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Relationship Between Tightness of the Hip Joint and Elbow Pain in Adolescent Baseball Players.

Saito M, Kenmoku T, Kameyama K, Murata R, Yusa T, Ochiai N, Kijima T, Takahira N, Fukushima K, Ishige N, Takaso M - Orthop J Sports Med (2014)

Bottom Line: Insufficient hip range of motion (ROM) can change throwing mechanics, reducing the transfer of energy from the lower to the upper extremities.P values <.05 were considered statistically significant.Differences in internal rotation angles between 0° and 90° of hip flexion may be important criteria for identifying adolescent baseball players at risk of elbow pain.

View Article: PubMed Central - PubMed

Affiliation: Division of Rehabilitation, Matsudo Orthopaedic Hospital, Chiba, Japan.

ABSTRACT

Background: Repetitive tensile stresses from valgus torque can induce elbow injury in adolescent baseball players. Insufficient hip range of motion (ROM) can change throwing mechanics, reducing the transfer of energy from the lower to the upper extremities. Thus, hip ROM limitations may force the upper extremities to bear the burden of a strong throw. Improper pitching mechanics caused by insufficient hip ROM are thought to increase valgus torque on the elbow when throwing, increasing the risk of elbow injury.

Purpose: To investigate the relationship between elbow pain and hip ROM in adolescent baseball players.

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

Methods: A total of 122 adolescent baseball players with a mean age of 12.0 years (range, 6-14 years) participated in this study. Elbow pain, hip flexion angle, and the internal rotation angles of the hip at 0° and 90° of flexion were assessed. Participants were divided into a pain group and a normal group based on the pain assessment, and each hip angle was compared between groups using Student t tests. P values <.05 were considered statistically significant.

Results: Thirty-one of 122 players had elbow pain. The hip flexion angle of the trail leg was 121.9° ± 12.3° for the normal group and 111.2° ± 11.3° for the pain group (P = .0001). The plant leg hip flexion angles were 122.0° ± 12.4° and 113.6° ± 11.3° (P = .0014) for the normal and pain groups, respectively. The internal rotation angle at 0° of hip flexion of the trail leg was 49.4° ± 12.6° and 45.6° ± 8.8° (not significant), and of the plant leg was 49.1° ± 12.5° and 48.7° ± 11.5° (not significant), for the normal and pain groups, respectively. The internal rotation of the trail leg at 90° of hip flexion was 46.9° ± 13.3° in the normal group and 36.1° ± 15.7° in the pain group (P = .0005). In the plant leg, the internal rotation angle at 90° of hip flexion was 46.9° ± 12.2° and 36.4° ± 18.1° for the normal and pain groups, respectively (P = .0013).

Conclusion: Limitations to hip flexion and internal rotation at 90° of hip flexion were risk factors for elbow injury. Differences in internal rotation angles between 0° and 90° of hip flexion may be important criteria for identifying adolescent baseball players at risk of elbow pain.

No MeSH data available.


Related in: MedlinePlus

Measurement techniques for (A) straight-leg raising angle (SLR), (B) hip flexion, (C) internal rotation at 90° of hip flexion (IR90), and (D) internal rotation at 0° of hip flexion (IR0).
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fig1-2325967114532424: Measurement techniques for (A) straight-leg raising angle (SLR), (B) hip flexion, (C) internal rotation at 90° of hip flexion (IR90), and (D) internal rotation at 0° of hip flexion (IR0).

Mentions: A total of 122 baseball players (mean age, 12.0 ± 1.9 years) who attended our preseason medical check volunteered to participate in this cross-sectional study. All participants and their parents provided informed consent. No participant had any history of hip disorders, such as Perthes disease, slipped capital femoral epiphysis, or any congenital disorders. To assess the relationships between hip ROM and throwing elbow pain, participants were divided into 2 groups: Those who reported elbow tenderness (medial, lateral, and posterior) at the medical check or who had felt pain while throwing during the past month were allocated to the pain group, and the rest were allocated to the normal group. The straight-leg raising angle (SLR) and hip ROM were measured in all participants using a standard technique19 and the same double-long-arm goniometer (Figure 1). Elbow pain was assessed separately from the SLR and hip measurements so that the examiners were unaware of each subject’s group designation.


