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Pain, overuse symptoms in high school pitchers varied during the season
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Results presented at the American College of Sports Medicine Annual Meeting showed high school baseball pitchers experienced a variation in pain and overuse symptoms during the season, which peaked by week 5.
Of the 97 pitchers from eight central and southern Ohio high schools who received a validated questionnaire via text message throughout the season to assess overuse and pain, James Onate, PhD, AT, ATC, and colleagues found 60 participants met all inclusion criteria. Of these, 44 participants responded a minimum of 80% of the time.
Results showed symptoms of overuse and pain were reported by approximately 34.8% and 28.5% of participants, respectively. Researchers noted reports of symptoms of overuse peaked at 45.5% in week 4 of practice with a trend downward to 26.2% in the final week of the season. Reports of pain also peaked in week 4 of practice at 40.9% with a downward trend to 19% at the final week, according to results. Using a report of moderate or greater effect on training or performance, researchers found a low prevalence of severe overuse throughout the season, with any symptom of overuse reported by participants was mild. Results showed approximately 81.3% of participants reported mild pain compared with approximately 18% reporting moderate pain and one participant reporting severe pain in week 3.
“Throwing workload and soreness needs to be monitored and assessed through a systematic fashion, and open communication is necessary to avoid major arm injuries,” Onate told Healio.com/Orthopedics. “Further research is needed to continue to understand the complexities of the dynamic human motion that is required when throwing a baseball, ranging from biomechanical to neurological contributing factors relative to musculoskeletal injury.” – by Casey Tingle
Reference:
McNally MP, et al. Pain and overuse in high school baseball pitchers over the course of a season. Presented at: American College of Sports Medicine Annual Meeting; May 29 – June 2, 2018; Minneapolis.
Disclosure: Onate reports no relevant financial disclosures.
Perspective
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Glenn S. Fleisig, PhD
Overuse has been shown to be the principal risk factor for pain and subsequent injury in adolescent baseball pitchers, leading to the National Federation of State High School Association mandating states to implement high school pitch count limits. In this study, McNally and colleagues followed a group of high school pitchers during their season. Results showed prevalence of about 30% for overuse symptoms and for pain each week.
This study adds to our understanding of injury etiology but leads to more questions as well. Overuse is repetition of an activity leading to accumulated trauma and eventual injury. McNally and colleagues assessed “overuse” by asking pitchers if their training and performance were affected by arm problems. While McNally and colleagues captured symptoms that may indicate accumulated trauma, it would be more comprehensive to also quantify the repetition (through pitch counts, the Motus sleeve for throwing workload or other metrics) and monitor injuries (time missed, surgery, etc.). Correlating pain and overuse symptoms with the quantity of pitching and throwing may enable leagues, teams, coaches and players to optimize their volume of pitching during the season to minimize risk of overuse injury and maximize their performance.
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