Olsen Samuel J, Fleisig Glenn S, Dun Shouchen, Loftice Jeremy, Andrews James R
American Sports Medicine Institute, 833 St Vincent's Drive, Suite 100, Birmingham, AL 35205, USA.
Am J Sports Med. 2006 Jun;34(6):905-12. doi: 10.1177/0363546505284188. Epub 2006 Feb 1.
There is little evidence supporting current safety recommendations for adolescent pitchers.
Pitching practices of adolescent pitchers without history of arm injury will be significantly different from those of adolescent pitchers who required shoulder or elbow surgery.
Case control study; Level of evidence, 3.
Ninety-five adolescent pitchers who had shoulder or elbow surgery and 45 adolescent pitchers who never had a significant pitching-related injury completed a survey. Responses were compared between the 2 groups using t tests and chi(2) analyses. Multivariable logistic regression models were developed to identify the risk factors.
The injured group pitched significantly more months per year, games per year, innings per game, pitches per game, pitches per year, and warm-up pitches before a game. These pitchers were more frequently starting pitchers, pitched in more showcases, pitched with higher velocity, and pitched more often with arm pain and fatigue. They also used anti-inflammatory drugs and ice more frequently to prevent an injury. Although the groups were age matched, the injured group was taller and heavier. There were no significant differences regarding private pitching instruction, coach's chief concern, pitcher's self-rating, exercise programs, stretching practices, relieving frequency, pitch type frequency, or age at which pitch types were first thrown.
Pitching practices were significantly different between the groups. The factors with the strongest associations with injury were overuse and fatigue. High pitch velocity and participation in showcases were also associated with increased risk for injury.
New recommendations were made based on these results. Adherence to the recommendations may reduce the incidence of significant injury to adolescent pitchers.
几乎没有证据支持目前针对青少年投手的安全建议。
无手臂受伤史的青少年投手的投球训练与需要进行肩部或肘部手术的青少年投手的投球训练存在显著差异。
病例对照研究；证据等级，3级。
95名接受过肩部或肘部手术的青少年投手和45名从未有过与投球相关严重损伤的青少年投手完成了一项调查。使用t检验和卡方分析比较两组的回答。建立多变量逻辑回归模型以确定风险因素。
受伤组每年投球的月数、每年的比赛场次、每场比赛的局数、每场比赛的投球数、每年的投球数以及比赛前的热身投球数明显更多。这些投手更常作为先发投手，参加更多的展示赛，投球速度更高，并且在手臂疼痛和疲劳时更频繁地投球。他们也更频繁地使用消炎药和冰敷来预防受伤。尽管两组年龄匹配，但受伤组更高更重。在私人投球指导、教练的主要关注点、投手的自我评分、锻炼计划、伸展练习、缓解频率、投球类型频率或首次投出投球类型的年龄方面没有显著差异。
两组之间的投球训练存在显著差异。与受伤关联最强的因素是过度使用和疲劳。高投球速度和参加展示赛也与受伤风险增加有关。
基于这些结果提出了新的建议。遵循这些建议可能会降低青少年投手严重受伤的发生率。
