Skip to main content
Top
Published in: Current Reviews in Musculoskeletal Medicine 1/2018

01-03-2018 | Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Injury Prevention in Baseball: from Youth to the Pros

Authors: Heath P. Melugin, Nels D. Leafblad, Christopher L. Camp, Stan Conte

Published in: Current Reviews in Musculoskeletal Medicine | Issue 1/2018

Login to get access

Abstract

Purpose of Review

This review examines recent literature on injury epidemiology and prevention in the sport of baseball from youth to professional levels.

Recent Findings

Overuse is the predominant mechanism of injury in youth baseball players. Newer stretching and exercise protocols may help prevent these injuries. At the professional level, however, overuse has not been proven to correlate with increased injury incidence, but pitch counts are still monitored. There continues to be a rise in operations performed for baseball-related injuries, including ulnar collateral ligament (UCL) reconstruction, particularly in younger athletes. As the level of play increases, there is significant loss of participation due to injuries, such as the UCL in the upper extremity and the hamstrings in the lower extremity.

Summary

Baseball is a widely popular sport, which has led to a focus on injury epidemiology and prevention. While the majority of research regarding baseball injuries focuses on pitchers, fielders and catchers are also at risk. In an attempt to decrease non-contact injuries in the upper and lower extremities, stretching and strengthening exercises are vitally important. Because injury profiles demonstrate significant variability from youth to professional baseball, unique prevention strategies are likely necessary at each level. More research is needed to develop and validate appropriately targeted injury prevention programs.
Literature
4.
go back to reference • Conte S, Camp CL, Dines JS. Injury trends in Major League Baseball over 18 seasons: 1998–2015. Am J Orthop (Belle Mead NJ). 2016;45(3):116–23. This study represents the most recent examining injury trends in major league baseball. They examined injury incidence and amount of lost participation time between 1998–2015 using an MLB injury database. They found the incidence of injury to increase steadily during this period. Shoulder and elbow injuries were the cause of the most lost participation time. During the study period, MUCL injury incidence increased significantly and a significant number of pitchers had MUCL reconstruction surgery. • Conte S, Camp CL, Dines JS. Injury trends in Major League Baseball over 18 seasons: 1998–2015. Am J Orthop (Belle Mead NJ). 2016;45(3):116–23. This study represents the most recent examining injury trends in major league baseball. They examined injury incidence and amount of lost participation time between 1998–2015 using an MLB injury database. They found the incidence of injury to increase steadily during this period. Shoulder and elbow injuries were the cause of the most lost participation time. During the study period, MUCL injury incidence increased significantly and a significant number of pitchers had MUCL reconstruction surgery.
6.
go back to reference • Makhni EC, Morrow ZS, Luchetti TJ, Mishra-Kalyani PS, Gualtieri AP, Lee RW, et al. Arm pain in youth baseball players: a survey of healthy players. Am J Sports Med. 2015;43(1):41–6. Though guidelines and recommendations are in place to prevent youth overuse injuries, adherence to them remains an issue for players and coaches. A recent study by Makhni et al. found that 46% of youth respondents said they were encouraged on at least one occasion to keep playing despite having arm pain. This is clearly a problem, as throwing-related arm pain is indicative of possible injury, and management involves cessation of throwing. It is imperative that adults, including coaches and parents, act in the interest of the athlete and not pressure them into continuation of potentially destructive activity. https://doi.org/10.1177/0363546514555506. • Makhni EC, Morrow ZS, Luchetti TJ, Mishra-Kalyani PS, Gualtieri AP, Lee RW, et al. Arm pain in youth baseball players: a survey of healthy players. Am J Sports Med. 2015;43(1):41–6. Though guidelines and recommendations are in place to prevent youth overuse injuries, adherence to them remains an issue for players and coaches. A recent study by Makhni et al. found that 46% of youth respondents said they were encouraged on at least one occasion to keep playing despite having arm pain. This is clearly a problem, as throwing-related arm pain is indicative of possible injury, and management involves cessation of throwing. It is imperative that adults, including coaches and parents, act in the interest of the athlete and not pressure them into continuation of potentially destructive activity. https://​doi.​org/​10.​1177/​0363546514555506​.
