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

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

Related Posts:

Yukutake, T., Kuwata, M., Yamada, M., & Aoyama, T. (2015). A Preseason Checklist for Predicting Elbow Injury in Little League Baseball Players Orthopaedic Journal of Sports Medicine, 3 (1) DOI: 10.1177/2325967114566788