Arm injury in youth baseball players: a 10-year cohort study

Shanley, Ellen; Thigpen, Charles A.; Boes, Nathan; Bailey, Lane; Arnold, Amanda; Bullock, Garrett S.; Kissenberth, Michael J.

doi:10.1016/j.jse.2023.02.009

Cited by 7 publications

(7 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Injuries to the upper extremity in baseball pitchers continue to rise across all levels of play. [1][2][3][4] Many shoulder and elbow injuries -such as injuries to the ulnar collateral ligament (UCL), rotator cuff, and glenohumeral capsulolabral complex -often require surgical intervention and an extensive period of rehabilitation. As pitchers prepare to return to competition after these injuries, interval throwing programs (ITP) are used to progressively apply load to the healing tissue.…”

Section: Introductionmentioning

confidence: 99%

An Interval Throwing Program for Baseball Pitchers Based upon Workload Data

Reinold,

Dowling,

Fleisig

et al. 2024

International Journal of Sports Physical Therapy

View full text Add to dashboard Cite

Background Interval throwing programs (ITP) have been used for decades to enable baseball pitchers to return to competition after injury or surgery by gradually applying load to the throwing arm. Past programs have been based on personal experience; however, advances in our understanding of the biomechanics and workloads of throwing allow for a more modern data-based program to be developed. Hypothesis/Purpose To 1) develop a updated ITP for rehabilitation of modern baseball pitchers based upon biomechanical and throwing workload data, and 2) compare the updated program with a past program to determine differences in chronic workload and acute:chronic workload ratios (ACWR). Study Design Cross-sectional study Methods Workloads (i.e. daily, acute, chronic, and ACWR) for the original ITP were built from the prescribed throwing schedule. Elbow varus torque per throw was calculated based upon a relationship between elbow varus torque and throwing distance. Throw counts, daily/chronic/acute workloads, and ACWR were calculated and plotted over time. A new ITP was built to model current pitcher’s throwing schedules and gradually increased ACWR over time. Results The original ITP had a throwing schedule of 136 days, final chronic workload 15.0, and the ACWR above or below the “safe” range (i.e. 0.7 – 1.3) for 18% of the program with a peak of 1.61. The updated ITP was built to consist of a 217-day schedule, final chronic workload of 10.8, and deviated from the safe range for 9% of the program, with a peak of 1.33. Conclusion The newly created ITP is more familiar to modern baseball pitchers while exhibiting a more gradual buildup of chronic workload than traditional ITP programs. This ITP may be used to return baseball pitchers back to competition as safely and efficiently as possible, and potentially with less risk of setbacks or reinjury. The ITP may be used following common injuries or surgeries to the throwing shoulder and elbow, such as Tommy John surgery, while also serving as a basis for future development of shorter duration ITPs. Level of Evidence 2c

show abstract

Section: Introductionmentioning

confidence: 99%

An Interval Throwing Program for Baseball Pitchers Based upon Workload Data

Reinold,

Dowling,

Fleisig

et al. 2024

International Journal of Sports Physical Therapy

View full text Add to dashboard Cite

show abstract

“…Unlike other overhead sports, elbow injuries were less prevalent in this study, constituting only 6.7% of overall injuries. 12 , 27 , 28 This is likely due to the mechanics of the elbow acting as a fulcrum for the load in the hand. 29 Given that the load in the upper extremity is limited to the weight of the hand in volleyball, there is lower stress placed at the elbow compared to that of baseball or tennis in which the athlete is holding a baseball or tennis racket throughout the range of motion.…”

Section: Discussionmentioning

confidence: 99%

The Finger, Wrist, and Shoulder are the Most Commonly Injured Areas in Youth Volleyball Players but the Incidence of Injuries Decreased Overall Between 2012 and 2022

Obana,

Singh,

Namiri

et al. 2024

Arthroscopy, Sports Medicine, and Rehabilitation

View full text Add to dashboard Cite

“…Despite continued improvements in the understanding of the overhead throwing motion, injuries to the upper extremities of baseball pitchers continue to rise across all levels of play. [1][2][3][4] Efforts to return pitchers to their pre-injury level of performance remains a critical, yet challenging task for sports medicine physicians, physical therapists, athletic trainers, and other rehabilitation specialists. Successful rehabilitation of baseball pitchers relies on a gradual building of strength, flexibility, and endurance to meet the demands of competition.…”

Section: Introductionmentioning

confidence: 99%

“…11,12 Previous research investigating ACWR has reported increased injury risk occurs when the workload ratio either exceeds 1.3 or drops below 0.7. [13][14][15][16] Together, biomechanical data and objective metrics for training loads afford an opportunity to optimize ITPs to avoid excessive variations in training loads and, potentially, avoid setbacks and recurrent injury during rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Workload Comparison of Contemporary Interval Throwing Programs and a Novel Optimized Program for Baseball Pitchers

Dowling,

Brusalis,

Streepy

et al. 2024

International Journal of Sports Physical Therapy

View full text Add to dashboard Cite

Background In the rehabilitation of injured baseball pitchers, there is lack of consensus on how to guide a player back to pitching. It is unknown how different contemporary interval throwing programs (ITPs) progress in the amount of throwing workload. Purposes To 1) evaluate three prominent ITPs commonly employed in baseball pitcher rehabilitation and assess whether these ITPs produce training loads that increase in a controlled, graduated manner and 2) devise an ITP that produced training loads which increased steadily over time. Study Design Cross-sectional study Methods Three publicly available ITPs from prominent sports medicine institutions were analyzed. Elbow varus torque per throw was calculated from a 2nd order polynomial regression based upon a relationship between recorded torque measurements and throwing distance measured from a database of 111,196 throws. The relative rate of workload increase was measured as an acute:chronic workload ratio (ACWR). For each ITP, throw counts, daily/acute/chronic workloads, and ACWR were calculated and plotted over time. Finally, an original ITP was devised based upon a computational model that gradually increases ACWR over time and finished with an optimal chronic workload. Results Each ITP exhibited a unique progression of throwing distances, quantities, and days to create different workload profiles. The three ITPs had throwing schedules ranging from 136 days to 187 days, ACWR spiked above or fell below a literature-defined “safe” range (i.e. 0.7 – 1.3) 19, 21, and 23 times. A novel ITP, predicated on a 146-day schedule and with a final chronic workload of 14.2, was designed to have no spikes outside of the safe range. Conclusion Existing ITPs widely utilized for rehabilitation of baseball pitchers exhibit significantly inconsistent variation in the rate of throwing load progression. Computational modeling may facilitate more incremental workload progression in ITPs, thereby reducing injury during rehabilitation and more efficiently condition a pitcher for return to competition. Level of Evidence 3b

show abstract

Arm injury in youth baseball players: a 10-year cohort study

Cited by 7 publications

References 13 publications

An Interval Throwing Program for Baseball Pitchers Based upon Workload Data

An Interval Throwing Program for Baseball Pitchers Based upon Workload Data

The Finger, Wrist, and Shoulder are the Most Commonly Injured Areas in Youth Volleyball Players but the Incidence of Injuries Decreased Overall Between 2012 and 2022

Workload Comparison of Contemporary Interval Throwing Programs and a Novel Optimized Program for Baseball Pitchers

Contact Info

Product

Resources

About