Abstract
Background:
Contributing factors for arm injuries among baseball players have been
described. However, no review has systematically identified risk factors
with findings from prospective cohort studies.
Purpose:
To systematically review prospective cohort studies that investigated risk
factors for arm injury among baseball players.
Study Design:
Systematic review; Level of evidence, 3.
Methods:
Electronic databases were searched for relevant English-language studies.
Titles, abstracts, and full-text articles were screened by 2 blinded
reviewers to identify only prospective cohort studies and randomized
controlled trials. Two independent investigators screened each article for
appropriate criteria.
Results:
Fourteen prospective articles were selected for this review. Youth, high
school, and professional baseball players (N = 2426) were pooled, and 43
risk factors were assessed in relation to general arm, shoulder, and elbow
injuries. All studies evaluated players for at least 1 season. Deficits in
preseason shoulder range of motion and strength were significant risk
factors for general arm or shoulder injury among high school and
professional players. Elbow and shoulder varus torque at peak external
shoulder rotation during pitching, high pitch velocity, and shoulder
rotational and flexion deficits were risk factors for elbow injuries among
professional pitchers. Pitching >100 innings in 1 year, being aged 9 to
11 years, being a pitcher or catcher, training >16 hours per week, and
having a history of elbow pain were significant risk factors for elbow
injury among youth players.
Conclusion:
History of elbow pain and age had a high risk of associated elbow injury
among youth players. Training or pitching load also increased elbow injury
risk for youth athletes. Loss of shoulder range of motion appears to
increase risk for elbow injury among professional athletes. Single
time-point data collections per season, studies with the same sample
population, and studies with self-reported injury and risk factor data may
limit the interpretation of these findings. Health care professionals should
use caution when assessing injury risk during evaluation and making
decisions about the training workload and playing time of baseball
players.
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