Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
School of Medicine, Wayne State University, Detroit, Michigan, USA.
Am J Sports Med. 2018 Aug;46(10):2509-2513. doi: 10.1177/0363546518782451. Epub 2018 Jun 28.
The incidence of overuse injury to the elbow among baseball pitchers continues to rise, despite extensive efforts at pitch count regulations and emphasis on proper throwing mechanics.
To determine if the medial elbow experiences increased torque levels as a baseball pitcher fatigues through the course of a simulated game.
Descriptive laboratory study.
High school and collegiate baseball pitchers were recruited for this simulated game study. Each pitcher completed a simulated game consisting of 6 innings and a standardized pitching scheme of fastballs, curveballs, and changeups. In total, each pitcher threw 90 pitches. Fatigue was reported per inning with a visual analog scale, and pitch velocity was captured per pitch with a radar gun. Outcome measures were assessed with a validated mobile sensor and included medial elbow torque, arm speed, arm rotation, and arm slot. Linear and quadratic regression modeling was used to evaluate the relationship between pitcher fatigue and pitching kinematics.
A total of 11 pitchers (mean age, 17.6 years; range, 15-20 years) completed the study. Visual analog scale fatigue scores increased 0.72 points per inning pitched ( P < .01, effect size = 0.64). Medial elbow torque also increased beyond inning 3, with an increase of 0.84 N·m each inning ( P < .01, effect size = 0.08), while pitch velocity decreased (0.28 mph per inning, P < .01, effect size = 0.27). Fastballs generated the greatest amount of medial elbow torque (49.3 ± 1.4 N·m, P < .01, effect size = 0.24). There were no differences in arm rotation ( P = .42) or arm speed ( P = .80) as the game progressed. However, arm slot decreased with each successive inning (0.73° on average per inning, P = .03, effect size = 0.12). No adverse outcomes were noted with use of the mobile sensor.
In this simulated game analysis, pitchers experienced increased fatigue after each successive inning. While the average pitch velocity declined with each successive inning, the torque on the medial elbow increased after inning 3. These findings signify a possible relationship between fatigue and injury risk.
尽管投球计数规定和强调正确投掷力学的措施广泛实施，但棒球投手肘部过度使用损伤的发生率仍在继续上升。
确定棒球投手在模拟比赛过程中疲劳时，肘内侧是否会经历更高的扭矩水平。
描述性实验室研究。
招募了高中和大学棒球投手参加这项模拟比赛研究。每位投手完成了由 6 局组成的模拟比赛，并采用了标准的投球方案，包括快球、曲线球和变速球。每位投手总共投了 90 球。使用视觉模拟量表报告每局的疲劳情况，并用雷达枪记录每球的投球速度。使用经过验证的移动传感器评估结果测量指标，包括肘内侧扭矩、手臂速度、手臂旋转和手臂位置。使用线性和二次回归模型评估投手疲劳与投球运动学之间的关系。
共有 11 名投手（平均年龄 17.6 岁；范围 15-20 岁）完成了研究。视觉模拟量表疲劳评分每局增加 0.72 分（P <.01，效应量 = 0.64）。肘内侧扭矩也在第 3 局后增加，每局增加 0.84 N·m（P <.01，效应量 = 0.08），而投球速度下降（每局下降 0.28 英里/小时，P <.01，效应量 = 0.27）。快球产生的肘内侧扭矩最大（49.3 ± 1.4 N·m，P <.01，效应量 = 0.24）。随着比赛的进行，手臂旋转（P =.42）或手臂速度（P =.80）没有差异。然而，手臂位置每局都在下降（平均每局下降 0.73°，P =.03，效应量 = 0.12）。使用移动传感器没有出现不良结果。
在这项模拟比赛分析中，投手在每局后都会经历更高的疲劳感。虽然每局投球速度下降，但肘内侧的扭矩在第 3 局后增加。这些发现表明疲劳与受伤风险之间可能存在关系。
