scholarly journals Epidemiology of shoulder injuries in young baseball players and grading of radiologic findings of Little Leaguer's shoulder

2015 ◽  
Vol 62 (3.4) ◽  
pp. 123-125 ◽  
Author(s):  
Yoshiji Kanematsu ◽  
Tetsuya Matsuura ◽  
Shinji Kashiwaguchi ◽  
Takenobu Iwase ◽  
Naoto Suzue ◽  
...  
Keyword(s):  
Shoulder Injuries ◽  
Baseball Players ◽  
Radiologic Findings ◽  
Little Leaguer’S Shoulder

scholarly journals Increasing Burden of Youth Baseball Elbow Injuries in US Emergency Departments

2019 ◽  
Vol 7 (5) ◽  
pp. 232596711984563 ◽  
Author(s):  
David P. Trofa ◽  
Kyle K. Obana ◽  
Hasani W. Swindell ◽  
Brian Shiu ◽  
Manish S. Noticewala ◽  
...  
Keyword(s):  
Linear Regression Analysis ◽  
Shoulder Injuries ◽  
Injury Surveillance System ◽  
Baseball Players ◽  
Elbow Injury ◽  
Youth Athletes ◽  
Increased Risk ◽  
Youth Baseball ◽  
Elbow Injuries ◽  
Over Time

Background: Youth athletes are starting sports earlier and training harder. Intense, year-round demands are encouraging early sports specialization under the perception that it will improve the odds of future elite performance. Unfortunately, there is growing evidence that early specialization is associated with increased risk of injury and burnout. This is especially true of pediatric and adolescent baseball players. Purpose/Hypothesis: The purpose of this investigation was to analyze national injury trends of youth baseball players. We hypothesized that while the total number of baseball injuries diagnosed over the past decade would decrease, there would be an increase in adolescent elbow injuries seen nationally. A further hypothesis was that this trend would be significantly greater than other injuries to the upper extremity and major joints. Study Design: Descriptive epidemiology study. Methods: Injury data from the National Electronic Injury Surveillance System, a United States Consumer Product Safety Commission database, were analyzed between January 1, 2006, and December 31, 2016, for baseball players aged ≤18 years. Data were collected on the location of injury, diagnosis, and mechanism of injury. Results: Between 2006 and 2016, an estimated 665,133 baseball injuries occurred nationally. The mean age of the injured players was 11.5 years. The most common injuries diagnosed included contusions (26.8%), fractures (23.6%), and strains and sprains (18.7%). Among major joints, the ankle (25.6%) was most commonly injured, followed by the knee (21.3%), wrist (19.2%), elbow (17.7%), and shoulder (16.2%). The incidence of the ankle, knee, wrist, and shoulder injuries decreased over time, while only the incidence of elbow injuries increased. A linear regression analysis demonstrated that the increasing incidence of elbow injuries was statistically significant against the decreasing trend for all baseball injury diagnoses, as well as ankle, knee, wrist, hand, and finger injuries ( P < .05). Additionally, the only elbow injury mechanism that increased substantially over time was throwing. Conclusion: The current investigation found that while the incidence of baseball injuries sustained by youth players is decreasing, elbow pathology is becoming more prevalent and is more commonly being caused by throwing. Given that the majority of elbow injuries among adolescent baseball players are overuse injuries, these findings underscore the importance of developing strategies to continue to ensure the safety of these youth athletes.

scholarly journals Return to Play in Adolescent Baseball Players after SLAP Repair (131)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0027
Author(s):  
Somnath Rao ◽  
Hareindra Jeyamohan ◽  
Taylor D’Amore ◽  
Robert Jack ◽  
Pankti Acharya ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Short Form ◽  
Return To Play ◽  
Shoulder Injuries ◽  
Baseball Players ◽  
Slap Repair ◽  
Patient Reported ◽  
Outcome Scores ◽  
Future Return

