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      Pitch Velocity Is a Predictor of Medial Elbow Distraction Forces in the Uninjured High School–Aged Baseball Pitcher

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          Abstract

          Background:

          Medial elbow injuries are common among baseball pitchers. Easily accessed methods to assess medial elbow stress may be useful in identifying individuals with increased injury risk.

          Hypothesis:

          Pitch velocity (PV) is positively associated with higher medial elbow adduction moments.

          Study Design:

          Cohort study; Level of evidence, 2.

          Methods:

          Participants included 26 uninjured high school pitchers, 15 to 18 years in age. Three-dimensional data and PV were collected as athletes threw 10 fastballs for strikes to a regulation-distance target. Variables of interest were the normalized peak internal elbow adduction moment and peak PV. Linear regression was performed to evaluate the influence of PV on the adduction moment.

          Results:

          For the group, mean PV was 71 mph (range, 58-81 mph), and the adduction moment was 0.558 Nm/Ht × mass (range, 0.378-0.723). PV was positively associated with the adduction moment ( P < 0.01, R 2= 0.373).

          Conclusions:

          Talented young pitchers may be more susceptible to elbow injuries as a consequence of a biomechanical coupling between PV and upper extremity joint moments.

          Clinical Relevance:

          PV may be measured easily and serve as an indicator of medial elbow stress.

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          Risk factors for shoulder and elbow injuries in adolescent baseball pitchers.

          Jason R Andrews, J. Olsen, Jeremy Loftice … (2006)
          There is little evidence supporting current safety recommendations for adolescent pitchers. Pitching practices of adolescent pitchers without history of arm injury will be significantly different from those of adolescent pitchers who required shoulder or elbow surgery. Case control study; Level of evidence, 3. Ninety-five adolescent pitchers who had shoulder or elbow surgery and 45 adolescent pitchers who never had a significant pitching-related injury completed a survey. Responses were compared between the 2 groups using t tests and chi(2) analyses. Multivariable logistic regression models were developed to identify the risk factors. The injured group pitched significantly more months per year, games per year, innings per game, pitches per game, pitches per year, and warm-up pitches before a game. These pitchers were more frequently starting pitchers, pitched in more showcases, pitched with higher velocity, and pitched more often with arm pain and fatigue. They also used anti-inflammatory drugs and ice more frequently to prevent an injury. Although the groups were age matched, the injured group was taller and heavier. There were no significant differences regarding private pitching instruction, coach's chief concern, pitcher's self-rating, exercise programs, stretching practices, relieving frequency, pitch type frequency, or age at which pitch types were first thrown. Pitching practices were significantly different between the groups. The factors with the strongest associations with injury were overuse and fatigue. High pitch velocity and participation in showcases were also associated with increased risk for injury. New recommendations were made based on these results. Adherence to the recommendations may reduce the incidence of significant injury to adolescent pitchers.
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            Risk of serious injury for young baseball pitchers: a 10-year prospective study.

            Adam Weber, Jason R Andrews, Jeremy Loftice … (2011)
            The risk of elbow or shoulder injury for young baseball pitchers is unknown. PURPOSE/ HYPOTHESIS: The purpose of this study was to quantify the cumulative incidence of throwing injuries in young baseball pitchers who were followed for 10 years. Three hypotheses were tested: Increased amount of pitching, throwing curveballs at a young age, and concomitantly playing catcher increase a young pitcher's risk of injury. Cohort study; Level of evidence, 3. In sum, 481 youth pitchers (aged 9 to 14 years) were enrolled in a 10-year follow-up study. Participants were interviewed annually. Injury was defined as elbow surgery, shoulder surgery, or retirement due to throwing injury. Fisher exact test compared the risk of injury between participants who pitched at least 4 years during the study and those who pitched less. Fisher exact tests were used to investigate risks of injury for pitching more than 100 innings in at least 1 calendar year, starting curveballs before age 13 years, and playing catcher for at least 3 years. The cumulative incidence of injury was 5.0%. Participants who pitched more than 100 innings in a year were 3.5 times more likely to be injured (95% confidence interval = 1.16 to 10.44). Pitchers who concomitantly played catcher seemed to be injured more frequently, but this trend was not significant with the study sample size. Pitching more than 100 innings in a year significantly increases risk of injury. Playing catcher appears to increase a pitcher's risk of injury, although this trend is not significant. The study was unable to demonstrate that curveballs before age 13 years increase risk of injury. The risk of a youth pitcher sustaining a serious throwing injury within 10 years is 5%. Limiting the number of innings pitched per year may reduce the risk of injury. Young baseball pitchers are encouraged to play other positions as well but might avoid playing catcher.
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              Longitudinal study of elbow and shoulder pain in youth baseball pitchers.

