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Tsutsui T, Maemichi T, Saeki J, Torii S. Characteristics of upper limb mass, muscle CSA and stiffness in adolescent baseball players with and without elbow injury. J Biomech 2023; 157:111750. [PMID: 37549463 DOI: 10.1016/j.jbiomech.2023.111750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023]
Abstract
Since elbow injuries are common in adolescent baseball players, this study aimed to determine the relationship between musculoskeletal status and elbow injuries in 47 baseball players aged 12-14 years. Participants answered a questionnaire and had their general body measurements taken. Magnetic resonance imaging was used to evaluate muscle cross sectional areas (CSA) of the upper arm flexor and extensor muscles, and x-ray absorptiometry was used to determine the mass of the upper arm and the total mass of the forearm and hand. Shear wave elastography was used to determine muscle stiffness of the biceps brachii, brachialis, pronator teres, and brachioradialis. An orthopedic surgeon performed a clinical assessment and elbow ultrasonography for each participant to diagnose elbow injuries. The measured values were compared between the elbow injury and control groups using two-sample t-tests. The elbow injury group had significantly higher muscle stiffness in the brachialis (p < 0.001) and brachioradialis (p = 0.004) muscles and greater elbow flexor CSA of the distal upper arm (p = 0.004) than the control group. The total mass of the forearm and hand and the mass ratio of the forearm and hand to the upper arm were significantly greater in the elbow injury group than in the control group (p = 0.002 and p < 0.001). Thus, it may be necessary to increase flexibility of the brachialis and brachioradialis flexible by stretching and massaging in addition to evaluating the mass distal to the elbow and the elbow flexor muscle size of the distal upper arm to manage elbow injury in youth baseball players. Characteristics of Upper Limb Mass, Muscle Cross-Sectional Area and Stiffness in Adolescent Baseball Players with and without Elbow Injury.
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Affiliation(s)
- Toshiharu Tsutsui
- Faculty of Sports Science, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, Japan.
| | - Toshihiro Maemichi
- Faculty of Sports Science, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, Japan
| | - Junya Saeki
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, Japan
| | - Suguru Torii
- Faculty of Sports Science, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, Japan
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Tanaka N, Sakai Y, Iwamoto W, Wagatsuma K. Influence of pitching grip on shoulder and elbow injuries in junior baseball players, focusing on hand length and the metacarpophalangeal joint angle. J Phys Ther Sci 2021; 33:637-640. [PMID: 34539066 PMCID: PMC8436034 DOI: 10.1589/jpts.33.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/06/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We investigated the relationship of pitching grip with hand length and index
finger metacarpophalangeal joint angle. [Participants and Methods] A total of 650 junior
baseball players divided into two groups according to whether they experienced shoulder or
elbow pain were divided into two groups based on their pitching grip, i.e., those who held
the ball with the ulnar side of the thumb and those who held it with the finger pad of the
thumb. The metacarpophalangeal joint angle was measured while the participants held a
ball. [Results] The average hand length was 16.3 ± 1.4 cm for those holding the ball with
the ulnar side of the thumb and 15.8 ± 1.2 cm for those holding it with the finger pad of
the thumb. Hand length and metacarpophalangeal angle were significantly greater in the
group using the ulnar side of the thumb. The two groups showed no significant differences
in the distribution of grip type or history of shoulder/elbow pain. The index finger
metacarpophalangeal angle and shoulder/elbow pain were significantly lower in the pain
group. [Conclusion] With respect to the pitching grip for junior baseball players, we
recommend a slightly flexed rather than extended position with the metacarpophalangeal
angle.