Objectives: Superior labrum from anterior to posterior (SLAP) tears are increasingly common shoulder injuries in adolescent athletes who participate in repetitive overhead throwing. The purpose of this study is to evaluate adolescent baseball athletes who undergo SLAP repair in order to determine their long-term progression of play, surgical outcomes, and overall satisfaction with surgery. Methods: Patients between the ages of 10-19 who underwent a SLAP repair over a 10-year period from 2008-2018 with minimum two year follow-up were identified by a database query in the medical records of a single institution. From this cohort, non-baseball athletes and injuries to non-throwing shoulders were excluded. After identifying the cohort, patients were contacted via phone to complete functional outcome scores including Conway Score, Western Ontario Shoulder Instability (WOSI) Index, Kerlan-Jobe Orthopedic Clinic (KJOC) Shoulder and Elbow Score, Short Form 12 Mental (MCS)/Physical (PCS) survey and a custom return to play questionnaire. Results: During this time period, 59 baseball players met the inclusion criteria for this study and 76.3% (45/59) of patients were available to be contacted to complete final follow-up surveys at a minimum of 2 years. All patients were male with a mean age of 17.4 +/- 1.5 (14-19) years. The mean follow-up of this cohort was 5.3 +/- 2.6 (2.1-12.1) years. The overall return to play rate was 75.6% (34/45). The average time from surgery to initiation of throwing was 5.9 +/- 2.0 (2-12) months and the average time to return to full competition was 11.3 +/- 3.5 (6-22) months after the surgery. After the SLAP repair, those who returned to play continuing playing baseball competitively for 3.0 +/- 1.9 (0.5-8.0) years after surgery. At the time of final follow-up, 71.1% (32/45) of players had stopped playing baseball. Of those who had stopped playing competitive baseball, 12 (37.5%) reported it was because they were not recruited to the next level, 10 (31.3%) reported they lost the desire to play and 10 (31.3%) reported their shoulder prevented them from playing. The overall mean KOJC, WOSI, SF-12 MCS and SF-12 PCS scores were 60.0 +/- 27.4 (range, 0-100), 21.0+/-20.6% (0-73.8%), 55.2+/-3.9 (37.4-59.8) and 55.2+/-5.6 (range, 37.9-65.7) respectively. The overall satisfaction score was 83.2% with 86.7% (39/45) saying they given the opportunity they would undergo surgery again. Conclusions: The results of this study demonstrated a low return to play rate and low patient reported outcomes on baseball specific surveys among adolescent baseball players who underwent a SLAP repair. Mean functional outcome scores between pitchers and position players were not found to be significantly different. Based on these findings, orthopedic surgeons can better counsel their adolescent baseball players on expectations for future return to play and functional outcomes after SLAP repair.

Risk Factors for Elbow and Shoulder Injuries in Adolescent Baseball Players: A Systematic Review

2018 ◽  
Vol 47 (4) ◽  
pp. 982-990 ◽  
Author(s):  
Ryan Norton ◽  
Christopher Honstad ◽  
Rajat Joshi ◽  
Matthew Silvis ◽  
Vernon Chinchilli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Risk Factor ◽  
External Rotation ◽  
Significant Risk ◽  
Shoulder Injuries ◽  
Baseball Players ◽  
Independent Variables ◽  
Arm Injuries ◽  
Independent Risk Factors

Background: The incidence of shoulder and elbow injuries among adolescent baseball players is on the rise. These injuries may lead to surgery or retirement at a young age. Purpose: To identify independent risk factors for elbow and shoulder injuries in adolescent baseball players. A secondary aim was to determine whether the literature supports the Major League Baseball and USA Baseball Pitch Smart guidelines. Study Design: Systematic review. Methods: A systematic review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines utilizing MEDLINE, SPORTDiscus, and Web of Science. Because of study heterogeneity, a quantitative synthesis was not performed. A qualitative review was performed on 19 independent risk factors for elbow and shoulder injuries in adolescent baseball players. Level of evidence was assigned per the Oxford Centre for Evidence-Based Medicine Working Group, and risk of bias was graded per the Newcastle-Ottawa Scale. Results: Twenty-two articles met criteria for inclusion. Of the 19 independent variables that were analyzed, age, height, playing for multiple teams, pitch velocity, and arm fatigue were found to be independent risk factors for throwing arm injuries. Pitches per game appears to be a risk factor for shoulder injuries. Seven independent variables (innings pitched per game, showcase participation, games per year, training days per week, pitch type, shoulder external rotation, and shoulder total range of motion) do not appear to be significant risk factors. The data were inconclusive for the remaining 6 variables (weight, months of pitching per year, innings or pitches per year, catching, shoulder horizontal adduction, and glenohumeral internal rotation deficit). Conclusion: The results from this study demonstrate that age, height, playing for multiple teams, pitch velocity, and arm fatigue are clear risk factors for throwing arm injuries in adolescent baseball players. Pitches per game appears to be a risk factor for shoulder injuries. Other variables are either inconclusive or do not appear to be specific risk factors for injuries.

