Early Sport Specialization Linked to Throwing Arm Function and Upper Extremity Injury History in College Baseball Players

Arm Health in Elite Collegiate Summer League Baseball Players Assessed by the Kerlan-Jobe Orthopaedic Clinic Score

CONTEXT

Collegiate baseball players with professional aspirations often participate in summer leagues; foremost among them is the Cape Cod Baseball League (CCBL). Injuries acquired during the collegiate baseball season can be carried into the CCBL season and vice versa.

OBJECTIVE

To assess the history of throwing arm injury and current functionality in midseason CCBL players.

DESIGN

Cross-sectional study.

SETTING

Online questionnaire.

PATIENTS OR OTHER PARTICIPANTS

A total of 123 CCBL players participated. Qualifying athletes were ≥18 years old and were rostered CCBL players with remaining collegiate eligibility.

MAIN OUTCOME MEASURE(S)

After collecting background information, we used the Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow questionnaire to assess the history of throwing arm injury and current functionality. The maximum KJOC score is 100.0; higher scores correspond with greater functionality.

RESULTS

The mean KJOC score was 86.6 ± 14.5 (n = 92); 24.5% (23/94) of players reported a prior diagnosis of throwing arm injury other than a strain or sprain. A total of 49 (49/96, 51.0%) players had undergone rehabilitation for a throwing arm injury, and 7 (7/96, 7.3%) had experienced a medical procedure. Players with no previous treatment (n = 41, mean KJOC score = 88.9 ± 19.0) more frequently demonstrated KJOC scores of ≥90 than players with such treatment (n = 55, 80.9 ± 17.1; P < .001). The 18 players with time-loss arm injury in the last year had lower mean KJOC scores (71.3 ± 20.0) than players with no injury or time loss (90.3 ± 9.8; P < .001). Similarly, players who reported current arm trouble (n = 15) had lower KJOC scores (71.6 ± 17.5) than players with healthy arms (89.5 ± 11.9; P < .001).

CONCLUSIONS

The average KJOC score of the CCBL players was <90, with particularly low scores in athletes with prior arm injury and treatment.

Overuse Injuries, Overtraining, and Burnout in Young Athletes

Sports participation can have tremendous physical and mental health benefits for children. Properly implemented progressive training programs can yield a broad range of beneficial physiologic adaptations, but imbalances of training load and recovery can have important negative consequences. Overuse injuries, for example, can result from repetitive stress without sufficient recovery that leads to accumulated musculoskeletal damage. In addition, extended periods of increased training loads that exceed the intervening recovery can have systemic consequences such as overtraining syndrome, which results in decreased performance, increased injury and illness risk, and derangement of endocrine, neurologic, cardiovascular, and psychological systems. Burnout represents one of the primary reasons for attrition in youth sports. Broadly defined as physical or mental exhaustion and a reduced sense of accomplishment that leads to devaluation of sport, burnout represents a direct threat to the goal of lifelong physical activity and the wide-ranging health benefits that it provides. This clinical report is intended to provide pediatricians with information regarding the risk factors, diagnosis, management, and prevention of these conditions to assist in the identification of at-risk children, the treatment of young athletes, and the guidance of families in the promotion of safe and healthy sport participation.

Tennis Specialization and Consequence of Injury/Illness Following Retirement

(1) Background: There is a lack of literature that examines the impact of early vs. late sport specialization on quality of life after retirement from tennis. Thus, the purpose of this study was to examine the relationship between early specialization in the sport of tennis and health outcomes after retirement from collegiate/professional sport; (2) Methods: Participants were recruited through social media posts, newsletters, and contacts with tennis organizations. Basic demographic and injury information was collected from 157 former tennis players, along with the age of tennis specialization and two questionnaires: the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC), and the CDC HRQOL-14 "Healthy Days Measure" Questionnaire (HRQOL); (3) Results: Significant differences (F_1,117 = 5.160, p < 0.025) in the specialization age between the low (11.9 ± 4.5 y) and high (9.8 ± 4.1 y) OSTRC groups were found after covarying for the current age. No difference (F_1,72 = 0.676, p < 0.414) was shown among the high (10.9 ± 4.4 y) and low (11.28 ± 4.6 y) HRQOL groups for the specialization age after covarying for the current age. A weak negative correlation was identified between the OSTRC score and specialization age (r = -0.233, p = 0.008), while no significant changes were shown between the specialization age and HRQOL score (r = -0.021, p = 0.857), or between the OSTRC and HRQOL scores (r = 0.146, p = 0.208); (4) Conclusions: Retired tennis players with low injury/illness severity scores specialized in tennis later than those with high injury/illness severity scores, while no differences in the specialization age were noted when the sample was separated into HRQOL groups.

