Prevention of Elbow Injuries in Youth Baseball Pitchers

Abstract

Context:Although baseball is a relatively safe sport, numerous reports suggest a rapid rise in elbow injury rate among youth baseball pitchers.Evidence Acquisition:PubMed was searched for epidemiologic, biomechanical, and clinical studies of elbow injuries in baseball (keywords: “youth OR adolescent” AND baseball AND pitching AND “ulnar collateral ligament OR elbow”; published January 2000 – April 2012). Studies with relevance to youth baseball pitchers were reviewed. Relevant references from these articles were also retrieved and reviewed. Original data, insight, and recommendations were added.Results:The majority of baseball elbow injuries are noncontact injuries to the dominant arm resulting from repetitive pitching. Five percent of youth pitchers suffer a serious elbow or shoulder injury (requiring surgery or retirement from baseball) within 10 years. The risk factor with the strongest correlation to injury is amount of pitching. Specifically, increased pitches per game, innings pitched per season, and months pitched per year are all associated with increased risk of elbow injury. Pitching while fatigued and pitching for concurrent teams are also associated with increased risk. Pitchers who also play catcher have an increased injury risk, perhaps due to the quantity of throws playing catcher adds to the athlete’s arm. Another risk factor is poor pitching biomechanics. Improper biomechanics may increase the torque and force produced about the elbow during each pitch. Although throwing breaking pitches at a young age has been suggested as a risk factor, existing clinical, epidemiologic, and biomechanical data do not support this claim.Conclusions:Some elbow injuries to youth baseball pitchers can be prevented with safety rules, recommendations, education, and common sense. Scientific and medical organizations have published safety rules and recommendations, with emphasis on prevention of overuse and pitching while fatigued.Strength-of-Recommendation Taxonomy (SORT):A

Stress Sonography of the Ulnar Collateral Ligament of the Elbow in Professional Baseball Pitchers

“…Several reports have shown that these factors play a role in the incidence of elbow pain, elbow injury, and need for elbow surgery in youth and adolescent pitchers; it is possible that these unknown factors may have had an effect on our results. 16-18,33 Last, because our data were obtained from asymptomatic participants, it is difficult to say with certainty if these observed abnormalities on stress US correlate with clinical symptoms and instability. Despite this, our study has shown that stress US can be used for long-term surveillance of the elbows of elite-level pitchers.…”

Risk of Anterior Cruciate Ligament Fatigue Failure Is Increased by Limited Internal Femoral Rotation During In Vitro Repeated Pivot Landings

“…39 Although research has long been directed at elucidating noncontact ACL injury mechanisms, the role of repetitive loading has received little attention. 33 Many joints in the human body are susceptible to repetitive loading injuries, including the wrist, 11 shoulder, 3 elbow, 10 intervertebral disc, 38 and hip. 5 In fact, failures due to tissue fatigue have been reported in the leporine medial collateral ligament 41 and the human extensor digitorum longus tendon.…”

A Survey Examining the Correlations Between Japanese Little League Baseball Coaches’ Knowledge of and Compliance With Pitch Count Recommendations and Player Elbow Pain

“…7 However, the incidence of Little League elbow, the most severe throwing injury among children, is increasing. 2 This injury can sometimes result in children no longer being able to play baseball; therefore, prevention is crucial for Little League baseball players. 4,5,9 …”