Baseball Players With an Ulnar Collateral Ligament Tear Display Increased Nondominant Arm Humeral Torsion Compared With Healthy Baseball Players

2016 ◽  
Vol 45 (1) ◽  
pp. 144-149 ◽  
Author(s):  
Casey J. Meyer ◽  
J. Craig Garrison ◽  
John E. Conway
Keyword(s):  
Ulnar Collateral Ligament ◽  
Protective Mechanism ◽  
Shoulder Injuries ◽  
Collateral Ligament ◽  
Baseball Players ◽  
Elbow Injury ◽  
Significant Difference ◽  
Humeral Torsion ◽  
The Mean ◽  
The Relationship

Background: Previous work has suggested that an increase in the amount of developmentally acquired, dominant arm humeral retrotorsion (D HRT) in the thrower’s shoulder may be a potentially protective mechanism. Although the relationship between HRT and shoulder injuries has been reported, the relationship between HRT and ulnar collateral ligament (UCL) tears in baseball players is not known. Purpose: To determine whether D HRT and nondominant arm HRT (ND HRT) measurements in baseball players with a UCL tear differ statistically from a matched healthy cohort. Study Design: Case-control study; Level of evidence, 3. Methods: D HRT and ND HRT were measured in 112 male competitive high school and collegiate baseball players seen over an 18-month period from 2013 to 2015. A total of 56 participants with a clinical and magnetic resonance imaging–confirmed diagnosis of a throwing-arm UCL tear (UCLInj group) were compared with 56 healthy baseball players with no history of an elbow injury who were matched for age, experience, and position (NUCLInj group). The mean ages in the UCLInj and NUCLInj groups were 17.9 ± 2.2 and 17.6 ± 2.8 years, respectively. Using a previously validated ultrasound method, D HRT and ND HRT were measured in the supine position, and the HRT side-to-side difference (D HRT – ND HRT) was calculated. A 1-way multivariate analysis of variance was used to determine the mean statistical differences between groups ( P < .05). Results: Baseball players with a UCL tear displayed significantly more humeral torsion (ie, less retrotorsion) in their nondominant arm compared with healthy baseball players (UCLInj = 33.27° ± 10.27°, NUCLInj = 27.82° ± 10.88°; P = .007). Baseball players with a UCL tear did not display any differences in D HRT compared with healthy baseball players (UCLInj = 18.67° ± 9.41°, NUCLInj = 17.09° ± 9.92°; P = .391). Significant side-to-side differences in HRT existed between groups (UCLInj = −14.60° ± 6.72°, NUCLInj = −10.72° ± 6.88°; P = .003). Conclusion: There was a significant increase in mean nondominant arm humeral torsion (ie, less retrotorsion) in the UCL tear group, but there was no significant difference in the mean D HRT between the injured and uninjured groups. A greater HRT side-to-side difference was displayed in the UCL tear group. The extent to which a thrower has developmentally acquired both D HRT and ND HRT may affect elbow UCL tear risk. Furthermore, it is possible that the extent of genetically predisposed ND HRT may influence the throwing-related increase in D HRT.

THE EFFECT OF COMPETITIVE PITCHING ON THE SHOULDERS AND ELBOWS OF PREADOLESCENT BASEBALL PLAYERS

PEDIATRICS ◽  
1972 ◽  
Vol 49 (2) ◽  
pp. 267-272
Author(s):  
Joseph S. Torg ◽  
Howard Pollack M.D. ◽  
Paul Sweterlitsch
Keyword(s):  
Adverse Effect ◽  
Competitive Situation ◽  
Baseball Players ◽  
Little League ◽  
Little Leaguer’S Shoulder

With the advent of Little League Baseball there has developed an awareness of the adverse effect that excessive pitching can have on the growth areas about the shoulder and elbow of the preadolescents. The terms "Little Leaguer's Shoulder" and "Little Leaguer's Elbow" describe distinct clinical entities. In addition to reviewing these problems, an attempt has been made to identify their cause. Specifically, clinical and radiological observations made on a group of 49 preadolescent pitchers who participated in a low-competition, recreational baseball program are reported. Although the data are not conclusive, we believe our observations indicate that the preadolescent should avoid pitching in an intensely competitive situation.

scholarly journals Little Leaguer’s Shoulder Caused Severe Humeral Retroversion: Ultrasonographic Analysis

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0043
Author(s):  
Teruhisa Mihata ◽  
Masashi Neo
Keyword(s):  
High School ◽  
Junior High ◽  
T Test ◽  
Control Group ◽  
Baseball Players ◽  
Little Leaguer’S Shoulder ◽  
Humeral Retroversion ◽  
And Control ◽  
Dominant Side ◽  
Throwing Motion

