University Hospital, Nagoya, Japan
| | - Ikuo Wada
- Department of Rehabilitation Medicine, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan; Faculty of Health and Medical Sciences, Aichi Shukutoku University, Nagakute, Japan
| | - Hideyuki Goto
- Department of Sports and Fitness, Faculty of Wellness, Shigakkan University, Obu, Japan
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Rhodes J, Tagawa A, McCoy A, Bazett-Jones D, Skinner A, Leveille L, Franklin C, Chafetz R, Tulchin-Francis K. Using Motion Analysis in the Evaluation, Treatment & Rehabilitation of Pediatric & Adolescent Knee Injuries: A Review of the Literature. Clin Sports Med 2022; 41:671-685. [DOI: 10.1016/j.csm.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Disabled Throwing Shoulder 2021 Update: Part 1-Anatomy and Mechanics. Arthroscopy 2022; 38:1714-1726. [PMID: 35307240 DOI: 10.1016/j.arthro.2022.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/15/2021] [Accepted: 02/03/2022] [Indexed: 02/02/2023]
Abstract
The purpose of this article is to provide updated information for sports health care specialists regarding the Disabled Throwing Shoulder (DTS). A panel of experts, recognized for their experience and expertise in this field, was assembled to address and provide updated information on several topics that have been identified as key areas in creating the DTS spectrum. Each panel member submitted a concise presentation on one of the topics within these areas, each of which were then edited and sent back to the group for their comments and consensus agreement in each area. Part 1 presents the following consensus conclusions and summary findings regarding anatomy and mechanics, including: 1) The current understanding of the DTS identifies internal impingement, resulting from a combination of causative factors, as the final common pathway for the great majority of the labral pathoanatomy; 2) intact labral anatomy is pivotal for glenohumeral stability, but its structure does not control or adapt well to shear or translational loads; 3) the biceps plays an active role in dynamic glenohumeral stability by potentiating "concavity compression" of the glenohumeral joint; 4) the ultimate function of the kinetic chain is to optimize the launch window, the precise biomechanical time, and position for ball release to most effectively allow the ball to be thrown with maximum speed and accuracy, and kinetic chain function is most efficient when stride length is optimized; 5) overhead throwing athletes demonstrate adaptive bony, capsular, and muscular changes in the shoulder with repetitive throwing, and precise measurement of shoulder range of motion in internal rotation, external rotation, and external rotation with forearm pronation is essential to identify harmful and/or progressive deficits. LEVEL OF EVIDENCE: Level V, expert opinion.
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Chen SW, Tang WT, Kung JT, Hung TY, Chen YL, Lin WH, Burgee DJ. Stride Pattern of the Lower Extremities Among Stride Types in Baseball Pitching. Front Sports Act Living 2021; 3:670395. [PMID: 34409287 PMCID: PMC8366559 DOI: 10.3389/fspor.2021.670395] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Abstract
The present study investigated the differences in the stride pattern of the lower extremities among different stride types in baseball pitchers with the aim of evaluating stride movement and skills to improve training effectiveness. Thirty elite male college baseball pitchers volunteered to pitch on an indoor-mound-like force plate, where motion data of their fastest strike trials were collected using an eight-camera motion analysis system at a 200-250 Hz sampling rate. Pelvis center trajectories of each participant were calculated and further categorized into three groups: tall-and-fall (TF), dip-and-drive (DD), and mixed (MX) pitchers. Motion analysis revealed that DD pitchers initiated pivot-knee extension and pivot-hip adduction earlier than TF pitchers and accelerated their bodies sooner than TF pitchers. In addition, TF pitchers accelerated their bodies forward by pivoting their legs until the middle of the arm-cocking and acceleration phases. The movement patterns of MX pitchers were similar to those of DD pitchers in terms of pivot leg, although this occurred a little later in the stride. Our findings are useful in developing training strategies for coaches, players, and trainers to better meet the demands of different pitching styles.
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Affiliation(s)
- Shu-Wei Chen
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Wen-Tzu Tang
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Jung-Tang Kung
- Department of Sports Training Science-Balls, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Tsung-Ying Hung
- Department of Leisure Sports and Health Management, St. John's University, New Taipei City, Taiwan
| | - Yu-Lin Chen
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Wei-Hsuan Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Daniel J. Burgee
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan City, Taiwan
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Hamano N, Shitara H, Tajika T, Ichinose T, Sasaki T, Kuboi T, Shimoyama D, Kamiyama M, Miyamoto R, Endo F, Nakase K, Kobayashi T, Yamamoto A, Takagishi K, Chikuda H. Relationship between the Lower Limb Function and Shoulder and Elbow Injuries in Elementary School Baseball Pitchers. Prog Rehabil Med 2021; 6:20210015. [PMID: 33728384 PMCID: PMC7952376 DOI: 10.2490/prm.20210015] [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: 10/19/2020] [Accepted: 02/03/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives We aimed to examine the relationship between the hip range of motion (ROM) and ankle ROM and throwing-related shoulder and elbow injuries in elementary school baseball pitchers. Methods This retrospective comparative study (Level of evidence: Level III) included 195 baseball pitchers (mean age 10.8±1.0 years, range 8-12 years). All pitchers underwent physical function measurements, including height, weight, shoulder strength, and hip and ankle ROM. Shoulder and elbow injury was defined as shoulder and elbow pain that the pitchers had been aware of in the past or at the time of medical checkups. The results for the injured and non-injured groups were then compared. Results The shoulder ROM and strength in the injured and non-injured groups did not differ to a statistically significant extent. The hip external rotation on the dominant side (injured vs. non-injured: 48.9±11.1° vs. 53.3±9.7°, P<0.01), the hip internal rotation on the non-dominant side (injured vs. non-injured: 36.6±12.0° vs. 40.9±11.0°, P=0.01), and ankle plantar flexion on the non-dominant side (injured vs. non-injured: 52.0±6.8° vs. 54.3±6.7°, P=0.02) were significantly smaller in the injured group than in the non-injured group. Conclusions The hip external rotation ROM on the dominant side and the hip internal rotation and ankle plantar flexion on the non-dominant side were significantly lower in the injured group than in the non-injured group. These results may suggest measures to reduce the incidence of elbow and shoulder injuries in elementary school baseball pitchers.
