Current Concepts in Arm Care Exercise Programs and Injury Risk Reduction in Adolescent Baseball Players: A Clinical Review

Abstract

Context: Awareness of important injury risk factors associated with excessive pitching volume has been highlighted in the literature, but injury rates remain high. Shoulder pain in baseball players is associated with various changes in musculoskeletal movements, which presents as measurable impairments throughout the kinetic chain. Baseball coaches and rehabilitation professionals have utilized exercise programs targeting strength and flexibility of the throwing arm to prevent injuries. The purpose of this review is to summarize the current evidence regarding the effectiveness of arm care exercise programs in reducing upper extremity injury rates in adolescent baseball players. Evidence Acquisition: A search of electronic databases, including CINAHL with full text, MEDLINE, and SPORTDiscus was conducted to retrieve available articles in English from the years 2010 through 2020. The search terms injury prevention, exercise, and adolescent baseball were used. Study Design: Clinical review. Level of Evidence: Level 4. Results: Improving shoulder internal rotation range of motion by stretching the posterior shoulder muscles daily was associated with a 36% risk reduction of shoulder and elbow injuries. Group-based arm care exercise programs that target multiple musculoskeletal impairments demonstrated an approximately 50% reduced risk of elbow injury. Conclusion: For adolescent baseball players, arm care injury prevention programs focusing on important musculoskeletal impairments are effective at reducing injury incidence rates. Multimodal injury prevention programs that improve multiple musculoskeletal impairments are more comprehensive and may result in better injury reduction than programs focusing on a singular impairment.

Efficacy of Injury Prevention Using Functional Movement Screen Training in High-School Baseball Players: Secondary Outcomes of a Randomized Controlled Trial

“…The RR was 1.36 for all injuries and 1.3 for noncontact injuries, indicating a 1.3-fold higher chance of injury compared to the control group. Regarding disability-prevention programs, the effects of measures such as stretching, physical function, and movement exercises have been presented [ 21 , 22 ]. In this study, the number of injuries did not decrease after 12 weeks of intervention; however, good movement patterns and kinetic chain were acquired after 12 weeks of FMS training.…”

Proposed Musculoskeletal Examination of Youth and Adolescent Baseball Players

“…A number of studies have looked at factors related to injury in the youth baseball population over the past year ranging in topics from; early sport specialization (ESS) (12)(13)(14)(15)(16), pitch counts (17)(18)(19)(20)(21)(22)(23), prethrowing protocols (24,25), imaging findings (26), to body region-specific inquiries (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43) in search for opportunities to reduce the risk of injury in this population. We will review a wide range of articles and their relevance to injury risk in this population.…”

“…The mYKB-9 (Fig. 1) consists of stretching for the elbow, shoulder, and hip, dynamic mobility for the scapula and thorax, and lower body balance (24). Implementation of systematic multimodal prethrowing protocols or dynamic warm-ups should be included in the youth and adolescent throwing population targeting the entire kinetic chain in preparation for athletic movement patterns.…”

“…Results of the protocol demonstrated improved isometric strength and better ability to maintain shoulder ROM compared with a control group (25). A clinical review of exercise programs targeting strength and flexibility of the throwing arm to prevent injury identified a 36% risk reduction of shoulder and elbow injuries after stretching the posterior shoulder muscles daily and 50% reduced risk of elbow injury when a multimodal group-based arm care program called the Yokohama Baseball-9 (YKB-9) was completed addressing multiple musculoskeletal impairments (nine strengthening; nine stretching) (24). The YKB-9 was completed two times per week and consisted of 18 exercises, whereas the modified YKB-9 (mYKB-9) consisted of nine exercises and demonstrated significantly increased adherence (24).…”

A Field-expedient Arm Care Screening Tool Can Identify Musculoskeletal Risk Factors in Baseball Players

“…45 To mitigate overuse arm injuries, baseball coaches implement arm care programs to target musculoskeletal injury risk factors by improving strength, dynamic stability, and range of motion (ROM) of muscles and joints. 20,22 However, these arm care programs tend to be more 1125465S PHXXX10.…”