A Preseason Checklist for Predicting Elbow Injury in Little League Baseball Players
Yukutake T, Kuwata M, Yamada M, Aoyama T. The Orthopaedic Journal of Sports Medicine 3.1 (2015): 1-7 doi: 10.1177/2325967114566788
Take Home Message: Using a preseason checklist with Little League Baseball Players may help to determine which young athletes are at risk of developing elbow injuries.
Little league elbow, epicondylitis, and osteochondrosis dissecans are just a few conditions that affect many young baseball players in the early years of their careers. These conditions occur due to a number of different circumstances including; overuse, improper pitching mechanics, repetitive microtraumas to the elbow, etc. Identifying risk factors that contribute to injury would allow us to educate parents and coaches to assist in preventative efforts. Therefore, the purpose of this prospective cohort study was to use a risk-evaluation checklist to predict injuries over the course of a season among young baseball players. The authors sent preseason checklists to 134 Little League baseball teams in Japan and 955 Little League baseball players completed the preseason checklist. The athletes with their parents filled out a 20-question checklist pertaining to the athlete’s pitching arm, baseball practices, mechanics, structure/flexibility of the elbow, pain, previous injuries, among others. The athletes also sent back a follow-up survey six months after they completed the preseason checklist. In the follow-up survey, the athlete and parents recorded if the athlete sustained an injury during the season. An elbow injury was an injury to the dominant arm that required medical treatment. Overall, 389 athletes (age ~10 years) completed the checklist and follow-up survey and had no existing elbow injuries during preseason. Fifty-three athletes reported sustaining an elbow injury during the season. The authors found that athletes were more likely to sustain an elbow injury during the season if they reported during preseason that they 1) experienced pain within the past 12 months, 2) had a previous injury that required treatment, 3) practiced more than 4 days/week, 4) practiced individually 7 days/week, 5) normally participate in games, or 6) felt fatigue while playing. From these results the authors created a 6-item checklist to assess the risk of elbow injuries, which may be used by youth baseball parents and coaches. Players who answered yes to three or more of these items had a higher injury rate (33%) than those who only answered yes to two or less items (6%).
This study adds to the growing literature which demonstrates excessive throwing contributes to elbow injuries. It is extremely important coaches and athletes adhere to limiting the number of pitchers to help prevent elbow injuries in young athletes due to the forces put on an athlete’s arm and fatigue caused by throwing if not properly managed. This checklist can be used by athletic trainers and other sports medicine clinicians working with young baseball players to determine if an athlete is prone to an elbow injury during the season. It is also a simple enough tool that it can be used by coaching staffs, parents, and others involved with youth athletics before the season starts to assist in prevention. It will be helpful to see if this checklist works well in other populations; such as, older baseball players and players from other countries. Creating pitching limits and developing maintenance programs to prevent fatigue and stress from throwing is pivotal in sustaining health among youth baseball athletes.
Questions for Discussion: Do you see this checklist as a helpful form to detect possible elbow injuries for those who are not health care professionals? What other methods have helped you determine whether or not a young athlete is more at risk for elbow injury?
Written by: Bailey Shiller and Adam Rosen
Reviewed by: Jeffrey Driban