A small number of daily pitches induces shoulder and elbow injuries among high school baseball pitchers: a prospective study
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ABSTRACT:
SUBMITTER: Shitara H
PROVIDER: S-EPMC7738486 | biostudies-literature | 2020 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundShoulder and elbow overuse injuries are the most common problems in baseball players. No scoping review has compared the findings from different types of evidence.PurposeTo map the broad evidence from 3 types of evidence (epidemiological, biomechanical, and narrative) on potential risk factors for shoulder and elbow injuries in baseball and identify gaps in the existing literature to guide future research.Study designScoping review.MethodsEight electronic databases were searched from inception to May 14, 2020. Any peer-reviewed papers that investigated or discussed potential risk factors for shoulder and elbow injuries in baseball were included.ResultsA total of 302 studies (107 epidemiological studies, 85 biomechanical studies, and 110 narrative reviews) were included. Risk factors were categorized into 9 domains: sports profiles, physical characteristics/functions, pitching mechanics, performance, behavioral, psychosocial, biological and developmental, injury/sports profiles, and environmental factors. Studies were consistent in supporting limited shoulder range of motion (ROM) and player positions (pitchers or catchers) as risk factors for shoulder injuries. For elbow injuries, the majority of the included studies suggested that being pitchers or catchers and working with higher ball velocity can be risk factors.ConclusionFindings were consistent in some risk factors, such as limited shoulder ROM and positions. However, findings were inconsistent or limited for most factors, and substantial research gaps were identified. Research assessing those factors with inconsistent or limited evidence in the current literature were recognized to be priorities for future studies.
| S-EPMC8721392 | biostudies-literature
Project description:BackgroundWeighted-ball throwing programs are commonly used in training baseball pitchers to increase ball velocity. The purpose of this study was to compare kinematics and kinetics among weighted-ball exercises with values from standard pitching (ie, pitching standard 5-oz baseballs from a mound).HypothesisBall and arm velocities would be greater with lighter balls and joint kinetics would be greater with heavier balls.Study designControlled laboratory study.MethodsTwenty-five high school and collegiate baseball pitchers experienced with weighted-ball throwing were tested with an automated motion capture system. Each participant performed 3 trials of 10 different exercises: pitching 4-, 5-, 6-, and 7-oz baseballs from a mound; flat-ground crow hop throws with 4-, 5-, 6-, and 7-oz baseballs; and flat-ground hold exercises with 14- and 32-oz balls. Twenty-six biomechanical parameters were computed for each trial. Data among the 10 exercises were compared with repeated measures analysis of variance and post hoc paired t tests against the standard pitching data.ResultsBall velocity increased as ball mass decreased. There were no differences in arm and trunk velocities between throwing a standard baseball and an underweight baseball (4 oz), while arm and trunk velocities steadily decreased as ball weight increased from 5 to 32 oz. Compared with values pitching from a mound, velocities of the pelvis, shoulder, and ball were increased for flat-ground throws. In general, as ball mass increased arm torques and forces decreased; the exception was elbow flexion torque, which was significantly greater for the flat-ground holds. There were significant differences in body positions when pitching on the mound, flat-ground throws, and holds.ConclusionsWhile ball velocity was greatest throwing underweight baseballs, results from the study did not support the rest of the hypothesis. Kinematics and kinetics were similar between underweight and standard baseballs, while overweight balls correlated with decreased arm forces, torques, and velocities. Increased ball velocity and joint velocities were produced with crow hop throws, likely because of running forward while throwing.Clinical relevanceAs pitching slightly underweight and overweight baseballs produces variations in kinematics without increased arm kinetics, these exercises seem reasonable for training pitchers. As flat-ground throwing produces increased shoulder internal rotation velocity and elbow varus torque, these exercises may be beneficial but may also be stressful and risky. Flat-ground holds with heavy balls should not be viewed as enhancing pitching biomechanics, but rather as hybrid exercises between throwing and resistance training.
