Is workload associated with latissimus dorsi and teres major tears in professional baseball pitchers? An analysis of days of rest, innings pitched, and batters faced

Chalmers, Peter N.; Mcelheny, Kathryn; D’Angelo, John; Ma, Kevin; Rowe, Dana; Romeo, Anthony A.; Erickson, Brandon J.

doi:10.1016/j.jse.2021.10.035

Cited by 4 publications

(13 citation statements)

References 22 publications

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“…Pitch counts are one of the many components that make up a pitcher's workload and have been tracked for quite some time. 5,16 To reduce injury risk in adolescents, MLB created the Pitch Smart Program, 20 which provides recommendations on the maximum number of pitches per game, as well as the number of rest days that players should have based on their age and the number of pitches they threw in a game. The institution of pitch count limits rather than inning limits in youth baseball was started in 2007 as a way to more tightly monitor workload.…”

Section: Discussionmentioning

confidence: 99%

“…The authors found that a player’s pitch count in the first full season back from UCLR was not a risk factor for requiring subsequent UCLR. Chalmers et al 5 evaluated the number of innings pitched as a risk factor for sustaining a latissimus dorsi injury in professional baseball pitchers and found that players who pitched more innings had a higher risk of injury; however, they did not evaluate pitch counts specifically. While the present study did not find the total number of hidden pitches or the total number of in-game pitches to be a risk factor for injury, this study only evaluated 1 professional baseball club over the course of 1 season.…”

Section: Discussionmentioning

confidence: 99%

“…1,8,10,11,13 Many risk factors for injury in baseball pitchers have been identified—including loss of shoulder motion, loss of hip motion, fastball velocity, and fatigue. 2,3,5,14,21,22 One of the major risk factors that has been correlated with injury is pitch count. 6,15,17,18 However, most attention surrounding pitches has involved the pitches that are thrown only during gameplay.…”

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confidence: 99%

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Hidden Pitches in Major League Baseball: What Are the Injury Implications of These Often Overlooked Pitches?

Erickson

Buchheit²,

Rauch³

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Pitch counts are tightly monitored in Major League Baseball (MLB). Hidden pitches—including warm-up pitches before and between innings and pitches before the starting/relieving pitcher’s appearance in a game—are not as closely monitored. Purpose/Hypothesis: To report the number of hidden pitches thrown per game and over the course of a season for a single organization. We hypothesized that players who threw more hidden pitches would be at an increased risk of injury compared with those who threw fewer hidden pitches. Study Design: Case-control study; Level of evidence, 3. Methods: All pitchers who played for a single MLB organization in the 2021 season were included. Hidden pitches, in-game pitches, and total pitches thrown during all games in the season were recorded. Injuries to these pitchers were also recorded. Players were defined as having an injury if they spent any time on the injured list. Results: Overall, 137 pitchers were included, 66 (48%) of whom sustained an injury and were placed on the IL during the 2021 season (mean time on IL, 53.6 ± 45.6 days). Of the 66 players who sustained an injury, 18 (27.3%) sustained an elbow injury, while 12 (18.2%) sustained a shoulder injury. Only 1 player sustained an ulnar collateral ligament tear. When comparing hidden pitches, in-game pitches, and total pitches between pitchers who sustained an injury and those who did not, there were no significant differences between groups ( P = .150; P = .830; and P = .377, respectively). On average, hidden pitches made up 45.4% of the total number of pitches thrown during the course of the season. When evaluating the number of hidden pitches as a percentage of the total number of pitches thrown in a season, there was no significant difference between pitchers who sustained an injury and those who did not ( P = .654). Conclusion: MLB pitchers who sustained an injury did not throw more hidden pitches than those who did not sustain an injury. Larger scale studies are needed to confirm the results of this single-team study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Hidden Pitches in Major League Baseball: What Are the Injury Implications of These Often Overlooked Pitches?

