Epidemiology of shoulder injuries in young baseball players and grading of radiologic findings of Little Leaguer's shoulder

Kanematsu, Yoshiji; Matsuura, Tetsuya; Kashiwaguchi, Shinji; Iwase, Takeshi; Suzue, Naoto; Iwame, Toshiyuki; Fukuta, Shoji; Hamada, Daisuke; Goto, Tomohiro; Sairyo, Koichi

doi:10.2152/jmi.62.123

Cited by 15 publications

(11 citation statements)

References 18 publications

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“…Twenty‐eight articles focused on pain of the elbow and/or shoulder related to overhead sports, published between 1965 and 2017. The studies were conducted in the USA, Japan, Norway, Brazil, Taiwan, and the UK . Sixteen of the articles that reported pain as outcome were cross‐sectional studies, nine articles collected data prospectively, and two studies had a retrospective design …”

Section: Resultsmentioning

confidence: 99%

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Incidence, prevalence, and risk factors for elbow and shoulder overuse injuries in youth athletes: A systematic review

et al. 2019

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Background:In order to create sport-specific preventive measures to enhance healthy sport participation in youth athletes, valid data on incidence, prevalence, and etiology of overuse injuries have to be identified. This systematic review aims to provide an update on incidence, prevalence, and risk factors for overuse injuries of the elbow and shoulder in youth athletes participating in overhead sports. Materials and Methods: MEDLINE and EMBASE were searched from inception until January 19, 2018, for studies that reported incidence, prevalence, or risk factors for overuse injuries or pain of the elbow and shoulder in youth overhead athletes. Results: In total, 36 studies were included. Incidence rates of overuse injuries of the elbow and shoulder were highest in tennis, baseball, and softball. Incidence and prevalence of elbow pain in baseball were 12%-58% and 17%-35%, respectively. Incidence of shoulder pain was 8%-32% for baseball, 47% for basketball, 63% for handball, and 52% for volleyball. Prevalence of shoulder pain was 9%-16% for baseball, 41% for basketball, 32%-49% for handball, and 40% for volleyball. Risk factors for pain were almost exclusively described for youth baseball players and included playing position, throwing technique, and intensity and duration of training. Conclusions: Incidence and prevalence of overuse injuries and pain of the elbow and shoulder are high in youth overhead athletes. Interpretation is challenging as different definitions are used to report overuse injuries and pain. Risk factors in youth baseball are largely covered by preventive pitch-count restrictions; knowledge on risk factors in other overhead sports is currently lacking. K E Y W O R D Sathletic injuries, elbow, overhead sports, overuse injuries, risk factors, shoulder

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Section: Resultsmentioning

confidence: 99%

“…Twelve studies reported odds ratios (OR) for univariate analysis of risk factors for pain of the elbow or shoulder related to baseball . One study reported risk factors for overuse injuries in baseball players, and one study reported risk factors for shoulder pain in volleyball .…”

Section: Resultsmentioning

confidence: 99%

Incidence, prevalence, and risk factors for elbow and shoulder overuse injuries in youth athletes: A systematic review

et al. 2019

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“…Table 3 summarizes the results of 19 imaging studies which provide prevalence estimates or comparative data on PPSIs involving the shoulder, wrist and fingers of baseball players [133][134][135], divers [136], gymnasts [26,27,[137][138][139][140][141][142][143][144][145][146], and climbers [147][148][149][150][151]. Cross-sectional data are also provided in one case series study [26] and one case-control study [135].…”