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Affiliation(s)
- Noritaka Hamano
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hitoshi Shitara
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tsuyoshi Ichinose
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tsuyoshi Sasaki
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takuro Kuboi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Daisuke Shimoyama
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masataka Kamiyama
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Ryosuke Miyamoto
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Fumitaka Endo
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kurumi Nakase
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tsutomu Kobayashi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Atsushi Yamamoto
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kenji Takagishi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
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Ankle dorsiflexion deficit in the back leg is a risk factor for shoulder and elbow injuries in young baseball players. Sci Rep 2021; 11:5500. [PMID: 33750882 PMCID: PMC7943763 DOI: 10.1038/s41598-021-85079-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/25/2021] [Indexed: 11/08/2022] Open
Abstract
The relationship between ankle joint function and throwing-related injuries has not been demonstrated. We hypothesized that limited ankle joint range of motion (ROM) was related to risk factors for shoulder and elbow injuries in young baseball players. This 12-month prospective cohort study evaluated the age, height, weight, playing position, shoulder, elbow, and ankle function of 228 enrolled baseball players. Shoulder and elbow injuries were tracked during the season. Univariate and multivariate analyses were performed to identify risk factors for shoulder and elbow injuries among participants divided into non-injured and injured groups. Univariate analysis showed that age, height, weight, ROM of elbow flexion in the dominant arm, muscle strength ratio of shoulder abduction, and the likelihood of being a pitcher or a catcher were significantly greater in the injured group than in the non-injured group. ROM of shoulder abduction-external/internal rotation, shoulder total arc on the dominant arm, ankle joint dorsiflexion, and plantar flexion on the back (non-lead) and front (lead) legs were significantly less in the injured group than in the non-injured group. In conclusion, ROM dorsiflexion deficits in the back leg, shoulder abduction-external rotation in the dominant arm, ROM increase in elbow flexion on the dominant side, older age, and being a pitcher were significant independent risk factors for injury.
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Bakshi NK, Inclan PM, Kirsch JM, Bedi A, Agresta C, Freehill MT. Current Workload Recommendations in Baseball Pitchers: A Systematic Review. Am J Sports Med 2020; 48:229-241. [PMID: 31013139 DOI: 10.1177/0363546519831010] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Several recommendations have been made regarding pitch counts and workload for baseball players of different levels, including Little League, high school, collegiate, and professional baseball. However, little consensus is found in the literature regarding the scientific basis for many of these recommendations. PURPOSE The primary purpose of this study was to summarize the evidence regarding immediate and long-term musculoskeletal responses to increasing pitching workload in baseball pitchers of all levels. A secondary purpose of this review was to evaluate the extent to which workload influences injury and/or performance in baseball pitchers. STUDY DESIGN Systematic review. METHODS We performed a systematic search in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for studies addressing physiologic and/or pathologic musculoskeletal changes in response to a quantifiable pitching workload. We included studies examining the effects of pitching workload on performance, injury rate, and musculoskeletal changes in Little League, high school, collegiate, and professional baseball players. RESULTS We identified 28 studies that met our inclusion and exclusion criteria: 16 studies regarding Little League and high school pitchers and 12 studies regarding collegiate and professional pitchers. The current evidence presented suggests that increased pitching workload may be associated with an increased risk of pain, injury, and arm fatigue in Little League and high school pitchers. However, little consensus was found in the literature regarding the association between pitching workload and physiologic or pathologic changes in collegiate and professional pitchers. CONCLUSION Evidence, although limited, suggests the use of pitch counts to decrease injury rates and pain in Little League and high school baseball pitchers. However, further research must be performed to determine the appropriate number of pitches (or throws) for players of different ages. This systematic review reported conflicting evidence regarding the use of pitch counts in college and professional baseball. Future high-quality research is required to determine the role, if any, of pitch counts for collegiate and professional pitchers.