| S-EPMC5435148 | biostudies-literature
Project description:BackgroundFatigue in baseball pitchers is a process linked to lowered physical and mental performance, injury, and changes in kinematics. Numerous studies have associated fatigue with overuse, high ball velocities, lack of rest time, poor mechanics, and degree of self-satisfaction. The aim of this study was to systematically review the literature to identify a theoretical framework for the relationship between outcomes and the manifestation of fatigue on baseball pitching. The synthesized data may identify areas requiring further research.MethodologyThis protocol was registered with PROSPERO (ID: CRD42018114194). SPORTDiscus, Medline, PubMed, Cochrane Database of Systematic Reviews, and Google Scholar were searched, using keywords such as fatigue in pitchers and changes in kinematics (e.g., pitching mechanics, valgus elbow torque), performance (e.g., pitch count, pitch type), and injury (e.g., pain, elbow, and shoulder soreness). Three reviewers independently screened the articles, selected relevant literature based on abstract eligibility, and assessed the methods described therein for final inclusion.ResultsA total of 31,860 articles were screened for eligibility and 25 articles were included for the review. The selected articles included epidemiological, longitudinal, experimental, conference papers, and crossover laboratory studies. Evidence extracted from the 25 studies demonstrates a relationship between fatigue in baseball pitching, and three overarching outcomes: changes in kinematics, a decrease in performance, and an increase in injury risk.ConclusionsFindings show that a co-dependence between changes in kinematics and a decrease in performance, which stems from central and peripheral fatigue, is a contributing factor of injury in baseball pitchers. A large percentage of baseball pitchers exhibit pain or soreness in either their elbow or shoulder, or both at some point in a season. Initially, kinematic changes occur that could maintain performance, but may increase joint and tissue loading. Performance decreased with elevated pitch counts and innings thrown, and pitching further into games or the season. Evidence was found to be consistent across all studies; however, more work is needed in the area of fatigue as an injury mechanism during pitching. With a proof of concept established, the prevention of negative outcomes associated with fatigue must be the focus of future research and performance should not be the only criteria.
| S-EPMC6673423 | biostudies-literature
Project description:PURPOSE OF REVIEW:The purposes of this review are to describe the epidemiology, treatment options, and clinical outcomes of revision medial ulnar collateral ligament reconstruction in baseball pitchers. RECENT FINDINGS:Rates of revision UCL range from 1 to 15% and have slowly increased over the past several years. Revision UCL procedures are associated with higher complication rates, likely due to the distortion of innate anatomy after primary reconstruction. Techniques for reconstruction are largely influenced by the index surgery and integrity of the ulnar and humeral bone tunnels/sockets. Current literature reporting on the outcomes following revision UCL reconstruction is limited to case series and database studies. Mean time between primary reconstruction and revision surgery is approximately 5 years and return to play rates range from 47 to 85%. Outcomes following revision UCL reconstruction are relatively guarded compared with those of primary UCL reconstruction with the most studies reporting lower return to play rates, decreased workloads compared with pre-injury levels of play, and shorter career longevity following revision surgery. Future research regarding optimal reconstruction techniques and post-operative rehabilitation are needed as the incidence and demand for this procedure is expected to increase.
| S-EPMC7251017 | biostudies-literature
Project description: Not available
| S-BSST825 | biostudies-other
Project description:BackgroundBone stress injuries (BSIs) are common among runners for which activity modification is the primary treatment. The clinical utility of measuring activity during recovery has not been evaluated.Questions/purposesWe sought to measure the physical activity of runners recovering from BSIs and determine if activity can be correlated with symptoms.MethodsA prospective observational pilot study was performed of runners with a new lower extremity BSI treated non-surgically. For 30 days, activity of runners was measured with a physical activity tracker and daily pain scores were collected.ResultsWe enrolled 18 runners (average age, 33 years; 72% female). Twelve had stress fractures and six had stress reactions. The average daily steps of all runners during the observation period was 10,018 ± 3232, and the runner with the highest daily steps averaged 15,976. There were similar average daily steps in those with stress fractures versus reactions, 10,329 versus 9965, respectively. There was no correlation between daily steps or relative change in daily steps with pain or relative change in pain scores.ConclusionRunners with BSIs averaged over 10,000 steps per day during early recovery. Clinicians may not be aware of the amount of activity runners maintain after being diagnosed with a BSI. Although daily steps and symptoms could not be correlated in this study, objectively measuring activity may assist clinicians in guiding runners recovering from BSIs.
| S-EPMC7749902 | biostudies-literature
Project description:Arm injuries in throwing athletes continue to increase. Injuries may be due to multiple variables, including inefficient body movement patterns, especially in young baseball throwers. It is unclear whether these patterns can be efficiently altered in this population.To investigate the effect of a novel 21-day throwing program on body movement patterns in youth baseball players using common practical tools. Our hypothesis was that this program would change body movement patterns over a relatively short period.Descriptive laboratory study.Ten 9-year-old baseball athletes were asked to participate in a 21-consecutive day throwing program focused on decreasing inefficiencies. All participants underwent video evaluation from 2 vantage points as well as radar evaluation before and after the programs. Throwing arm humerothoracic and antecubital angles as well as pelvic angles in the frontal view were measured at the time of front (directional) leg heel/toe down (late cocking) for each of 3 pitches. Glove-side humerothoracic angles and back leg minimum popliteal angles were measured from behind for each of 3 additional pitches. Velocity was measured using a radar gun. All angular measurements were performed by a physical therapist blinded to the purposes of the program and study as well as to video chronology.Throwing arm antecubital angle (P = .01) and humerothoracic angle (P = .03) as well as back leg minimum popliteal angle (P = .03) all decreased, with mean decreases of 35°, 10°, and 8°, respectively. Velocity increased with decreased back leg popliteal angles (P = .019); mean velocity increased 2.6 mph (P = .016).Young baseball throwers can quickly retrain their bodies to accomplish different movement patterns.This novel throwing program may have implications for injury prevention and treatment as we identify better baseball-throwing movement patterns.