Section: Cross-sectional Studiesmentioning

confidence: 99%

Primary Periphyseal Stress Injuries in Young Athletes: A Systematic Review

et al. 2021

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Background Overuse injuries are common in sporting children and adolescents. These injuries are a particular concern when they involve the epiphyseal-physeal-metaphyseal (EPM) complex given their potential to disturb skeletal growth. Specifically, the limits of mechanical tolerance of the EPM complex to repetitive stress may be exceeded by the intense and continuous training characteristic of many youth sports today. Objective This article describes the present status of knowledge on the occurrence and outcome of primary periphyseal stress injuries (PPSIs) affecting the EPM complex in the extremities of children and adolescents involved in youth sports. Methods A comprehensive review of the sports medicine literature was conducted to determine the nature and extent of PPSIs affecting the EPM complex of the extremities among youth sports participants and the potential for consequent skeletal growth disturbance and resultant limb deformity associated with these injuries. Results Our initial search uncovered 128 original published scientific articles reporting relevant data on PPSIs. There were 101 case reports/series, 19 cross-sectional, 1 case-control, and 7 cohort studies with relevant data. The case reports/series studies reported 448 patients with PPSIs involving the extremities. Children and adolescents representing a variety of high impact repetitive youth sports activities-including baseball, badminton, climbing, cricket, dance, gymnastics, rugby, soccer, swimming, tennis, and volleyball-may sustain PPSIs involving the shoulder, elbow, hand and wrist, knee, and ankle and foot. Although incidence data from prospective cohort studies are lacking, data arising from cross-sectional studies suggest that PPSIs may be common in select groups of youth athletes-including the shoulder in baseball players (0-36.6%), wrist in gymnasts (10-83%) and platform divers (52.6%), and fingers in rock climbers (5-58%). Notably, not all stress-related skeletal changes detected on imaging were symptomatic in these studies. When diagnosed and treated with an appropriate period of rest and rehabilitation, most patients studied were able to return to their sport activities. However, our data also show that 57/448 PPSIs (12.7%) produced growth disturbance, and that 28/448 patients (6.2%) underwent surgery for their injuries. Absence of treatment, delayed presentation and diagnosis, and non-compliance with a rest regimen were common in cases that produced growth disturbance. Conclusions PPSIs may affect the extremities of children and adolescents engaged in a variety of youth sports, especially at advanced levels of training and competition. Most skeletally immature patients with PPSIs respond well to timely treatment; however, in extreme cases, PPSIs can progress to produce skeletal growth disruption which may necessitate surgical intervention. Clearly, establishing the early diagnosis of PPSIs and providing timely treatment of these injuries are needed to ensure the skeletal health of youth sports participants. Rigorous prospective lo...

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“…Throwing injuries in junior baseball players typically manifest as Little Leaguer's shoulder, humeral medial epicondylar lesions, and osteochondritis dissecans of the capitellum. They can be caused by traction stress, compression stress, and blood flow disorders on the growing cartilage plate [1][2][3] . It has been reported that 30-58% of junior baseball players experience elbow pain during their growing up age 4,5) .…”

Section: Introductionmentioning

confidence: 99%

Influence of pitching grip on shoulder and elbow injuries in junior baseball players, focusing on hand length and the metacarpophalangeal joint angle

et al. 2021

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We investigated the relationship of pitching grip with hand length and index finger metacarpophalangeal joint angle. [Participants and Methods] A total of 650 junior baseball players divided into two groups according to whether they experienced shoulder or elbow pain were divided into two groups based on their pitching grip, i.e., those who held the ball with the ulnar side of the thumb and those who held it with the finger pad of the thumb. The metacarpophalangeal joint angle was measured while the participants held a ball. [Results] The average hand length was 16.3 ± 1.4 cm for those holding the ball with the ulnar side of the thumb and 15.8 ± 1.2 cm for those holding it with the finger pad of the thumb. Hand length and metacarpophalangeal angle were significantly greater in the group using the ulnar side of the thumb. The two groups showed no significant differences in the distribution of grip type or history of shoulder/elbow pain. The index finger metacarpophalangeal angle and shoulder/elbow pain were significantly lower in the pain group. [Conclusion] With respect to the pitching grip for junior baseball players, we recommend a slightly flexed rather than extended position with the metacarpophalangeal angle.

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Epidemiology of shoulder injuries in young baseball players and grading of radiologic findings of Little Leaguer's shoulder

Cited by 15 publications

References 18 publications

Incidence, prevalence, and risk factors for elbow and shoulder overuse injuries in youth athletes: A systematic review

Incidence, prevalence, and risk factors for elbow and shoulder overuse injuries in youth athletes: A systematic review

Primary Periphyseal Stress Injuries in Young Athletes: A Systematic Review

Influence of pitching grip on shoulder and elbow injuries in junior baseball players, focusing on hand length and the metacarpophalangeal joint angle

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