Objectives: The increased humeral retroversion on the dominant side in throwing athletes is thought to result from repetitive throwing motion. In the previous studies, the degree of increased humeral retroversion was various, suggesting that other factors may affect humeral retroversion. Little Leaguer’s shoulder, which is rotational stress fracture of the proximal humeral epiphyseal plate, may change humeral retroversion. The purpose of this study was to investigate effect of Little Leaguer’s shoulder on humeral retroversion. Methods: Ten high-school baseball players (average, 16.6 years; range, 16 to 18 years), who had had Little Leaguer’s shoulder during elementary or junior high schools (average, 12.6 years; range, 11 to 15 years), were enrolled in the study. As a control group, 22 high-school baseball players (average, 16.9 years; range, 16 to 18 years), who have never had shoulder or elbow pain, were included in this study. Humeral retroversion was ultrasonographically measured on the dominant and non-dominant sides. Humeral retroversion was compared between dominant and non-dominant shoulders with paired t-test. Side-to-side difference in humeral retroversion was compared between Little Leaguer’s shoulders and control group with unpaired t-test. Results: Humeral retroversion was significantly greater on the dominant side than on the non-dominant side in both Little Leaguer’s shoulder (Dominant, 104°±8°; Non-dominant, 84°±12°; P < .001) and control groups (Dominant, 91°±13°; Non-dominant, 81°±10°; P < .001). The side-to-side difference in humeral retroversion in Little Leaguer’s shoulder group (20°±10°) was significantly greater than that in control group (10°±10°, P = .02). Conclusion: Humeral retroversion was increased with repetitive throwing motion without any symptom in the shoulder and elbow joint. Additional increase in humeral retroversion was made when the players had had Little Leaguer’s shoulder in elementary or junior high school.

Epidemiology of Shoulder and Elbow Injuries Among United States High School Baseball Players: School Years 2005-2006 Through 2014-2015

2017 ◽  
Vol 46 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Michael G. Saper ◽  
Lauren A. Pierpoint ◽  
Wei Liu ◽  
R. Dawn Comstock ◽  
John D. Polousky ◽  
...  
Keyword(s):  
United States ◽  
High School ◽  
Injury Prevention ◽  
Rate Ratio ◽  
Injury Rate ◽  
Injury Surveillance ◽  
Shoulder Injuries ◽  
Baseball Players ◽  
Elbow Injury ◽  
Elbow Injuries

Background: Shoulder and elbow injuries are common in young athletes, especially high school baseball players. Understanding the risk factors associated with baseball injuries is an essential first step in the development of injury prevention strategies. Purpose: To provide a comprehensive understanding of the epidemiology of shoulder and elbow injuries among high school baseball players in the United States. Study Design: Descriptive epidemiological study. Methods: Baseball-related injury data were obtained from the National High School Sports-Related Injury Surveillance Study using High School RIO (Reporting Information Online), an Internet-based sports injury surveillance system. Athletic trainers from high schools across the country uploaded data regarding athlete-exposures (AEs) (defined as practice or game participation) and shoulder and elbow injuries from the school years 2005-2006 through 2014-2015. Results: A total of 241 shoulder injuries and 150 elbow injuries occurred during 1,734,198 AEs during the study period, for an overall shoulder injury rate of 1.39 per 10,000 AEs and an overall elbow injury rate of 0.86 per 10,000 AEs. The overall rates of injury were higher in competitions compared with practices for shoulders (rate ratio, 1.44; 95% CI, 1.11-1.85) and elbows (rate ratio, 2.15; 95% CI, 1.56-2.96). The majority of shoulder (39.6%) and elbow (56.9%) injuries were sustained by pitchers, and most injuries were chronic and caused by overuse. Position players were more likely to sustain injuries by contact with the playing surface or apparatus. For pitchers, muscle strains were the most common shoulder injuries (38.7%), while ligament sprains were the most common elbow injuries (42.7%). The majority of pitchers with shoulder (70.8%) and elbow (64.6%) injuries returned to play within 21 days. Among pitchers, a higher proportion of elbow injuries (11.4%) resulted in medical disqualification compared with shoulder injuries (5.6%). Among pitchers, the majority of shoulder (89.2%) and elbow (96.4%) injuries were managed nonsurgically. Conclusion: Shoulder and elbow injury rates and patterns in high school baseball players differed between field positions (pitchers vs position players) and by type of exposure (practice vs competition). This study suggests several areas of emphasis for targeted injury prevention interventions, most notably limiting fatigue and preventing overuse injuries.