Relationship Between Tightness of the Hip Joint and Elbow Pain in Adolescent Baseball Players.

Saito M, Kenmoku T, Kameyama K, Murata R, Yusa T, Ochiai N, Kijima T, Takahira N, Fukushima K, Ishige N, Takaso M - Orthop J Sports Med (2014)

Measurement techniques for (A) straight-leg raising angle (SLR), (B) hip flexion, (C) internal rotation at 90° of hip flexion (IR90), and (D) internal rotation at 0° of hip flexion (IR0).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555537&req=5

fig1-2325967114532424: Measurement techniques for (A) straight-leg raising angle (SLR), (B) hip flexion, (C) internal rotation at 90° of hip flexion (IR90), and (D) internal rotation at 0° of hip flexion (IR0).
Mentions: A total of 122 baseball players (mean age, 12.0 ± 1.9 years) who attended our preseason medical check volunteered to participate in this cross-sectional study. All participants and their parents provided informed consent. No participant had any history of hip disorders, such as Perthes disease, slipped capital femoral epiphysis, or any congenital disorders. To assess the relationships between hip ROM and throwing elbow pain, participants were divided into 2 groups: Those who reported elbow tenderness (medial, lateral, and posterior) at the medical check or who had felt pain while throwing during the past month were allocated to the pain group, and the rest were allocated to the normal group. The straight-leg raising angle (SLR) and hip ROM were measured in all participants using a standard technique19 and the same double-long-arm goniometer (Figure 1). Elbow pain was assessed separately from the SLR and hip measurements so that the examiners were unaware of each subject’s group designation.

Bottom Line: Insufficient hip range of motion (ROM) can change throwing mechanics, reducing the transfer of energy from the lower to the upper extremities.P values <.05 were considered statistically significant.Differences in internal rotation angles between 0° and 90° of hip flexion may be important criteria for identifying adolescent baseball players at risk of elbow pain.

View Article: PubMed Central - PubMed

Affiliation: Division of Rehabilitation, Matsudo Orthopaedic Hospital, Chiba, Japan.

ABSTRACT

Background: Repetitive tensile stresses from valgus torque can induce elbow injury in adolescent baseball players. Insufficient hip range of motion (ROM) can change throwing mechanics, reducing the transfer of energy from the lower to the upper extremities. Thus, hip ROM limitations may force the upper extremities to bear the burden of a strong throw. Improper pitching mechanics caused by insufficient hip ROM are thought to increase valgus torque on the elbow when throwing, increasing the risk of elbow injury.

Purpose: To investigate the relationship between elbow pain and hip ROM in adolescent baseball players.

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

Methods: A total of 122 adolescent baseball players with a mean age of 12.0 years (range, 6-14 years) participated in this study. Elbow pain, hip flexion angle, and the internal rotation angles of the hip at 0° and 90° of flexion were assessed. Participants were divided into a pain group and a normal group based on the pain assessment, and each hip angle was compared between groups using Student t tests. P values <.05 were considered statistically significant.

Results: Thirty-one of 122 players had elbow pain. The hip flexion angle of the trail leg was 121.9° ± 12.3° for the normal group and 111.2° ± 11.3° for the pain group (P = .0001). The plant leg hip flexion angles were 122.0° ± 12.4° and 113.6° ± 11.3° (P = .0014) for the normal and pain groups, respectively. The internal rotation angle at 0° of hip flexion of the trail leg was 49.4° ± 12.6° and 45.6° ± 8.8° (not significant), and of the plant leg was 49.1° ± 12.5° and 48.7° ± 11.5° (not significant), for the normal and pain groups, respectively. The internal rotation of the trail leg at 90° of hip flexion was 46.9° ± 13.3° in the normal group and 36.1° ± 15.7° in the pain group (P = .0005). In the plant leg, the internal rotation angle at 90° of hip flexion was 46.9° ± 12.2° and 36.4° ± 18.1° for the normal and pain groups, respectively (P = .0013).

Conclusion: Limitations to hip flexion and internal rotation at 90° of hip flexion were risk factors for elbow injury. Differences in internal rotation angles between 0° and 90° of hip flexion may be important criteria for identifying adolescent baseball players at risk of elbow pain.

No MeSH data available.


Related in: MedlinePlus