Hitoshi Shitara1, Tsutomu Kobayashi2, Atsushi Yamamoto3, Daisuke Shimoyama3, Tsuyoshi Ichinose3, Tsuyoshi Tajika3, Toshihisa Osawa4, Haku Iizuka3, Kenji Takagishi3. 1. Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan. hshitara@gunma-u.ac.jp. 2. Department of Physical Therapy, Takasaki University of Health and Welfare, 37-1 Nakaorui, Takasaki, Gunma, 370-0033, Japan. 3. Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan. 4. Department of Orthopaedic Surgery, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu, Takasaki, Gunma, 370-0829, Japan.
Abstract
PURPOSE: To prospectively identify preseason physical factors for shoulder and elbow injuries during the season in high school baseball pitchers. METHODS: The study included 105 high school baseball pitchers [median age 16 (15-17) years]. The range of motion of the shoulder (90° abducted external and internal rotation) and elbow (extension/flexion), shoulder muscle strength (abduction and prone internal and external rotation), shoulder and elbow laxity, horizontal flexion, and scapular dyskinesis were assessed. After the season, the participants completed questionnaires regarding shoulder and/or elbow injuries, with injury defined as an inability to play for ≥1 week due to elbow/shoulder problems. The results of two groups (injured and noninjured) were compared using t tests and Chi-square analyses. Stepwise forward logistic regression models were developed to identify risk factors. RESULTS: Twenty-one injuries were observed. In univariate analysis, 90° abducted internal rotation and total arc of the dominant shoulder and the ratio of prone external rotation in the dominant to nondominant sides in the injured group were significantly less than those in the noninjured group (P = 0.02, 0.04, and 0.01, respectively). In logistic regression analysis, 90° abducted internal rotation in the dominant shoulder and prone external rotation ratio were significantly associated with injuries (P = 0.02 and 0.03, respectively). CONCLUSION: A low prone external rotation ratio and decreased 90° abducted internal rotation in the dominant shoulder in the preseason were significant risk factors for shoulder and elbow injuries in high school baseball pitchers. The results may contribute to reduce the incidence of these injuries. LEVEL OF EVIDENCE: II.
PURPOSE: To prospectively identify preseason physical factors for shoulder and elbow injuries during the season in high school baseball pitchers. METHODS: The study included 105 high school baseball pitchers [median age 16 (15-17) years]. The range of motion of the shoulder (90° abducted external and internal rotation) and elbow (extension/flexion), shoulder muscle strength (abduction and prone internal and external rotation), shoulder and elbow laxity, horizontal flexion, and scapular dyskinesis were assessed. After the season, the participants completed questionnaires regarding shoulder and/or elbow injuries, with injury defined as an inability to play for ≥1 week due to elbow/shoulder problems. The results of two groups (injured and noninjured) were compared using t tests and Chi-square analyses. Stepwise forward logistic regression models were developed to identify risk factors. RESULTS: Twenty-one injuries were observed. In univariate analysis, 90° abducted internal rotation and total arc of the dominant shoulder and the ratio of prone external rotation in the dominant to nondominant sides in the injured group were significantly less than those in the noninjured group (P = 0.02, 0.04, and 0.01, respectively). In logistic regression analysis, 90° abducted internal rotation in the dominant shoulder and prone external rotation ratio were significantly associated with injuries (P = 0.02 and 0.03, respectively). CONCLUSION: A low prone external rotation ratio and decreased 90° abducted internal rotation in the dominant shoulder in the preseason were significant risk factors for shoulder and elbow injuries in high school baseball pitchers. The results may contribute to reduce the incidence of these injuries. LEVEL OF EVIDENCE: II.
Entities:
Keywords:
Baseball; High school pitcher; Multifactorial analysis; Prospective; Risk factor
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