Humeral Retroversion and Injury Risk After Proximal Humeral Epiphysiolysis (Little Leaguer’s Shoulder)

2019 ◽  
Vol 47 (13) ◽  
pp. 3100-3106 ◽  
Author(s):  
Atsushi Ito ◽  
Teruhisa Mihata ◽  
Yuji Hosokawa ◽  
Akihiko Hasegawa ◽  
Masashi Neo ◽  
...  
Keyword(s):  
High School ◽  
Junior High School ◽  
Junior High ◽  
Control Group ◽  
Baseball Players ◽  
Elbow Pain ◽  
Elbow Injury ◽  
Elbow Injuries ◽  
Little Leaguer’S Shoulder ◽  
Humeral Retroversion

Background: The increased humeral retroversion on the dominant side of throwing athletes is thought to result from repetitive throwing motion. Little Leaguer’s shoulder—a rotational stress fracture of the proximal humeral epiphyseal plate—may influence the risk of humeral retroversion and injury of the shoulder or elbow joint. Purpose: To investigate the effect of Little Leaguer’s shoulder on humeral retroversion and the rates of shoulder and elbow injuries. Study Design: Cohort study; Level of evidence, 3. Methods: 10 high school baseball players (average age, 16.6 years; range, 16-18 years) who had experienced Little Leaguer’s shoulder during elementary or junior high school (average age, 12.6 years; range, 11-15 years) were enrolled in the study. As a control group, 22 high school baseball players (average age, 16.9 years; range, 16-18 years) who had never had any shoulder or elbow injury during elementary and junior high school were included. Humeral retroversion on ultrasonographic measurement, shoulder range of motion, and rates of shoulder and elbow injuries were evaluated. Results: Humeral retroversion was significantly greater on the dominant side than on the nondominant side in both players with Little Leaguer’s shoulder (dominant, 104°± 8°; nondominant, 84°± 12°; P < .001) and controls (dominant, 91°± 13°; nondominant, 81°± 10°; P < .001). In the dominant shoulder, humeral retroversion was greater in the Little Leaguer’s shoulder group than in the control group ( P = .008). When the effects of humeral retroversion were excluded, maximal external rotation was significantly less in the dominant shoulder than in the nondominant shoulder in the Little Leaguer’s shoulder group (by 11°± 12°, P = .02), whereas no significant difference was found between dominant (110°± 11°) and nondominant (111°± 13°) shoulders in the control group ( P = .64). The rates of shoulder and elbow pain were significantly higher in the Little Leaguer’s shoulder group (shoulder pain 80%, elbow pain 70%) than in the control group (shoulder pain 9%, P < .001; elbow pain 32%, P = .04). Conclusion: Humeral retroversion was increased in baseball players without any history of shoulder or elbow injury during elementary and junior high school and was further increased in players who had had Little Leaguer’s shoulder. Increased humeral retroversion after Little Leaguer’s shoulder may be a risk factor for future shoulder or elbow injury.

Supraspinatus Tendon Changes and Glenohumeral Range of Motion in College Baseball Players

2021 ◽  
Author(s):  
Tomonobu Ishigaki ◽  
Motoki Hirokawa ◽  
Yuya Ezawa ◽  
Masanori Yamanaka
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Pearson Correlation ◽  
Supraspinatus Tendon ◽  
Shoulder Injuries ◽  
Baseball Players ◽  
Collegiate Baseball ◽  
Tendon Thickness ◽  
College Baseball

AbstractBaseball players commonly show altered glenohumeral range of motion during internal rotation, external rotation, total rotation, and horizontal adduction. These altered ranges of motion appear to be associated with throwing shoulder injuries, which frequently involve the supraspinatus tendons; thus, we aimed to examine the relationship between altered glenohumeral range of motion and supraspinatus tendon changes in collegiate baseball players. To investigate this association using the Pearson correlation coefficient, we measured glenohumeral internal rotation, external rotation, total rotation, and horizontal adduction ranges of motion and supraspinatus tendon thickness in 22 college baseball players. Consequently, there was a significant relationship between increase in supraspinatus tendon thickness and greater deficit of internal rotation (r=–0.520, P=0.013). Increased supraspinatus tendon thickness tended to be associated with greater external rotation gain (r=0.394, P=0.073). No other range of motion had any relationship with supraspinatus tendon changes. These results might indicate that restricted glenohumeral internal rotation and excessive gain in external rotation increase the risk of supraspinatus tendon abnormalities in baseball players.

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