| S-EPMC5495506 | biostudies-other
Project description:Shoulder range of motion and pitch count in baseball pitchers have been linked to pitching-related upper extremity injury.To investigate upper extremity range of motion and pitching profiles in baseball pitchers in Japan as well as to make a comparison between injured and noninjured pitchers.Cross-sectional study; Level of evidence, 3.Forty-one Little League to college-level baseball pitchers were measured for bilateral shoulder and elbow range of motion, including shoulder internal rotation (IR), external rotation (ER), shoulder horizontal adduction (HAD), and elbow extension (EXT). They were also asked to answer a simple questionnaire regarding their past pitching-related medical history and pitching profile. Additionally, 28 participants with baseball-related upper extremity injuries (injury group) were compared with 13 participants without injury (no-injury group) for the same parameters. Collected data were analyzed using analysis of variance.Significant limb differences (dominant vs nondominant side) were noted for ER (117.2° vs 109.8°, P = .02), IR (53.5° vs 61.9°, P = .007), HAD (28.3° vs 32.8°, P = .03), and EXT (1.0° vs 4.6°, P = .01). A significant between-group difference (injury vs no-injury group) was observed for IR in both the dominant (55.4° vs 45.6°, P = .03) and nondominant shoulder (65.3° vs 55.0°, P = .01). Participants in the injury group pitched more games in a season and more innings per game started.Japanese baseball pitchers displayed adaptive changes in upper extremity range of motion similar to American pitchers when compared bilaterally. Injured pitchers exhibited greater IR range of motion in their pitching arm compared with noninjured pitchers.
| S-EPMC5521341 | biostudies-other
Project description:A 26-year-old Olympic wrestling athlete presented with a pectoralis major muscle injury, glenohumeral instability and acromioclavicular joint dislocation separately. The patient underwent surgical treatment to repair these injuries. The pectoralis major muscle was reconstructed with a semitendinosus tendon graft using the endobutton technique, as described by Pochini et al. Treatment of the traumatic anterior instability was performed using the technique described by Bristow-Latarjet, and the acromioclavicular joint dislocation was repaired using the modified technique of Weaver-Dunn with the aid of an anchor. The athlete exhibited a rapid recovery and could return to normal activities 6 months after surgery. At present, 18 months postoperatively, the patient is asymptomatic.
| S-EPMC3987643 | biostudies-other
Project description:Baseball pitchers use various pitch types to reduce hitting accuracy, but little is understood of the practical strategy of using visuomotor skills and timing control to respond to different pitches. This study examined 1) effectiveness of pitch type combinations, and 2) relationship between the presence and absence of advance information about the next pitch and the timing error. Twenty-six high school baseball players hit a ball launched from a pitching machine in a combination of fastballs (34.3±1.3 m·s-1), curveballs (25.4±1.0 m·s-1), and slowballs (25.5±0.9 m·s-1). Each participant performed three conditions. (1) Continuity condition (15 trials), in which the same pitch type was thrown five times consecutively. (2) Random condition (30 trials), in which pitch type was not preliminarily conveyed to the participants. (3) Open condition (20 trials), in which the next pitch type was preliminarily conveyed to participants. Participants' hitting movement was recorded by an optical motion capture system and force platform. We calculated timing error based on the difference between the measured impact location (ball position relative to the batter's body at ball-bat impact) and optimal impact location. The timing error between n-th pitch type, (n-1)-th pitch, and the presence or absence of advance information about pitch type (open vs random condition) were analyzed using three-way repeated ANOVA. The results showed that the (n-1)-th pitch type did not affect the timing of impact (p = 0.338). In contrast, the timing errors in open conditions were fewer compared to random conditions (p < 0.001). These results indicate that the pitch type sequence has insignificant effects, and advance information about pitches affects the timing errors. Therefore, having two or more pitch types, reducing the fluctuation of the pitching motion, and the early trajectory of the ball between different pitches potentially lead to increase timing errors.
| S-EPMC7077830 | biostudies-literature