Weill Cornell Medical College, New York, New York, USA.
Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA.
Am J Sports Med. 2022 Mar;50(4):1054-1060. doi: 10.1177/03635465211072223. Epub 2022 Feb 2.
Elbow flexion at late portions of the pitch has been associated with increased elbow varus torque, a kinetic surrogate associated with injury risk. Direct examinations of injury incidence with elbow flexion angles have not been conducted in professional pitchers.
To compare elbow and shoulder injury incidence among professional baseball players stratified by degree of elbow flexion at ball release (BR).
Descriptive laboratory study.
Professional pitchers (N = 314) were instructed to pitch between 8 and 12 fastballs while being evaluated using motion capture technology. Upper extremity injury incidence was recorded upon interview. Pitchers were subsequently subdivided into 3 groups based on increasing elbow flexion at BR. Analysis of variance was used to compare participant characteristics and kinematic and peak kinetic variables. An odds ratio (OR) was calculated to determine the risk of having a previous upper extremity injury based on the degree of elbow flexion at BR.
A total of 116 pitchers (132 documented injuries) had a previous upper extremity injury, with elbow injury (76 injuries; 57.6%) being the most common. Evaluation of kinetic values showed that pitchers with the smallest elbow flexion at BR had significantly less peak elbow flexion torque than did those with greatest elbow flexion at BR (3.8 ± 0.5 vs 4.1 ± 0.6 %weight × height; = .003). Pitchers who demonstrated a greater than average degree of elbow flexion at BR when pitching were more likely to have a history of elbow injury (OR, 1.97; 95% CI, 1.14-3.40; = .015) and olecranon spur formation or stress fracture (OR, 5.79; 95% CI, 1.25-26.85; = .025).
Pitchers with greater elbow flexion at BR had significantly higher odds of previous injury of the elbow and olecranon. Increasing elbow flexion has been shown to place the medial elbow in a position to carry a greater amount of load, which may be exacerbated during the final moments of the pitching motion. Professional pitchers can consider decreasing elbow flexion at BR as a potential, modifiable risk factor for elbow injury, in particular for olecranon spur formation and fracture.
This study attempts to associate injury incidence with a modifiable, kinematic variable for an at-risk population.
在投球的后期阶段，肘部弯曲与增加的肘内翻扭矩有关，这是一种与受伤风险相关的动力学替代指标。在职业投手中，尚未对与肘部弯曲角度相关的损伤发生率进行直接检查。
比较不同肘部弯曲角度下的投球时，职业棒球运动员肘部和肩部受伤的发生率。
描述性实验室研究。
指导 314 名职业投手投 8 到 12 个快球，同时使用运动捕捉技术进行评估。通过采访记录上肢受伤的发生率。根据投球时肘部弯曲程度将投手分为 3 组。使用方差分析比较参与者特征、运动学和峰值动力学变量。根据投球时肘部弯曲程度计算优势比（OR），以确定以前上肢损伤的风险。
共有 116 名投手（132 次记录的损伤）有以前的上肢损伤，其中肘部损伤（76 次损伤；57.6%）最常见。对动力学值的评估表明，在投球时肘部弯曲最小的投手中，峰值肘部弯曲扭矩明显小于肘部弯曲最大的投手中的峰值肘部弯曲扭矩（3.8 ± 0.5%体重×身高与 4.1 ± 0.6%体重×身高； =.003）。在投球时表现出大于平均肘部弯曲程度的投手更有可能有肘部受伤史（OR，1.97；95%CI，1.14-3.40； =.015）和鹰嘴突形成或应力性骨折（OR，5.79；95%CI，1.25-26.85； =.025）。
在投球时肘部弯曲程度较大的投手中，肘部和鹰嘴突受伤的几率明显较高。已经证明，增加肘部弯曲会使内侧肘部承受更大的负荷，这在投球运动的最后时刻可能会加剧。职业投手可考虑在投球时减少肘部弯曲程度，作为肘部受伤的潜在、可改变的风险因素，特别是对于鹰嘴突形成和骨折。
本研究试图将损伤发生率与高危人群的可改变运动学变量相关联。
