Lyman Stephen, Fleisig Glenn S, Andrews James R, Osinski E David
American Sports Medicine Institute, Birmingham, Alabama. American Baseball Foundation, Birmingham, Alabama 35205, USA.
Am J Sports Med. 2002 Jul-Aug;30(4):463-8. doi: 10.1177/03635465020300040201.
Joint pain is thought to be an early sign of injury to a pitcher.
To evaluate the association between pitch counts, pitch types, and pitching mechanics and shoulder and elbow pain in young pitchers.
Prospective cohort study.
Four hundred and seventy-six young (ages 9 to 14 years) baseball pitchers were followed for one season. Data were collected from pre- and postseason questionnaires, injury and performance interviews after each game, pitch count logs, and video analysis of pitching mechanics. Generalized estimating equations and logistic regression analysis were used.
Half of the subjects experienced elbow or shoulder pain during the season. The curveball was associated with a 52% increased risk of shoulder pain and the slider was associated with an 86% increased risk of elbow pain. There was a significant association between the number of pitches thrown in a game and during the season and the rate of elbow pain and shoulder pain.
Pitchers in this age group should be cautioned about throwing breaking pitches (curveballs and sliders) because of the increased risk of elbow and shoulder pain. Limitations on pitches thrown in a game and in a season can also reduce the risk of pain. Further evaluation of pain and pitching mechanics is necessary.
关节疼痛被认为是投手受伤的早期迹象。
评估投球次数、投球类型和投球动作与年轻投手肩部和肘部疼痛之间的关联。
前瞻性队列研究。
对476名年轻（9至14岁）棒球投手进行了一个赛季的跟踪研究。数据收集自赛季前和赛季后的问卷、每场比赛后的伤病与表现访谈、投球次数记录以及投球动作的视频分析。使用广义估计方程和逻辑回归分析。
一半的受试者在赛季中经历过肘部或肩部疼痛。变速球与肩部疼痛风险增加52%相关，滑球与肘部疼痛风险增加86%相关。一场比赛和整个赛季中投球的次数与肘部疼痛和肩部疼痛的发生率之间存在显著关联。
由于肘部和肩部疼痛风险增加，该年龄组的投手应注意投出变速球（曲线球和滑球）。限制一场比赛和一个赛季中的投球次数也可以降低疼痛风险。有必要对疼痛和投球动作进行进一步评估。
