Skillington S Andrew, Brophy Robert H, Wright Rick W, Smith Matthew V
Washington University in St Louis School of Medicine, St Louis, Missouri, USA.
Department of Orthopedics, Washington University in St Louis School of Medicine, St Louis, Missouri, USA.
Am J Sports Med. 2017 May;45(6):1413-1419. doi: 10.1177/0363546516688657. Epub 2017 Feb 1.
The windmill pitching motion has been associated with risk for shoulder injury. Because there are no pitching limits on youth fast-pitch softball pitchers, these athletes often pitch multiple games across consecutive days. Strength changes, fatigue levels, and shoulder pain that develop among female fast-pitch pitchers over the course of consecutive days of pitching have not been investigated.
Over the course of 2- and 3-day fast-pitch softball tournaments, pitchers will develop progressive objective weakness and increased subjective shoulder fatigue and pain without complete recovery between days.
Cross-sectional study; Level of evidence, 3.
Fourteen female fast-pitch softball pitchers between the ages of 14 and 18 years were evaluated for strength and fatigue changes across 2- and 3-day tournaments. At the beginning and end of each day of tournament play, pitchers were asked to quantify shoulder fatigue and shoulder pain levels of their dominant throwing arm using a 10-point visual analog scale (VAS). Shoulder abduction, flexion, external rotation, internal rotation, elbow flexion, and elbow extension strength measurements were gathered using a handheld dynamometer.
Over the course of an average single day of tournament participation, pitchers developed significant increases in VAS scores for shoulder fatigue (median, 2.0; 95% CI, 1.3-3.0) and pain (median, 1.3; 95% CI, 0.5-2.3) and significant strength loss in all tested motions. Pitchers also developed significant increases in VAS shoulder fatigue (median, 3.5; 95% CI, 1.5-5.5), VAS shoulder pain (median, 2.5; 95% CI, 1.0-4.5), and strength loss in all tested motions over the entire tournament. Shoulder pain, fatigue, and strength do not fully recover between days. The accumulation of subjective shoulder pain and fatigue over the course of tournament play were closely correlated.
Among youth female fast-pitch softball pitchers, there is a progressive increase in shoulder fatigue, pain, and weakness over the course of 2- and 3-day tournaments without full recovery between consecutive days of pitching.
风车式投球动作与肩部受伤风险相关。由于青少年快速垒球投手没有投球限制，这些运动员经常连续多天参加多场比赛。连续多天投球过程中，女性快速垒球投手的力量变化、疲劳程度和肩部疼痛情况尚未得到研究。
在为期2天和3天的快速垒球锦标赛期间，投手会逐渐出现客观的力量减弱、主观的肩部疲劳和疼痛加剧，且每天之间无法完全恢复。
横断面研究；证据等级，3级。
对14名年龄在14至18岁之间的女性快速垒球投手在为期2天和3天的锦标赛中的力量和疲劳变化进行评估。在比赛的每一天开始和结束时，要求投手使用10分视觉模拟量表（VAS）对其优势投掷手臂的肩部疲劳和肩部疼痛程度进行量化。使用手持测力计收集肩部外展、前屈、外旋、内旋、肘部屈曲和肘部伸展力量测量数据。
在平均一天的比赛过程中，投手的肩部疲劳VAS评分（中位数，2.0；95%可信区间，1.3 - 3.0）和疼痛评分（中位数，1.3；95%可信区间，0.5 - 2.3）显著增加，所有测试动作的力量均显著下降。在整个锦标赛期间，投手的肩部疲劳VAS评分（中位数，3.5；95%可信区间，1.5 - 5.5）、肩部疼痛VAS评分（中位数，2.5；95%可信区间，1.0 - 4.5）以及所有测试动作的力量下降也均显著增加。肩部疼痛、疲劳和力量在每天之间并未完全恢复。比赛过程中主观肩部疼痛和疲劳的累积密切相关。
在青少年女性快速垒球投手中，在为期2天和3天的锦标赛期间，肩部疲劳、疼痛和力量减弱会逐渐增加，且连续投球日之间无法完全恢复。
