Increasing Burden of Youth Baseball Elbow Injuries in US Emergency Departments

Abstract

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.

Prevalence and Consequences of Sport Specialization Among Little League Baseball Players

“…32 Despite the popularity of youth baseball and the known benefits of youth sport participation, there has been a concerning rise in the rates of certain overuse injuries among youth baseball players. 16,22,33 For example, the infamous "Tommy John" surgery, also known as elbow ulnar collateral ligament (UCL) reconstruction, was once reserved for veteran pitchers nearing the end of their careers. However, 60% of current UCL reconstructions are performed on pitchers 970956S PHXXX10.…”

Is Allograft Reconstruction of the Medial Ulnar Collateral Ligament of the Elbow a Viable Option for Nonelite Athletes? Outcomes at a Mean of 8 Years

“…Over the past decade, there has been an increase in the frequency of MUCL injuries not only in high-level athletes but also in adolescent and youth athletes. 19 , 38 , 43 As a response, a significant body of research has been published in the past 2 decades attempting to understand the optimal anatomic configuration of MUCL grafts and anchors during reconstruction. ‡ While the results of MUCL reconstruction are generally reliable in throwing athletes, the vast majority of this literature is still focused on the young, elite athlete population utilizing autograft.…”

Influence of pitching grip on shoulder and elbow injuries in junior baseball players, focusing on hand length and the metacarpophalangeal joint angle

“…It is imperative to prevent injuries in junior players because they can result in significant immediate and long-term consequences, including risk of future injuries, cognitive deficits, and other health burdens 12) . The majority of baseball elbow injuries are non-contact injuries to the dominant arm resulting from repetitive pitching 13,14) .…”