Relationship Between Tightness of the Hip Joint and Elbow Pain in Adolescent Baseball Players

Abstract

Background:Repetitive tensile stresses from valgus torque can induce elbow injury in adolescent baseball players. Insufficient hip range of motion (ROM) can change throwing mechanics, reducing the transfer of energy from the lower to the upper extremities. Thus, hip ROM limitations may force the upper extremities to bear the burden of a strong throw. Improper pitching mechanics caused by insufficient hip ROM are thought to increase valgus torque on the elbow when throwing, increasing the risk of elbow injury.Purpose:To investigate the relationship between elbow pain and hip ROM in adolescent baseball players.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A total of 122 adolescent baseball players with a mean age of 12.0 years (range, 6-14 years) participated in this study. Elbow pain, hip flexion angle, and the internal rotation angles of the hip at 0° and 90° of flexion were assessed. Participants were divided into a pain group and a normal group based on the pain assessment, and each hip angle was compared between groups using Student t tests. P values <.05 were considered statistically significant.Results:Thirty-one of 122 players had elbow pain. The hip flexion angle of the trail leg was 121.9° ± 12.3° for the normal group and 111.2° ± 11.3° for the pain group (P = .0001). The plant leg hip flexion angles were 122.0° ± 12.4° and 113.6° ± 11.3° (P = .0014) for the normal and pain groups, respectively. The internal rotation angle at 0° of hip flexion of the trail leg was 49.4° ± 12.6° and 45.6° ± 8.8° (not significant), and of the plant leg was 49.1° ± 12.5° and 48.7° ± 11.5° (not significant), for the normal and pain groups, respectively. The internal rotation of the trail leg at 90° of hip flexion was 46.9° ± 13.3° in the normal group and 36.1° ± 15.7° in the pain group (P = .0005). In the plant leg, the internal rotation angle at 90° of hip flexion was 46.9° ± 12.2° and 36.4° ± 18.1° for the normal and pain groups, respectively (P = .0013).Conclusion:Limitations to hip flexion and internal rotation at 90° of hip flexion were risk factors for elbow injury. Differences in internal rotation angles between 0° and 90° of hip flexion may be important criteria for identifying adolescent baseball players at risk of elbow pain.

Hip Range of Motion in Recreational Weight Training Participants: A Descriptive Report

“…Impaired hip ROM may be a relative factor needing to be considered for injury prevention and athletic performance, thus should be considered for inclusion when prescribing exercises for these individuals. 14,19,23 These data are the first to be reported among WT participants, thus should be considered for clinical practice when managing such patients. WT participants may have different values based upon the types of WT activities, performed, thus general population normative values may not be relevant.…”

“…The connection between hip ROM deficits and injury has been reported for other athletic activities. For baseball, a higher risk of shoulder, 13 elbow, 14 and groin injuries 15 have been found in players with hip ROM deficits. Hip ROM deficits have also been associated with hip, groin, and knee injuries in soccer, [16][17][18][19] tennis 20 and ice hockey.…”

“…Given the recent evidence associating hip ROM deficits and athletic injuries, future research in warranted in this population. [13][14][15][50][51][52]20,21 Also, attempts to further classify the recreational WT participant according to the type of weight training and level of training may assist in providing a better understating of subgroups based on WT activities. This may provide insight into common mechanisms of injury related to specific weight training activities and help guide injury prevention strategies.…”

Restriction in the hip internal rotation of the stride leg is associated with elbow and shoulder pain in elite young baseball players

“…Some research has been performed on the relationship between hip ROM and throwing injuries among young baseball players. 10,26,27 Sakata et al 28 reported that a prevention program consisting of 9 stretching and 9 strengthening exercises could prevent elbow injury and improve several indicators of physical function, such as shoulder ROM and hip IR ROM, as well as thoracic kyphosis. A single cross-sectional study showed a significant association between medial elbow injury and hip IR ROM on the stride side.…”

Side-to-side differences in range of motion, muscle strength, and medial elbow laxity in young baseball players with medial elbow injuries

“…If this rotation is inefficient, the medial elbow is likely to be injured due to an increase in mechanical stress on the elbow 9) . Saito et al 10) reported that hip IR ROM in adolescent baseball players with elbow pain was decreased in comparison to that without elbow pain. Among studies of muscle strength, Donatelli et al 11) reported that shoulder ER strength and shoulder ER strength-to-IR strength (ER-to-IR) ratio on the throwing side were lower compared to the nonthrowing side, while strength of shoulder IR and lower *Correspondence: morifujit@kawasakigakuen.ac.jp trapezius (LT) on the throwing side were stronger than those on the non-throwing side of professional baseball players, suggesting that the repeated throwing motion affects strength of rotator cuff and scapular muscles.…”