Association of Head-Neck Rotation With History of Pitching-Related Elbow Pain in Youth Baseball Players

Masumi Yoshimoto; Masashi Kawabata; Toru Miyata; Yosuke Sato; Daichi Naoi; Mitsuaki Ashihara; Nobuyuki Suzuki; Chihiro Ikoma; Hiroaki Tatsuki; Ryota Kuratsubo; Hiroyuki Watanabe; Yohei Kusaba; Daiki Watanabe

doi:10.1177/23259671241229079

Association of Head-Neck Rotation With History of Pitching-Related Elbow Pain in Youth Baseball Players

Orthop J Sports Med. 2024 Feb 23;12(2):23259671241229079. doi: 10.1177/23259671241229079. eCollection 2024 Feb.

Authors

Masumi Yoshimoto¹, Masashi Kawabata^{2

3

4}, Toru Miyata³, Yosuke Sato³, Daichi Naoi³, Mitsuaki Ashihara³, Nobuyuki Suzuki³, Chihiro Ikoma³, Hiroaki Tatsuki³, Ryota Kuratsubo^{5

6}, Hiroyuki Watanabe², Yohei Kusaba^{7

8}, Daiki Watanabe⁹

Affiliations

¹ Department of Physical Therapy, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan.
² Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
³ Department of Rehabilitation, Sagamihara Kyodo Hospital, Sagamihara, Japan.
⁴ Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan.
⁵ Department of Rehabilitation, Kitasato Institute Hospital, Kitasato University, Tokyo, Japan.
⁶ Department of Sports Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
⁷ Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan.
⁸ Department of Orthopaedic Surgery, Sagamihara Kyodo Hospital, Sagamihara, Kanagawa, Japan.
⁹ Department of Orthopedic Sports Medicine, Yokohama Minami Kyosai Hospital, Yokohama, Kanagawa, Japan.

Abstract

Background: Prevention of pitching-related elbow pain in youth baseball players is important. Overhead pitching involves a whole-body motion, including head-neck rotation. A limited range of motion of head-neck rotation may cause inefficient pitching motion; however, this association is unclear.

Purpose: To determine whether the range of motion of head-neck rotation is associated with the history of pitching-related elbow pain in youth baseball players.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: A total of 311 youth baseball players were selected and asked to complete a questionnaire survey about their age, weight, height, sex, baseball experience, main position, pitching side, and previous/current elbow pain during pitching. The range of motion of the upper and lower limb joints, head-neck rotation, and thoracic kyphosis angle were measured. Binomial logistic regression analysis was used to identify factors associated with the history of elbow pain related to pitching.

Results: There were 101 players with a history of pitching-related elbow pain (history group) and 142 players with no pitching-related elbow pain (no-history group). The history group had significantly lower values than the no-history group regarding the range of motion of head-neck rotation on the nondominant side (74.9°± 9° vs 77.7°± 9.6°; P = .02) and overall head-neck rotation (150.6°± 14.7° vs 154.9°± 18.4°; P = .04). Binomial logistic regression analysis identified head-neck rotation on the nondominant side (odds ratio [OR], 0.97 [95% CI, 0.94-1.00]), shoulder horizontal adduction on the dominant side (OR, 0.98 [95% CI, 0.96-1.00]), height (OR, 1.04 [95% CI, 1.00-1.08]), and playing position (pitcher) (OR, 0.40 [95% CI, 0.21-0.76]) as factors associated with a history of pitching-related elbow pain.

Conclusion: Our cross-sectional analysis demonstrated that youth baseball players with a history of pitching-related elbow pain had limited head-neck rotation range of motion on the nondominant side, and this was a significant factor associated with the history of pitching-related elbow pain.

Keywords: baseball injuries; head-neck rotation; hip internal rotation; pitching pain; range of motion; youth.