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Affiliation(s)
- Neil K Bakshi
- Department of Orthopedic Surgery, University of Michigan, Ypsilanti, Michigan, USA
| | - Paul M Inclan
- Department of Orthopedic Surgery, Washington University in St Louis, St Louis, Missouri, USA
| | - Jacob M Kirsch
- Department of Orthopedic Surgery, University of Michigan, Ypsilanti, Michigan, USA
| | - Asheesh Bedi
- Department of Orthopedic Surgery, University of Michigan, Ypsilanti, Michigan, USA
| | - Cristine Agresta
- School of Kinesiology, University of Michigan, Ypsilanti, Michigan, USA
| | - Michael T Freehill
- Department of Orthopedic Surgery, University of Michigan, Ypsilanti, Michigan, USA
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Wasserberger K, Barfield J, Anz A, Andrews J, Oliver G. Using the single leg squat as an assessment of stride leg knee mechanics in adolescent baseball pitchers. J Sci Med Sport 2019; 22:1254-1259. [PMID: 31285146 DOI: 10.1016/j.jsams.2019.06.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/13/2019] [Accepted: 06/21/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Lack of control of the lower extremity or trunk during single leg tasks is often associated with pathomechanic adaptations during the pitching motion which may increase the risk of pain and injury to the upper extremity. The objectives of the study were to determine the amount of variability in stride knee mechanics accounted for by compensations during a common movement assessment, the single leg squat (SLS) and to establish the usefulness of SLS as a screening tool for at-risk athletes. DESIGN Cross-sectional design. METHODS Sixty-one adolescent baseball pitchers performed a SLS on each leg. Participants performed three fastball pitches to a catcher at a regulation distance. Kinematic data were collected at 100Hz using an electromagnetic tracking device. RESULTS MANOVAs with follow-up one-way ANOVAs were used to examine the amount of variance in pitching knee mechanics explained by SLS compensations. At stride foot contact, there was a significant effect of SLS valgus angle on knee valgus angle (F1,51=23.16, p<0.001, ηp2=0.31) and valgus moment (F1,51=8.28, p=0.006, ηp2=0.14). At ball release (BR), there was a significant effect of SLS valgus angle on flexion angle (F1,51=9.37, p=0.004, ηp2=0.16) and valgus angle (F1,51 = 26.93, p<0.001, ηp2=0.35). Examination of the average values occurring between SFC and BR, revealed a significant effect of SLS valgus angle on knee valgus angle (F1,51=30.91, p<0.001, ηp2=0.38). CONCLUSIONS SLS compensations are potentially a useful screening tool for stride knee mechanics in adolescent baseball pitchers.
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Affiliation(s)
- Kyle Wasserberger
- Sports Medicine & Movement Laboratory, School of Kinesiology, Auburn University, Alabama, United States
| | - Jeff Barfield
- Sports Medicine & Movement Laboratory, School of Kinesiology, Auburn University, Alabama, United States
| | - Adam Anz
- Andrews Research & Education Foundation, Gulf Breeze, Florida, United States
| | - James Andrews
- Andrews Research & Education Foundation, Gulf Breeze, Florida, United States
| | - Gretchen Oliver
- Sports Medicine & Movement Laboratory, School of Kinesiology, Auburn University, Alabama, United States.
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van Trigt B, Schallig W, van der Graaff E, Hoozemans MJM, Veeger D. Knee Angle and Stride Length in Association with Ball Speed in Youth Baseball Pitchers. Sports (Basel) 2018; 6:sports6020051. [PMID: 29910355 PMCID: PMC6026789 DOI: 10.3390/sports6020051] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/24/2018] [Accepted: 05/23/2018] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to determine whether stride length and knee angle of the leading leg at foot contact, at the instant of maximal external rotation of the shoulder, and at ball release are associated with ball speed in elite youth baseball pitchers. In this study, fifty-two elite youth baseball pitchers (mean age 15.2 SD (standard deviation) 1.7 years) pitched ten fastballs. Data were collected with three high-speed video cameras at a frequency of 240 Hz. Stride length and knee angle of the leading leg were calculated at foot contact, maximal external rotation, and ball release. The associations between these kinematic variables and ball speed were separately determined using generalized estimating equations. Stride length as percentage of body height and knee angle at foot contact were not significantly associated with ball speed. However, knee angles at maximal external rotation and ball release were significantly associated with ball speed. Ball speed increased by 0.45 m/s (1 mph) with an increase in knee extension of 18 degrees at maximal external rotation and 19.5 degrees at ball release. In conclusion, more knee extension of the leading leg at maximal external rotation and ball release is associated with higher ball speeds in elite youth baseball pitchers.
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Affiliation(s)
- Bart van Trigt
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 BT Amsterdam, The Netherlands.
| | - Wouter Schallig
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 BT Amsterdam, The Netherlands.
| | - Erik van der Graaff
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 BT Amsterdam, The Netherlands.
| | - Marco J M Hoozemans
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 BT Amsterdam, The Netherlands.
| | - Dirkjan Veeger
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 BT Amsterdam, The Netherlands.
- Department of Biomechanical Engineering, Delft University of Technology, 2828 CE Delft, The Netherlands.
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