Understanding the Disabled Throwing Shoulder Requires Updated Review of Anatomy, Mechanics, Pathomechanics, and Treatment

Understanding both shoulder health and shoulder pathology in throwers is relevant to overhead athletes, and also relevant to nonoverhead athletes and even nonathletes. The thrower's shoulder is a clinically relevant topic of medical research scholarship today. Some of the greatest advances in sports medicine result from our ability to visualize normal and pathologic anatomy of joints, including the shoulder, using a small camera and a fiberoptic light source, through small portals, and without disruptive surgical dissection, or, in a word, "arthroscopy." Updates on the thrower's shoulder, including anatomy, mechanics, pathomechanics, and treatment, are essential for clinicians and researchers treating or investigating the shoulder.

Youth sport specialization associated with poorer lower extremity function & pain as young adults

OBJECTIVE

Examine the link between youth sports specialization and long-term lower extremity joint health after sports by comparing lower extremity function, pain, and history of sport-related injuries between young adults that were highly, moderately, and low specialized in youth sports.

METHODS

We used a cross-sectional design, and all data was collected using an electronic survey. Our sample included N = 356 young adults who participated in a primary sport during youth and high school sports but were no longer participating in that sport as a young adult. Participants were stratified into high (n = 111), moderate (n = 119), and low (n = 126) specialization groups using a 3-criteria sport specialization questionnaire based on youth sports participation prior to high school. We compared participants current Lower Extremity Functional Scale (LEFS) score (0-80), the proportion of participants with clinically important deficits in LEFS score (≤71/80), current lower extremity (foot/ankle, knee, hip) pain scores (0-10), and history of lower extremity (foot/ankle, knee, hip) injuries between the high, moderate, and low specialization groups.

RESULTS

The high specialization group reported significantly lower overall LEFS scores, and a greater proportion (40%) reported clinically important deficits in LEFS scores compared to the low specialization group (20%). The high specialization group also reported greater foot/ankle and knee pain and a greater proportion of sport-related knee injuries than the low specialization group (49% vs 25%).

CONCLUSIONS

Our findings suggest that even after discontinuing sports, young adults who were highly specialized in youth sports before high school reported clinically important deficits in lower extremity function, greater foot/ankle and knee pain, and a greater history of knee injuries than young adults who were not specialized in youth sports, suggesting a possible link between youth sports specialization and long-term lower extremity health after sports.

Early Sport Specialization in College Athletes and the Impact on Health-Related Quality of Life: A Critically Appraised Topic

Clinical Scenario: Youth athletes may specialize in a sport of their choosing, or based on external pressures, to pursue elite status in that sport. Current evidence shows an association between highly specialized athletes and an increase in injuries as well as a connection between injury and lower health-related quality of life (HRQOL). Clinical Question: In college athletes, do early sport specialization characteristics (ie, age at specialization and degree of specialization) impact current HRQOL? Summary of Key Findings: The literature was searched for studies that investigated the age of specialization (early vs late) or degree of specialization (high, moderate, and low) and the impact on HRQOL. (1) The search returned 6 possible studies related to the clinical question. Three of the studies met the inclusion criteria and were used for this appraisal. (2) Two of the 3 included studies reported that highly specialized athletes noted lower HRQOL. (3) One study found there to be no significant difference in HRQOL between athletes who specialized early versus late but did find those who specialized early to have a greater incidence of injuries that required surgery. Clinical Bottom Line: There is moderate evidence that early sport specialization is associated with lower HRQOL compared with late sport specialization. It is important to educate athletes, parents, and coaches on the potential detriments that are associated with early sport specialization to allow stakeholders to make informed decisions regarding participation. Strength of Recommendation: Grade B evidence exists to support the idea that early, intensive sport specialization may be associated with decreased HRQOL in current college athletes.