Erickson

Buchheit²,

Rauch³

et al. 2023

Orthopaedic Journal of Sports Medicine

Self Cite

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“…Included studies were categorized and evaluated according to the Oxford Study Design. 11 Because only Level III cohort studies were included from the systematic review, 12 , 13 risk of bias was assessed using the ROBINS-I tool. 14 …”

Section: Methodsmentioning

confidence: 99%

Baseball Pitchers who Suffer Latissimus Dorsi and Teres Major Tendon Injuries Have a High Return to Play Rate After Either Operative or Nonoperative Treatment

Recker,

Gehrman,

Diaz

et al. 2023

Arthroscopy, Sports Medicine, and Rehabilitation

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“… 22 Multiple subsequent studies have confirmed the relationship between workload and arm pain. 6 , 7 , 12 , 20 , 25 , 26 , 35 This relationship may be driven by changes in mechanics with fatigue. 9 , 14 , 28 However, although there is a clear relationship between pain and workload, not all studies have confirmed a relationship between injury and workload.…”

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confidence: 99%

Characteristics Associated With Noncompliance of Current Pitch Smart Guidelines in High School Baseball Pitchers Throughout the United States

Erickson,

Bowman,

Camp

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Although pitch count and rest guidelines have been promoted for youth and adolescent baseball players for nearly 2 decades, compliance with guidelines remains poorly understood. Purpose/Hypothesis: The purpose of this study was to determine the frequency of compliance with Major League Baseball (MLB) Pitch Smart guidelines as well as the association between compliance and range of motion (ROM), strength, velocity, injury, and pitcher utilization. It was hypothesized that pitchers in violation of current recommendations would have increased strength, velocity, and injury. Study Design: Case-control study; Level of evidence, 3. Methods: This was a prospective, multicenter study of 115 high school pitchers throughout the United States. Pitchers were surveyed about their compliance with current off-season, rest-related guidelines, and history of injury. During the preseason, pitchers underwent standardized physical examinations, and pitch velocity was measured. Pitch counts were collected during the baseball season that followed. Dynamometer strength testing of shoulder forward flexion, and external rotation as well as grip strength was recorded. We compared pitchers who were compliant with recommendations with those who were noncompliant using Student t and Mann-Whitney U tests. Results: Based on preseason data, 84% of pitchers had violated current Pitch Smart guidelines. During the season, 14% had at least 1 violation of the Pitch Smart guidelines. Across both the preseason survey and in-season pitch counts, 89% of players had at least 1 violation of the Pitch Smart guidelines. While there were no significant differences in ROM or strength, the noncompliant group had higher maximum pitch velocity than the compliant group (74 ± 8 vs 69 ± 5 mph [119 ± 13 vs 111 ± 8 kph], respectively; P = .009). Players’ self-reported velocity differed significantly from the direct measurement, for both peak velocity (80 ± 6 vs 73 ± 8 mph [129 ± 9 vs 117 ± 13 kph], respectively; P < .001) and mean velocity (73 ± 8 vs 53 ± 27 mph [117 ± 13 vs 85 ± 43 kph], respectively; P < .001). Conclusion: Most high school pitchers were not fully compliant with current Pitch Smart guidelines, and they tended to overestimate their peak velocity by 7 mph (11 kph). Pitchers who threw with greater velocity were at higher risk for violating Pitch Smart recommendations.

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Is workload associated with latissimus dorsi and teres major tears in professional baseball pitchers? An analysis of days of rest, innings pitched, and batters faced

Cited by 4 publications

References 22 publications

Hidden Pitches in Major League Baseball: What Are the Injury Implications of These Often Overlooked Pitches?

Hidden Pitches in Major League Baseball: What Are the Injury Implications of These Often Overlooked Pitches?

Baseball Pitchers who Suffer Latissimus Dorsi and Teres Major Tendon Injuries Have a High Return to Play Rate After Either Operative or Nonoperative Treatment

Characteristics Associated With Noncompliance of Current Pitch Smart Guidelines in High School Baseball Pitchers Throughout the United States

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