ATI Physical Therapy, Greenville, SC, USA; University of South Carolina Center for Effectiveness Research in Orthopedics, Greenville, SC, USA.
ATI Physical Therapy, Greenville, SC, USA.
J Shoulder Elbow Surg. 2023 Jun;32(6S):S106-S111. doi: 10.1016/j.jse.2023.02.009. Epub 2023 Feb 23.
Arm injuries are commonly encountered in baseball as young athletes play into adulthood. The purpose of this study was to examine the incidence of arm injury and risk for surgery in adolescent baseball players followed over a 10-year period from scholastic, age-group, and travel baseball leagues through their highest level of competition.
A prospective study was conducted enrolling middle and high school baseball players in 2010-2012, then followed for 10 years or until retirement from competitive baseball. Players were included if fully participating in team activities at the time of preseason study enrollment. Players with prior arm (shoulder or elbow) surgery or those diagnosed with time loss arm injury within the past year were excluded. Only shoulder and elbow overuse problems resulting in time-loss from sport and medical attention from a sports medicine physician or orthopedic surgeon were documented as injuries in this study. Musculoskeletal overuse injuries were classified based on the orchard injury classification system. Incidence proportion and risk ratio (RR) and 95% confidence intervals (CIs) for initial injury and injuries requiring surgery were calculated.
A total of 261 pitchers (age: 14.2 ± 2.6 years; follow-up: 4.2 ± 2.7 years) were enrolled. Twenty percent of the cohort was followed for ≥7 years. The overall injury incidence was 25.6/100 athletes (95% CI 21-31) with a cumulative surgical incidence of 5.4/100 athletes (95% CI 3.2-8.8). The risk of experiencing shoulder injury (n = 25) and elbow injury (n = 38) were similar (n = 38) (RR 0.7, 95% CI 0.4-1.1). The athletes also presented with a similar frequency of requiring surgery regardless of the injured body part. However, the risk of surgery in those playing beyond the high school level was 4.3 times greater (95% CI 1.2-15.0) than those only playing high school.
This is the first study to follow a large cohort of youth baseball players as they progress, showing a relatively high arm injury incidence. Shoulder and elbow injury incidence was similar but surgical risk increased playing beyond high school, specifically for the elbow. The high injury frequency and burden of care required by young baseball players as reported in this study is concerning, and strategies to reduce injury should be investigated.
手臂受伤在青少年棒球运动员中很常见，他们从少年时期一直打到成年。本研究的目的是检查在 10 年的时间里，从学校、年龄组和旅行棒球队到他们最高水平的比赛中，青少年棒球运动员手臂受伤的发生率和手术风险。
进行了一项前瞻性研究，纳入 2010-2012 年的中学和高中棒球运动员，然后随访 10 年或直至他们从竞技棒球退役。如果在 preseason 研究入组时完全参加团队活动，则纳入运动员。排除有手臂（肩部或肘部）手术史或过去 1 年内有因手臂受伤而导致时间损失的运动员。在这项研究中，仅记录因过度使用导致的肩部和肘部时间损失问题，以及需要运动医学医生或骨科医生治疗的伤病。肌肉骨骼过度使用损伤根据果园损伤分类系统进行分类。计算初始损伤和需要手术的损伤的发生率比例和风险比（RR）及 95%置信区间（CI）。
共纳入 261 名投手（年龄：14.2±2.6 岁；随访：4.2±2.7 年）。20%的队列随访时间≥7 年。总体损伤发生率为 25.6/100 名运动员（95%CI 21-31），累积手术发生率为 5.4/100 名运动员（95%CI 3.2-8.8）。肩部损伤（n=25）和肘部损伤（n=38）的风险相似（n=38）（RR 0.7，95%CI 0.4-1.1）。无论受伤部位如何，运动员因需要手术而就诊的频率也相似。然而，在高中以后继续打球的运动员手术风险高 4.3 倍（95%CI 1.2-15.0）。
这是第一项对大量青少年棒球运动员进行随访的研究，结果显示手臂受伤发生率相对较高。肩部和肘部损伤的发生率相似，但在高中以后继续打球的运动员手术风险增加，特别是肘部。本研究报道的青少年棒球运动员高受伤频率和护理负担令人担忧，应研究减少受伤的策略。
