Ankle dorsiflexion deficit in the back leg is a risk factor for shoulder and elbow injuries in young baseball players

Hitoshi Shitara,Masataka Kamiyama,Akira Honda,Takuro Kuboi,Atsushi Yamamoto,Kurumi Nakase,Takafumi Endo,Hirotaka Chikuda,Kenji Takagishi,Tsuyoshi Ichinose,Tsutomu Kobayashi,Ryosuke Miyamoto,Noritaka Hamano,Tsuyoshi Tajika,Tsuyoshi Sasaki

doi:10.1038/s41598-021-85079-8

Abstract

The relationship between ankle joint function and throwing-related injuries has not been demonstrated. We hypothesized that limited ankle joint range of motion (ROM) was related to risk factors for shoulder and elbow injuries in young baseball players. This 12-month prospective cohort study evaluated the age, height, weight, playing position, shoulder, elbow, and ankle function of 228 enrolled baseball players. Shoulder and elbow injuries were tracked during the season. Univariate and multivariate analyses were performed to identify risk factors for shoulder and elbow injuries among participants divided into non-injured and injured groups. Univariate analysis showed that age, height, weight, ROM of elbow flexion in the dominant arm, muscle strength ratio of shoulder abduction, and the likelihood of being a pitcher or a catcher were significantly greater in the injured group than in the non-injured group. ROM of shoulder abduction-external/internal rotation, shoulder total arc on the dominant arm, ankle joint dorsiflexion, and plantar flexion on the back (non-lead) and front (lead) legs were significantly less in the injured group than in the non-injured group. In conclusion, ROM dorsiflexion deficits in the back leg, shoulder abduction-external rotation in the dominant arm, ROM increase in elbow flexion on the dominant side, older age, and being a pitcher were significant independent risk factors for injury.

Highlights

The relationship between ankle joint function and throwing-related injuries has not been demonstrated
We aimed to prospectively investigate whether ankle joint range of motion (ROM) affected the incidence of shoulder and elbow injuries in young baseball players after adjusting for differences in demographic data and upper extremity function
We prospectively investigated whether ankle joint ROM affected the incidence of shoulder and elbow injuries in young baseball players after adjusting for differences in demographic data and upper extremity function

Summary

Introduction

The relationship between ankle joint function and throwing-related injuries has not been demonstrated. We hypothesized that limited ankle joint range of motion (ROM) was related to risk factors for shoulder and elbow injuries in young baseball players. This 12-month prospective cohort study evaluated the age, height, weight, playing position, shoulder, elbow, and ankle function of 228 enrolled baseball players. While a few studies have investigated the risk factors for shoulder and elbow injuries related to dysfunction of the trunk and lower extremities, throwing-related shoulder and elbow injuries are reportedly significantly associated with trunk and lower limb dysfunction, involving hip joint ROM deficits, abnormal foot posture, lack of lumbopelvic control, and inadequate dynamic balance[8,9,10,11,12,13,14,15,16,17,18,19,20,21]. We aimed to prospectively investigate whether ankle joint ROM affected the incidence of shoulder and elbow injuries in young baseball players after adjusting for differences in demographic data and upper extremity function

Objectives

Methods

Results

Conclusion