Risk Factors for Shoulder and Elbow Injuries in High School Baseball Pitchers

Tyler, Timothy F.; Mullaney, Michael J.; Mirabella, Michael R.; Nicholas, Stephen; McHugh, Malachy P.

doi:10.1177/0363546514535070

Cited by 113 publications

(158 citation statements)

References 18 publications

(56 reference statements)

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“…After successfully contacting three authors,24 34 35 five studies met the inclusion and exclusion criteria and were included in the meta-analysis 36 37. Of the four studies excluded at full-text review, one text was not available in full text,38 one was cross-sectional in study design,39 one did not distinguish between shoulder and elbow injuries25 and one measured scapular muscle strength but not scapular dyskinesis 40…”

Section: Resultsmentioning

confidence: 99%

Scapular dyskinesis increases the risk of future shoulder pain by 43% in asymptomatic athletes: a systematic review and meta-analysis

et al. 2017

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BackgroundIt is unclear whether the presence of scapular dyskinesis increases the risk of developing shoulder pain in asymptomatic athletes.ObjectivesTo determine whether the presence of scapular dyskinesis in asymptomatic athletes increases the risk of developing shoulder pain by systematic review and meta-analysis.MethodsA systematic search was conducted in the Cochrane Library, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database and SPORTDiscus. Prospective studies that assessed athletes for scapular dyskinesis and recorded incidents of shoulder pain were included. Study quality was assessed using the Downs and Black checklist. Meta-analysis was conducted to derive a pooled risk ratio (RR) for the development of shoulder pain in athletes with scapular dyskinesis compared with those without scapular dyskinesis.ResultsFive studies were included with a total of 419 athletes. Of the athletes with scapular dyskinesis, 35% (56/160) experienced shoulder pain during the follow-up, whereas 25% (65/259) of athletes without scapular dyskinesis experienced symptoms. The presence of scapular dyskinesis at baseline indicated a 43% increased risk of a shoulder pain event over a 9 to 24 months follow-up (RR=1.43, 95% CI 1.05 to 1.93).ConclusionsAthletes with scapular dyskinesis have 43% greater risk of developing shoulder pain than those without scapular dyskinesis.

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Section: Resultsmentioning

confidence: 99%

Scapular dyskinesis increases the risk of future shoulder pain by 43% in asymptomatic athletes: a systematic review and meta-analysis

et al. 2017

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“…Regarding rotator cuff strength, external rotation weakness and low ratios of concentric and eccentric external to internal rotation strength have been reported as risk factors in handball and baseball 2 6 22–24. In addition, weakness in glenohumeral abduction strength has been associated with shoulder injury in baseball 6 24 25. Recently, the presence of scapular dyskinesis was reported as a risk factor correlated with shoulder problems in elite handball 2.…”

Section: Introductionmentioning

confidence: 99%

Preventing overuse shoulder injuries among throwing athletes: a cluster-randomised controlled trial in 660 elite handball players

et al. 2016

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Dette er siste tekst-versjon av artikkelen, og den kan inneholde små forskjeller fra forlagets pdf-versjon. Forlagets pdf-versjon finner du på bjsm.bmj.com: http://dx.doi. org/10.1136/bjsports-2016-096226 This is the final text version of the article, and it may contain minor differences from the journal's pdf version. Design Stratified cluster-randomised controlled trial with teams as the unit of randomisation.Setting 45 handball teams (22 female, 23 male) from the two upper divisions in Norway (22 in the intervention group, 23 in the control group) were followed for one competitive season (7 months).Participants 660 players aged 16-47 (331 in the intervention group, 329 in the control group).Intervention Ten-minute comprehensive exercise program to increase glenohumeral internal rotation, external rotation strength and scapular control, as well as improve kinetic chain and thoracic mobility, to be delivered by coaches and team captains three times per week as a part of the handball warm-up throughout the season. Main outcome measuresPrevalence of shoulder problems and substantial shoulder problems. ResultsThe average prevalence of shoulder problems during the season was 17% (95% CI: 16% to 19%) in the intervention group and 23% (95% CI: 21% to 26%) in the control group (mean difference: 6%). The average prevalence of substantial shoulder problems was 5% (95% CI: 4% to 6%) in the intervention group and 8% (95% CI: 7% to 9%) in the control group (mean difference: 3%). Using generalized estimating equation models, a 28% lower risk of shoulder problems (OR 0.72, 95% CI: 0.52 to 0.98, p=0.038) and 22% lower risk of substantial shoulder problems (OR 0.78, 95% CI: 0.53 to 1.16, p=0.23) was observed in the intervention group compared to the control group.Conclusion A comprehensive exercise program reduced the prevalence of shoulder problems in elite handball.

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“…Traditionally, studies have investigated associations between non-participation-related risk factors, such as glenohumeral range of motion (ROM),1 5–8 shoulder strength1 7 9 10 and scapular control,1 11–13 and risk of shoulder injuries among overhead athletes. However, sports injury research needs to move from simple analyses of risk factors and concentrate on how these factors interact among other determinants for injury 14.…”

Section: Introductionmentioning

confidence: 99%

Handball load and shoulder injury rate: a 31-week cohort study of 679 elite youth handball players

et al. 2017

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BackgroundKnowledge of injury patterns, an essential step towards injury prevention, is lacking in youth handball.AimTo investigate if an increase in handball load is associated with increased shoulder injury rates compared with a minor increase or decrease, and if an association is influenced by scapular control, isometric shoulder strength or glenohumeral range of motion (ROM).Methods679 players (14–18 years) provided weekly reports on shoulder injury and handball load (training and competition hours) over 31 weeks using the SMS, phone and medical examination system. Handball load in a given week was categorised into (1) <20% increase or decrease (reference), (2) increase between 20% and 60% and (3) increase >60% relative to the weekly average amount of handball load the preceding 4 weeks. Assessment of shoulder isometric rotational and abduction strength, ROM and scapular control was performed at baseline and midseason.ResultsAn increase in handball load by >60% was associated with greater shoulder injury rate (HR 1.91; 95% CI 1.00 to 3.70, p=0.05) compared with the reference group. The effect of an increase in handball load between 20% and 60% was exacerbated among players with reduced external rotational strength (HR 4.0; 95% CI 1.1 to 15.2, p=0.04) or scapular dyskinesis (HR 4.8; 95% CI 1.3 to 18.3, p=0.02). Reduced external rotational strength exacerbated the effect of an increase above 60% (HR 4.2; 95% CI 1.4 to 12.8, p=0.01).ConclusionsA large increase in weekly handball load increases the shoulder injury rate in elite youth handball players; particularly, in the presence of reduced external rotational strength or scapular dyskinesis.

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Risk Factors for Shoulder and Elbow Injuries in High School Baseball Pitchers

Cited by 113 publications

References 18 publications

Scapular dyskinesis increases the risk of future shoulder pain by 43% in asymptomatic athletes: a systematic review and meta-analysis

Scapular dyskinesis increases the risk of future shoulder pain by 43% in asymptomatic athletes: a systematic review and meta-analysis

Preventing overuse shoulder injuries among throwing athletes: a cluster-randomised controlled trial in 660 elite handball players

Handball load and shoulder injury rate: a 31-week cohort study of 679 elite youth handball players

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