14.
go back to reference • Oliver GD, Plummer H, Henning L, Saper M, Glimer G, Brambeck A, et al. Effects of a simulated game on upper extremity pitching mechanics and muscle activations among various pitch types in youth baseball pitchers. J Pediatr Orthop. 2017. Whether or not young athletes should throw breaking balls prior to skeletal maturity has been a controversial topic over the years. This recent biomechanical study in youth athletes throwing various breaking and non-breaking pitches demonstrated no significant difference in arm slot position or muscle activation in the pelvis, torso, and upper extremity. This lends support to the argument that throwing a breaking ball is no more dangerous than throwing other pitches. • Oliver GD, Plummer H, Henning L, Saper M, Glimer G, Brambeck A, et al. Effects of a simulated game on upper extremity pitching mechanics and muscle activations among various pitch types in youth baseball pitchers. J Pediatr Orthop. 2017. Whether or not young athletes should throw breaking balls prior to skeletal maturity has been a controversial topic over the years. This recent biomechanical study in youth athletes throwing various breaking and non-breaking pitches demonstrated no significant difference in arm slot position or muscle activation in the pelvis, torso, and upper extremity. This lends support to the argument that throwing a breaking ball is no more dangerous than throwing other pitches.
15.
go back to reference Bohne C, George SZ, Zeppieri G Jr. Knowledge of injury prevention and prevalence of risk factors for throwing injuries in a sample of youth baseball players. Int J Sports Phys Ther. 2015;10(4):464–75.PubMedPubMedCentral Bohne C, George SZ, Zeppieri G Jr. Knowledge of injury prevention and prevalence of risk factors for throwing injuries in a sample of youth baseball players. Int J Sports Phys Ther. 2015;10(4):464–75.PubMedPubMedCentral
18.
go back to reference • Sakata J, Nakamura E, Suzuki T, Suzukawa M, Akaike A, Shimizu K, et al. Efficacy of a prevention program for medial elbow injuries in youth baseball players. Am J Sports Med. 2017:363546517738003. This prospective randomized trial of a unique stretching and strengthening protocol demonstrated a significant decrease in medial elbow injuries in adolescent baseball players. The exercises also improved dominant side total range of shoulder rotation, non-dominant side hip internal rotation, bilateral shoulder internal rotation deficit, dominant side lower trapezius muscle strength, and the thoracic kyphosis angle. This appears to be the first prospective study of its kind. The Yokohama Baseball-9, or similar exercises, could be incorporated into pre-game and pre-practice routines. • Sakata J, Nakamura E, Suzuki T, Suzukawa M, Akaike A, Shimizu K, et al. Efficacy of a prevention program for medial elbow injuries in youth baseball players. Am J Sports Med. 2017:363546517738003. This prospective randomized trial of a unique stretching and strengthening protocol demonstrated a significant decrease in medial elbow injuries in adolescent baseball players. The exercises also improved dominant side total range of shoulder rotation, non-dominant side hip internal rotation, bilateral shoulder internal rotation deficit, dominant side lower trapezius muscle strength, and the thoracic kyphosis angle. This appears to be the first prospective study of its kind. The Yokohama Baseball-9, or similar exercises, could be incorporated into pre-game and pre-practice routines.
27.
go back to reference Saper MG, Pierpoint LA, Liu W, Comstock RD, Polousky JD, Andrews JR. Epidemiology of shoulder and elbow injuries among United States high school baseball players: school years 2005-2006 Through 2014-2015. Am J Sports Med. 2017:363546517734172. Saper MG, Pierpoint LA, Liu W, Comstock RD, Polousky JD, Andrews JR. Epidemiology of shoulder and elbow injuries among United States high school baseball players: school years 2005-2006 Through 2014-2015. Am J Sports Med. 2017:363546517734172.
34.
go back to reference Centers for Disease C. Prevention. Sliding-associated injuries in college and professional baseball—1990–1991. MMWR Morb Mortal Wkly Rep. 1993;42(12): 223, 229–30. Centers for Disease C. Prevention. Sliding-associated injuries in college and professional baseball—1990–1991. MMWR Morb Mortal Wkly Rep. 1993;42(12): 223, 229–30.
35.
