Department of Orthopaedics and Rehabilitation, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
Penn State College of Medicine, Hershey, Pennsylvania, USA.
Am J Sports Med. 2019 Mar;47(4):982-990. doi: 10.1177/0363546518760573. Epub 2018 Apr 9.
The incidence of shoulder and elbow injuries among adolescent baseball players is on the rise. These injuries may lead to surgery or retirement at a young age.
To identify independent risk factors for elbow and shoulder injuries in adolescent baseball players. A secondary aim was to determine whether the literature supports the Major League Baseball and USA Baseball Pitch Smart guidelines.
Systematic review.
A systematic review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines utilizing MEDLINE, SPORTDiscus, and Web of Science. Because of study heterogeneity, a quantitative synthesis was not performed. A qualitative review was performed on 19 independent risk factors for elbow and shoulder injuries in adolescent baseball players. Level of evidence was assigned per the Oxford Centre for Evidence-Based Medicine Working Group, and risk of bias was graded per the Newcastle-Ottawa Scale.
Twenty-two articles met criteria for inclusion. Of the 19 independent variables that were analyzed, age, height, playing for multiple teams, pitch velocity, and arm fatigue were found to be independent risk factors for throwing arm injuries. Pitches per game appears to be a risk factor for shoulder injuries. Seven independent variables (innings pitched per game, showcase participation, games per year, training days per week, pitch type, shoulder external rotation, and shoulder total range of motion) do not appear to be significant risk factors. The data were inconclusive for the remaining 6 variables (weight, months of pitching per year, innings or pitches per year, catching, shoulder horizontal adduction, and glenohumeral internal rotation deficit).
The results from this study demonstrate that age, height, playing for multiple teams, pitch velocity, and arm fatigue are clear risk factors for throwing arm injuries in adolescent baseball players. Pitches per game appears to be a risk factor for shoulder injuries. Other variables are either inconclusive or do not appear to be specific risk factors for injuries.
青少年棒球运动员肩部和肘部受伤的发生率正在上升。这些伤害可能导致他们在年轻时接受手术或退役。
确定青少年棒球运动员肘部和肩部受伤的独立风险因素。次要目的是确定文献是否支持美国职棒大联盟和美国棒球投球明智指南。
系统评价。
根据 PRISMA（系统评价和荟萃分析的首选报告项目）指南，利用 MEDLINE、SPORTDiscus 和 Web of Science 进行了系统评价。由于研究存在异质性，因此未进行定量综合分析。对 19 项青少年棒球运动员肘部和肩部受伤的独立风险因素进行了定性综述。根据牛津循证医学中心工作组对证据水平进行了分配，并根据纽卡斯尔-渥太华量表对偏倚风险进行了分级。
有 22 篇文章符合纳入标准。在分析的 19 个独立变量中，年龄、身高、多支球队参赛、投球速度和手臂疲劳被认为是投球手臂受伤的独立危险因素。投球次数似乎是肩部受伤的危险因素。 pitching per game 似乎是肩部受伤的危险因素。有 7 个独立变量（每场比赛投球数、展示参与度、每年比赛数、每周训练天数、投球类型、肩部外旋和肩部总活动范围）似乎不是重要的危险因素。其余 6 个变量（体重、每年投球月数、每年投球局数或投球数、接球、肩部水平内收和盂肱关节内旋不足）的数据不确定。
这项研究的结果表明，年龄、身高、多队参赛、投球速度和手臂疲劳是青少年棒球运动员投球手臂受伤的明确危险因素。投球次数似乎是肩部受伤的危险因素。其他变量要么不确定，要么似乎不是受伤的特定危险因素。
