Chalmers Peter N, Mcelheny Kathryn, D'Angelo John, Ma Kevin, Rowe Dana, Erickson Brandon J
Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA.
Hospital for Special Surgery, New York, New York, USA.
Orthop J Sports Med. 2023 Aug 18;11(8):23259671231191223. doi: 10.1177/23259671231191223. eCollection 2023 Aug.
Internal impingement is a common cause of shoulder pain and dysfunction in baseball pitchers.
PURPOSE/HYPOTHESIS: The purpose of this study was to determine if the amount of rest days between outings, the number of innings pitched in each outing, and the number of batters faced in each outing are risk factors for internal impingement in professional baseball pitchers. It was hypothesized that a higher workload would significantly increase a pitcher's risk of developing internal impingement.
Case-control study; Level of evidence, 3.
All professional (Major and Minor League) baseball pitchers who were diagnosed with internal impingement between 2011 and 2017 were identified using the Major League Baseball's Health and Injury Tracking System. A separate player usage data set was used to determine workload. The authors compared workload variables (days of rest, innings pitched, and batters faced per game) between each of 4 injury-exposure groups (pitchers with documented internal impingement <2, <6, <12, and >12 weeks after a game) and a control group of pitchers with no internal impingement using Student tests or Mann-Whitney tests. In a within-pitcher paired analysis of the injury groups, the workload variables during 3 acute periods (<2, <6, and <12 weeks preinjury) were compared with the baseline values (>12 weeks preinjury).
Overall, there were 624 professional baseball pitchers diagnosed with internal impingement during the study period. Compared with pitcher games (n = 213,964), pitchers in all 4 injury-exposure groups had significantly more innings pitched per game ( ≤ .003 for all) and faced significantly more batters per game ( < .001 for all). There were significantly more starting pitchers in each of the injury-exposure groups when compared with the controls ( < .001 for all). However, when comparing acute and baseline workloads in the pitchers diagnosed with internal impingement, there were no significant differences in the number of innings pitched, batters faced, or days of rest.
This analysis revealed significantly greater pitcher workload and percentage of starting pitchers in professional baseball players diagnosed with internal impingement when compared with healthy controls. However, this injury did not seem to be associated with an acute increase in workload.
内撞击是棒球投手肩部疼痛和功能障碍的常见原因。
目的/假设：本研究的目的是确定每次出场之间的休息天数、每次出场投球的局数以及每次出场面对的击球手数量是否为职业棒球投手发生内撞击的风险因素。研究假设更高的工作量会显著增加投手发生内撞击的风险。
病例对照研究；证据等级，3级。
使用美国职业棒球大联盟的健康与伤病追踪系统，确定了2011年至2017年期间所有被诊断为内撞击的职业（大联盟和小联盟）棒球投手。使用单独的球员使用数据集来确定工作量。作者比较了4个受伤暴露组（比赛后记录有内撞击<2周、<6周、<12周和>12周的投手）与无内撞击的对照投手组之间的工作量变量（休息天数、投球局数和每场面对的击球手数量），采用Student检验或Mann-Whitney检验。在对受伤组进行的投手内配对分析中，比较了3个急性期（受伤前<2周、<6周和<12周）的工作量变量与基线值（受伤前>12周）。
总体而言，在研究期间有624名职业棒球投手被诊断为内撞击。与投手比赛（n = 213,964）相比，所有4个受伤暴露组的投手每场投球局数显著更多（所有P≤0.003），每场面对的击球手数量显著更多（所有P<0.001）。与对照组相比，每个受伤暴露组的先发投手显著更多（所有P<0.001）。然而，在比较被诊断为内撞击的投手的急性期和基线工作量时，投球局数、面对的击球手数量或休息天数没有显著差异。
该分析显示，与健康对照组相比，被诊断为内撞击的职业棒球运动员的投手工作量和先发投手百分比显著更高。然而，这种损伤似乎与工作量的急性增加无关。
