Longitudinal study of elbow and shoulder pain in youth baseball pitchers

Purpose: Previous studies among young pitchers have focused on the frequenc y and description of elbow injuries. The purpose of this study was to evalu ate the frequency of elbow and shoulder complaints in young pitchers and to identify the associations between pitch types, pitch volume, and other ris k factors for theses conditions. Methods: A prospective cohort study of 298 youth pitchers was conducted over two seasons. Each participant was contac ted via telephone after each game pitched to identify arm complaints. Gener alized estimating equations were used to assess associations between arm co mplaints and independent variables. Results: The frequency of elbow pain wa s 26%; that of shoulder pain, 32%. Risk factors for elbow pain were increas ed age, increased weight, decreased height, lifting weights during the seas on, playing baseball outside the league, decreased self-satisfaction, arm f atigue during the game pitched, and throwing fewer than 300 or more than 60 0 pitches during the season. Risk factors for shoulder pain included decrea sed satisfaction, arm fatigue during the game pitched, throwing more than 7 5 pitches in a game, and throwing fewer than 300 pitches during the season. Conclusion: Ann complaints are common, with nearly half of the subjects re porting pain. The factors associated with elbow and shoulder pain were diff erent suggesting differing etiologies. Developmental factors may be importa nt in both. To lower the risk of pain at both locations, young pitchers pro bably should not throw more than 75 pitches in a game. Other recommendation s are to remove pitchers from a game if they demonstrate arm fatigue and li mit pitching in nonleague games.