Elbow Injuries in Youth Baseball Players Without Prior Elbow Pain A 1-Year Prospective Study

Elbow Injuries in Youth Baseball Players Without Prior Elbow Pain A 1-Year Prospective Study

(Yasui et al.; Open Access Journal for Orthopaedic Sports Medicine; October 29, 2013)

• In 2006, 449 players without prior elbow pain were observed prospectively for 1 season to study injury incidence in relation to specific risk factors. The average age was 10.1 years (range, 7-11 years). One year later, all players were examined by administering a questionnaire, physical examination, and radiographic examination.
• It is expected that 30% of youth baseball players have elbow pain each year, and nearly 60% of players with elbow pain exhibit radiographic abnormalities. The age of 12 years, pitcher and catcher positions, and playing more than 100 games per year are risk factors for elbow pain Association of Maximum Pitch Velocity and Elbow Injury in Professional Baseball Pitchers (Hawkins et al.; The American Journal of Sports Medicine; January 21, 2010)
• Twenty-three professional pitchers were analyzed during spring training games and the ball velocity of the fastest pitch thrown for a strike (maximum pitch velocity) was recorded. This group was then followed prospectively over the following 3 seasons for elbow injury significant enough to warrant inclusion on the disabled list and/or require surgery.
• There were 9 players with elbow injuries in the group of pitchers studied, including 4 pitchers with an elbow muscle strain and/or joint inflammation and 5 pitchers with an ulnar collateral ligament sprain or tear. Three of the ulnar collateral ligament injuries required surgery. For the 14 pitchers in the noninjured group, the mean pitch velocity was 38.09 m/s (±1.45) or 85.22 mph (±3.24). For the 9 players in the injured group, the mean pitch velocity was 39.88 m/s (±2.39) or 89.22 mph (±5.36). There was a statistically significant association between maximum ball velocity and elbow injury (P = .0354). The injured group had a longer average career length (9.7 years) than the noninjured group (6.5 years; P = .0248). The 3 pitchers with the highest maximum ball velocity had the injuries requiring surgery. Risk of Serious Injury for Young Baseball Pitchers (Andrews et al.; The American Journal of Sports Medicine; May 9, 2011)
• In sum, 481 youth pitchers (aged 9 to 14 years) were enrolled in a 10-year follow-up study. Participants were interviewed annually. Injury was defined as elbow surgery, shoulder surgery, or retirement due to throwing injury. Fisher exact test compared the risk of injury between participants who pitched at least 4 years during the study and those who pitched less. Fisher exact tests were used to investigate risks of injury for pitching more than 100 innings in at least 1 calendar year, starting curveballs before age 13 years, and playing catcher for at least 3 years.
• There was no significant relationship between age at the beginning of the study, in number of years playing catcher during the study or in age began using curveballs.
• Pitchers who pitched more than 100 innings in at least one year were 3.5 times more likely to be injured during the study than those who did not exceed 100 innings pitched.
• Pitchers who threw curveballs before the age of 13 had a slight increase in risk of injury, but this increase was not statistically significant and players who played catcher were also at a slightly higher risk of injury but that also fell below the threshold for statistical significance.
• 5% of players (25 of 481) had elbow surgery, shoulder surgery or retired from baseball due to injury.
• Only 2.2% of the participants were still pitching by the end of the study.