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Affiliation(s)
- Naoki Tanaka
- Faculty of Health Care and Medical Sports, Teikyo Heisei University: 4-1 Uruidominami, Ichihara, Chiba 290-0193, Japan.,Graduate School of Health Science, Teikyo Heisei University, Japan
| | - Yasutomo Sakai
- Graduate School of Health Science, Teikyo Heisei University, Japan
| | | | - Koji Wagatsuma
- Department of Sports Rehabilitation, Edogawa Hospital, Japan
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Suzuki Y, Muraki T, Sekiguchi Y, Ishikawa H, Yaguchi H, Suzuki Y, Morise S, Honda K, Izumi SI. Influence of thoracic posture on scapulothoracic and glenohumeral motions during eccentric shoulder external rotation. Gait Posture 2019; 67:207-212. [PMID: 30368207 DOI: 10.1016/j.gaitpost.2018.10.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Throwing injuries to the shoulder joint often occur during shoulder external rotation. An appropriate combination of thoracic, scapular, and humeral motion during throwing is important to prevent such injuries, but it is unclear how thoracic posture contributes to shoulder motion during throwing. RESEARCH QUESTION The purpose of this study, therefore, was to clarify the influence of thoracic posture on scapulothoracic and glenohumeral motion during shoulder external rotation. METHODS Eccentric external rotation at 90° of shoulder abduction in thoracic flexion and extension postures was performed by 15 asymptomatic participants. Three-dimensional scapulothoracic and glenohumeral movements were measured with an electromagnetic tracking device at 75°, 80°, 85°, and maximum shoulder external rotation. The thoracic angle and maximum shoulder external rotation in absolute coordination were measured with a three-dimensional motion capture system. RESULTS The results showed that scapular posterior tilting and external rotation in the thoracic extension posture were significantly greater than those in the flexion posture (p < 0.05). Glenohumeral horizontal extension was significantly less in the thoracic extension posture than in the flexion posture (p < 0.05), whereas maximum shoulder external rotation was significantly greater (p < 0.01). Thus, thoracic extension increased scapulothoracic posterior tilting and external rotation and reduced glenohumeral horizontal extension during shoulder external rotation, as well as increasing maximum shoulder external rotation. SIGNIFICANCE These findings suggest that thoracic extension may contribute to reduction of mechanical demand in the glenohumeral joint during throwing, potentially reducing shoulder injuries.
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Affiliation(s)
- Yusuke Suzuki
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan; Department of Rehabilitation, Matsuda Hospital, 17-1 Tachitayasiki, Sanesawa, Izumi-ku, sendai, 981-3217, Japan
| | - Takayuki Muraki
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Yusuke Sekiguchi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Hiroaki Ishikawa
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Haruki Yaguchi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Yutaro Suzuki
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Shuhe Morise
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Keita Honda
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan; Graduate School of Biomedical Engineering, Tohoku University, 2-1, Seiryo-machi, Sendai, 980-8575, Japan.
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Asker M, Holm LW, Källberg H, Waldén M, Skillgate E. Female adolescent elite handball players are more susceptible to shoulder problems than their male counterparts. Knee Surg Sports Traumatol Arthrosc 2018; 26:1892-1900. [PMID: 29427220 PMCID: PMC6061455 DOI: 10.1007/s00167-018-4857-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/02/2018] [Indexed: 10/31/2022]
Abstract
PURPOSE Shoulder problems are frequent among senior elite handball players. The objective of this study was to assess the prevalence of shoulder problems among adolescent elite handball players and to investigate potential differences in gender, school grade, playing position and playing level. METHODS During the 2014 and 2015 pre-season periods, 471 players (age 15-18 years, 54% female) completed a comprehensive baseline questionnaire regarding history of any shoulder pain and shoulder problems experienced during the past season. The players were monitored weekly for one competition season (September-April) regarding shoulder problems and the amount of match and training. Generalised linear models with a binomial link function were used to calculate a prevalence ratio (PR) with 95% confidence interval (CI) to compare the subgroups of players. RESULTS In total, 110 players (23%) reported having substantial shoulder problems (defined as moderate/severe reduction in training volume, or moderate/severe reduction in performance, or complete inability to participate) at some point during the follow-up season, of which almost half reported complete inability to participate. Of those players reporting substantial problems, 43% (95% CI 39-48) did so for at least 3 consecutive weeks during the season. The prevalence was significantly higher in female players (PR 1.46, 95% 1.04-2.06) and in backcourt players (PR 1.58, 95% CI 1.08-2.32), but no differences were found for school grade (PR 1.21 95% CI 0.88-1.67) or playing level (PR 1.09 95% CI 0.76-1.56). CONCLUSIONS The prevalence of substantial shoulder problems in adolescent elite handball players is high, especially among females, and this warrants further studies on risk factors for shoulder injury and the development of prevention strategies in handball players already before the age of 15. These findings also highlight the importance of introducing a clinical monitoring programme on a routine basis and improving the medical support, taking gender-related aspects into consideration, at handball-profiled secondary schools. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Martin Asker
- Musculoskeletal and Sports Injury Epidemiology Center, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. .,Naprapathögskolan-Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden.
| | - Lena W. Holm
- 0000 0004 1937 0626grid.4714.6Musculoskeletal and Sports Injury Epidemiology Center, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Källberg
- 0000 0000 9580 3113grid.419734.cDepartment of Monitoring and Evaluation, Public Health Agency of Sweden, Solna, Sweden
| | - Markus Waldén
- 0000 0001 2162 9922grid.5640.7Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden ,Department of Orthopaedics, Hässleholm-Kristianstad-Ystad Hospitals, Hässleholm, Sweden
| | - Eva Skillgate
- 0000 0004 1937 0626grid.4714.6Musculoskeletal and Sports Injury Epidemiology Center, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden ,Naprapathögskolan-Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
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