Abstract
We prospectively evaluated the effects of a prevention program on the incidence of shoulder and elbow injuries in high school baseball pitchers. Ninety-two pitchers participated in this study and were taught to perform stretching and strength exercises aimed at improving shoulder external rotation strength in the preseason. The pitchers freely chose to participate in one of four groups [SM-group: performed both exercises, S-group: performed stretching exercise only, M-group: performed strength training only, and N-group: performed neither intervention]. Injury was defined as inability to play for ≥8 days because of shoulder/elbow symptoms. Kaplan-Meier survival curves were generated and hazard ratios (HRs) for injury occurrence were calculated using multivariate Cox regression. Log-rank test was used for between-group comparisons of survival distributions. The injuries occurred in 25, 35, and 57% of participants and median times to injury were 89, 92, and 29.5 days in the S- (n = 32), SM- (n = 46), and N- (n = 14) group, respectively. Nobody chose M-group. HRs were 0.36 and 0.47 for the S- and SM-group, respectively, based on the N-group. The incidence of injury was significantly lower in the S-group than in the N-group (p = 0.04). Daily posterior shoulder stretching may reduce the incidence of the injuries in high school baseball pitchers.
Highlights
Shoulder and elbow injuries are common in baseball pitchers
A prior prospective study of a homogenous group of high school pitchers showed that deficits in internal rotation on the dominant side and weakness of prone external rotation strength were risk factors for injury[1]; we designed our prevention program to improve both internal rotation range of motion (ROM) and prone external rotation strength
Our results demonstrated that pitchers who performed daily sleeper stretching were able to continue pitching during the season approximately three times longer than pitchers who did not perform daily sleeper stretching
Summary
Few prospective studies have investigated the risk factors for throwing-related shoulder and elbow injuries in the preseason. Among high school baseball and softball players, risk factors have been shown to include shoulder internal rotation and horizontal adduction ROM deficits[2]. There is a clear need to investigate if interventions targeted to specific injury risk factors can reduce the incidence of shoulder and elbow injuries in baseball players. A prior prospective study of a homogenous group of high school pitchers showed that deficits in internal rotation on the dominant side and weakness of prone external rotation strength were risk factors for injury[1]; we designed our prevention program to improve both internal rotation ROM and prone external rotation strength
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