Risk Factors for Throwing-Related Shoulder and Elbow Pain in Adolescent Baseball Players: A Prospective Study of Physical and Developmental Factors

Detection of Factors Related to the Development of Osteochondritis Dissecans in Youth Baseball Players Screening

On-field screening for 'elbow injury in baseball', a condition commonly seen in youth baseball players, was conducted over two years on 160 elementary school students in Ibaraki Prefecture, Japan. This on-field screening was conducted in collaboration with the Ibaraki Prefecture High School Baseball Federation. Pitchers, catchers, symptomatic players, and players who had previously experienced elbow pain were given a comprehensive evaluation that included a physical exam and ultrasound. Out of the 135 students who were successfully screened, 10 were diagnosed with osteochondritis dissecans of the humeral capitellum (OCD). Notably, seven among these were asymptomatic. This assessment identified limited range of motion and pain when extending their elbow as significant risk factors for OCD. An attempt at on-field screening for baseball elbow injuries in collaboration with the local baseball federation was introduced. The risk factors for OCD were identified. Considering these factors, more efficient screening will be possible in the next attempt.

Comparison of Trunk and Pelvic Kinematics in Youth Baseball Pitchers With and Without Upper Extremity Pain: A Cross-Sectional Study

Background

Motion of the pelvis and trunk during baseball pitching is associated with increased upper extremity (UE) kinetics. Increased kinetics on the UE may lead to throwing-arm pain in youth pitchers. Limited biomechanical comparisons have been conducted on youth pitchers with and without throwing-arm pain to identify mechanical risk factors associated with pain.

Purpose

To examine trunk and pelvic kinematics in youth baseball pitchers with and without UE pain.

Study Design

Cross-sectional study; Level of evidence, 3.

Methods

A total of 26 male youth baseball pitchers (mean age, 12.7 ± 1.5 years; mean height, 162.2 ± 12.9 cm; mean weight, 52.6 ± 13.1 kg) were recruited to participate. An electromagnetic tracking system was used to obtain kinematic data during the fastball pitch. Data from a health history questionnaire was examined. Participants who answered "yes" to experiencing pain and who selected a region on their UE as the pain location were placed into the UE pain group. Participants who responded "no" to experiencing pain were placed into the pain-free group. We compared between-group differences in trunk rotation, flexion, and lateral flexion; pelvic rotation, anteroposterior tilt, and lateral tilt; and hip-shoulder separation from peak knee height to ball release of the baseball pitch using 1-dimensional statistical parametric mapping with an alpha level set at .05.

Results

No statistically significant differences were observed between the UE pain and pain-free groups in the 7 trunk and pelvic kinematics analyzed from peak knee height to ball release (P > .05).

Conclusion

Trunk and pelvic kinematics during the pitching motion did not differ between pain and pain-free groups of youth baseball pitchers.

Shoulder stretching versus shoulder muscle strength training for the prevention of baseball-related arm injuries: a randomized, active-controlled, open-label, non-inferiority study

Glenohumeral internal rotation deficit (GIRD) and weakness in prone external rotation are risk factors for shoulder and elbow injuries in high school baseball pitchers. While a shoulder-stretching prevention program to improve GIRD decreases the injury rate, the effects of external rotation strength remain unclear. This non-inferiority (NI) study investigates the hypothesis that external rotation strength training is not inferior to sleeper stretching for shoulder and elbow injury prevention in high school baseball pitchers. Participants were randomly allocated to the stretching (n = 62; active control group) and muscle-training (n = 51) groups. Specific exercises were performed each night. Elbow and shoulder injuries were monitored for 150 days. Kaplan-Meier survival curves were generated, and the hazard ratios (HRs) for injury occurrence were calculated using multivariate Cox regression. The log-rank test was used to compare the injury-free time. A one-sided NI test using a fixed NI margin was performed (significance level, P = 0.025). The injury rates were 22.6% (n = 14) in the stretching group and 9.8% (n = 5) in the muscle-training group. The muscle-training group had a lower injury rate (P < 0.001) and a lower risk of injury than the stretching group (HR = 0.489). Therefore, external rotation muscle strength training is not inferior to stretching for preventing baseball-related arm injuries.

Analysis of Research Trends on Elbow Pain in Overhead Sports: A Bibliometric Study Based on Web of Science Database and VOSviewer

The publications on elbow pain (EP) in overhead sports are increasing. The results of previous studies mostly focus on the influence of EP in the ball game and throwing sports. Thus, a bibliometric analysis of these publications may show the direction of hot topics and future research trends. The purpose of this study is to identify the research trends on EP in overhead sports. For the methods, the first step is to use the main keywords of 'Elbow pain' and 'Overhead sport' merging auxiliary vocabulary to reach the relevant global publications between 1970 and 2022 in the Web of Science (WoS) database. The literature data set is imported into EndNote literature manager software to remove duplication. Secondly, the duplication-reduced articles are imported to an Excel sheet according to the inclusion and exclusion criteria of this study. In the third step, VOSviewer software is applied as the main analysis tool in extracting data for analysis from the articles. Then, the main research results for three aspects are obtained by VOSviewer software which extracted and analyzed the parameters of author name, article title, publication journal, keywords, organization, publication country/region, and the sum of times cited from 455 qualified papers. The study found that the United States of America made the most outstanding contribution to this theme study. The research on EP in overhead sports in China requires more attention from scholars. EP in swimming is a new research direction worthy of attention. In conclusion, the research results prove the growth trend of EP in overhead sports. The EP problem not only exists in the ball game and throwing sports but also swimming. Sport commercialization and the involvement of related professional sports organizations determine the degree of EP's attention in a specific sport and the development of solutions. The development of a region or country also affects the depth and scope of EP study. Clinical research development and in-depth exploration are one of the bases to solve EP problems. Non-clinical action is beneficial to EP patients, but it still needs to be explored and studied.

Understanding the Disabled Throwing Shoulder Requires Updated Review of Anatomy, Mechanics, Pathomechanics, and Treatment

Understanding both shoulder health and shoulder pathology in throwers is relevant to overhead athletes, and also relevant to nonoverhead athletes and even nonathletes. The thrower's shoulder is a clinically relevant topic of medical research scholarship today. Some of the greatest advances in sports medicine result from our ability to visualize normal and pathologic anatomy of joints, including the shoulder, using a small camera and a fiberoptic light source, through small portals, and without disruptive surgical dissection, or, in a word, "arthroscopy." Updates on the thrower's shoulder, including anatomy, mechanics, pathomechanics, and treatment, are essential for clinicians and researchers treating or investigating the shoulder.