              STEPHEN LYMAN, GLENN FLEISIG, JOHN WATERBOR … (2001)
              Previous studies among young pitchers have focused on the frequency and description of elbow injuries. The purpose of this study was to evaluate the frequency of elbow and shoulder complaints in young pitchers and to identify the associations between pitch types, pitch volume, and other risk factors for these conditions. A prospective cohort study of 298 youth pitchers was conducted over two seasons. Each participant was contacted via telephone after each game pitched to identify arm complaints. Generalized estimating equations were used to assess associations between arm complaints and independent variables. The frequency of elbow pain was 26%; that of shoulder pain, 32%. Risk factors for elbow pain were increased age, increased weight, decreased height, lifting weights during the season, playing baseball outside the league, decreased self-satisfaction, arm fatigue during the game pitched, and throwing fewer than 300 or more than 600 pitches during the season. Risk factors for shoulder pain included decreased satisfaction, arm fatigue during the game pitched, throwing more than 75 pitches in a game, and throwing fewer than 300 pitches during the season. Arm complaints are common, with nearly half of the subjects reporting pain. The factors associated with elbow and shoulder pain were different, suggesting differing etiologies. Developmental factors may be important in both. To lower the risk of pain at both locations, young pitchers probably should not throw more than 75 pitches in a game. Other recommendations are to remove pitchers from a game if they demonstrate arm fatigue and limit pitching in nonleague games.
              Article 0 comments Cited 133 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Sports Health
                Journal ID (iso-abbrev): Sports Health
                Journal ID (publisher-id): SPH
                Journal ID (hwp): spsph
                Title: Sports Health
                Publisher: SAGE Publications (Sage CA: Los Angeles, CA )
                ISSN (Print): 1941-7381
                ISSN (Electronic): 1941-0921
                Publication date (Print and electronic): September 2012
                Publication date (Print): September 2012
                Volume: 4
                Issue: 5
                Pages: 415-418
                Affiliations
                [† ]Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
                [‡ ]Kerlan-Jobe Orthopedic Clinic, Los Angeles, California
                Author notes
                [*] [* ]Address correspondence to Wendy J. Hurd, PT, PhD, SCS, Charlton North Building, L110, Rochester, MN 19716 (e-mail: hurd.wendy@ 123456mayo.edu )
                Article
                Publisher ID: 10.1177_1941738112439695
                DOI: 10.1177/1941738112439695
                PMC ID: 3435942
                PubMed ID: 23016114
                SO-VID: 64766c23-9c25-43fc-a254-c9fc0a96c923
                Copyright © © 2012 The Author(s)
                History
                Categories
                Subject: Athletic Training
                Subject: 2
                Subject: 6
                Subject: 108
                Custom metadata
                cover-date September/October 2012

                ScienceOpen disciplines: Sports medicine
                Keywords: biomechanics,throwing,upper extremity,adolescent,injury risk
                Data availability:
                ScienceOpen disciplines: Sports medicine
                Keywords: biomechanics, throwing, upper extremity, adolescent, injury risk

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