go back to reference Dick R, Sauers EL, Agel J, Keuter G, Marshall SW, McCarty K, et al. Descriptive epidemiology of collegiate men's baseball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 through 2003–2004. J Athl Train. 2007;42(2):183–93.PubMedPubMedCentral Dick R, Sauers EL, Agel J, Keuter G, Marshall SW, McCarty K, et al. Descriptive epidemiology of collegiate men's baseball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 through 2003–2004. J Athl Train. 2007;42(2):183–93.PubMedPubMedCentral
47.
go back to reference Dahm DL, Curriero FC, Camp CL, Brophy RH, Leo T, Meister K, et al. Epidemiology and impact of knee injuries in major and minor league baseball players. Am J Orthop (Belle Mead NJ). 2016;45(3):E54–62.PubMed Dahm DL, Curriero FC, Camp CL, Brophy RH, Leo T, Meister K, et al. Epidemiology and impact of knee injuries in major and minor league baseball players. Am J Orthop (Belle Mead NJ). 2016;45(3):E54–62.PubMed
48.
go back to reference Erickson BJ, Chalmers PN, Bush-Joseph CA, Romeo AA. Predicting and preventing injury in Major League Baseball. Am J Orthop (Belle Mead NJ). 2016;45(3):152–6.PubMed Erickson BJ, Chalmers PN, Bush-Joseph CA, Romeo AA. Predicting and preventing injury in Major League Baseball. Am J Orthop (Belle Mead NJ). 2016;45(3):152–6.PubMed
50.
go back to reference Camp CL, Conti MS, Sgroi T, Cammisa FP, Dines JS. Epidemiology, treatment, and prevention of lumbar spine injuries in major league baseball players. Am J Orthop (Belle Mead NJ). 2016;45(3):137–43. Camp CL, Conti MS, Sgroi T, Cammisa FP, Dines JS. Epidemiology, treatment, and prevention of lumbar spine injuries in major league baseball players. Am J Orthop (Belle Mead NJ). 2016;45(3):137–43.
57.
go back to reference • Chalmers PN, Erickson BJ, Ball B, Romeo AA, Verma NN. Fastball pitch velocity helps predict ulnar collateral ligament reconstruction in major league baseball pitchers. Am J Sports Med. 2016;44(8):2130–5. In this analysis of major league baseball pitchers, it was shown that peak velocity was an independent predictor of UCL reconstruction status. They also found that increased mean velocity was a statistically significant secondary predictor. https://doi.org/10.1177/0363546516634305.CrossRefPubMed • Chalmers PN, Erickson BJ, Ball B, Romeo AA, Verma NN. Fastball pitch velocity helps predict ulnar collateral ligament reconstruction in major league baseball pitchers. Am J Sports Med. 2016;44(8):2130–5. In this analysis of major league baseball pitchers, it was shown that peak velocity was an independent predictor of UCL reconstruction status. They also found that increased mean velocity was a statistically significant secondary predictor. https://​doi.​org/​10.​1177/​0363546516634305​.CrossRefPubMed
64.
go back to reference • Seagrave RA 3rd, Perez L, McQueeney S, Toby EB, Key V, Nelson JD. Preventive effects of eccentric training on acute hamstring muscle injury in professional baseball. Orthop J Sports Med. 2014;2(6):2325967114535351. This study demonstrated a decreased incidence of hamstring injuries in a single professional baseball franchise when eccentric or Nordic hamstring strengthening exercises were implemented. This led to decreased loss of participation time as well. https://doi.org/10.1177/2325967114535351. • Seagrave RA 3rd, Perez L, McQueeney S, Toby EB, Key V, Nelson JD. Preventive effects of eccentric training on acute hamstring muscle injury in professional baseball. Orthop J Sports Med. 2014;2(6):2325967114535351. This study demonstrated a decreased incidence of hamstring injuries in a single professional baseball franchise when eccentric or Nordic hamstring strengthening exercises were implemented. This led to decreased loss of participation time as well. https://​doi.​org/​10.​1177/​2325967114535351​.
Metadata
Title
Injury Prevention in Baseball: from Youth to the Pros
Authors
Heath P. Melugin
Nels D. Leafblad
Christopher L. Camp
Stan Conte
Publication date
01-03-2018
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 1/2018
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-018-9456-5

Other articles of this Issue 1/2018

Current Reviews in Musculoskeletal Medicine 1/2018 Go to the issue

Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Treatment of Partial Thickness Rotator Cuff Tears in Overhead Athletes

Rotator Cuff Repair (M Tao and M Teusink, section editors)

The Role of Biologic Therapy in Rotator Cuff Tears and Repairs

Rotator Cuff Repair (M Tao and M Teusink, section editors)

Management of Rotator Cuff Injuries in the Elite Athlete

Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Return to Throwing after Shoulder or Elbow Injury

Rotator Cuff Repair (M Tao and M Teusink, section editors)

Partial and Full-Thickness RCT: Modern Repair Techniques

Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Diagnosis and Treatment of Injuries to the Biceps and Superior Labral Complex in Overhead Athletes