Relationship between tightness of the hip joint and shoulder/elbow injury in high school baseball pitchers: a prospective study

Abstract

Some studies have reported that upper limb tightness is a risk factor for shoulder/elbow pain in high school baseball pitchers; but there has been insufficient research on the relationship between lower limb tightness and shoulder and elbow pain in pitchers. This study aimed to clarify the correlation among pre-season hip range of motion (ROM) and shoulder and elbow disorders in high school baseball pitchers. We surveyed 125 high school pitchers. Hip ROM was measured in the supine and prone positions. After the season, based on their answers to the self-recorded questionnaire, a “shoulder or elbow injury” was defined as any condition resulting in the pitcher being considered disabled for ≥ 8 days. An independent t-test and logistic regression analysis were used for statistical analysis. Eleven disabled pitchers (9%) were identified during the season. In the injured group, the ROM of the plant side hip with 90° flexed external rotation was smaller than that in the non-injured group. Preseason limited ROM in the plant side hip with 90° flexed external rotation was a risk factor for the occurrence of shoulder/elbow pain in the season.

Risk factor for elbow symptom manifestation in young baseball players with asymptomatic medial elbow abnormalities: a prospective cohort study

“…Hamano et al demonstrated that preseason limited ROM of the hip with 90° flexed external rotation in the front leg was a risk factor for shoulder/elbow pain in the playing season 16 . In a cross-sectional study, these authors additionally reported that hip external rotation ROM on the back leg was significantly lower in injured high school baseball pitchers than in non-injured pitchers 17 .…”

Lower extremity injuries in the baseball athlete

“…27 Conventional physical therapy techniques, including hip mobility drills, stretching, gluteus medius/minimus strengthening, and dedicated core stability work have been suggested as essential elements of baseball athletic training for injury prevention, particularly among high school athletes in which pelvic and core stability may be relatively underdeveloped. 25,26…”

“…23 Decreased internal rotation ROM while the hip is at 90 degrees of flexion has been identified as a risk factor for shoulder, elbow, back, groin, abdominal, and hamstring injuries in baseball players. 20,[24][25][26] Reduced ROM or hip instability results in subtle, maladaptive compensation throughout the throwing motion, as force that is not properly transmitted throughout the kinetic chain places an increased burden on the distal elements, resulting in accumulation of damage through repeated activity. In addition, injuries to the ulnar collateral ligament (UCL) have been correlated with hip/groin pathology both prior to and after UCL surgery, and although the nature of this relationship is not well-understood, it provides further evidence that altered hip mechanics can be related to both proximal LE injuries and dysfunction of distal kinetic chain components.…”

“…27 Conventional physical therapy techniques, including hip mobility drills, stretching, gluteus medius/ minimus strengthening, and dedicated core stability work have been suggested as essential elements of baseball athletic training for injury prevention, particularly among high school athletes in which pelvic and core stability may be relatively underdeveloped. 25,26 Aside from its importance to the kinetic chain, injuries to the groin and hip joint itself can be significant in baseball athletes. These injuries account for 5.5%-7% of observed injuries across positions, and were to found to result in an average of 37.7 days missed.…”

The Intra- and Inter-rater Reliability of an Arm Care Screening Tool in High School Baseball Coaches

“…17 Although the shoulder and elbow are common areas for symptom development, increased physiological stress on these joints can be produced by other remote regions in the body. 18,19 Risk factors such as glenohumeral internal rotation deficit (GIRD), [20][21][22][23][24] limited hip internal rotation ROM, 25-28 limited hip external rotation, 29 thoracic spine mobility, 30 total shoulder ROM, [22][23][24][31][32][33] and dynamic single leg balance 34 have been identified during comprehensive pre-season examinations and can result in time loss from sport.…”