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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

Comparison of internal rotation at 0° of hip flexion (IR0) and internal rotation at 90° of hip flexion (IR90) between the normal group and the pain group. There were no differences in IR0 between the normal group and the pain group on either side (trail leg: P = .16, power = 0.26; plant leg: P = .67, power = 0.052). Significant differences in IR90 between the 2 groups were observed bilaterally: *trail leg, P = .0005, power = 0.96; **plant leg: P = .0013, power = 0.95.
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fig3-2325967114532424: Comparison of internal rotation at 0° of hip flexion (IR0) and internal rotation at 90° of hip flexion (IR90) between the normal group and the pain group. There were no differences in IR0 between the normal group and the pain group on either side (trail leg: P = .16, power = 0.26; plant leg: P = .67, power = 0.052). Significant differences in IR90 between the 2 groups were observed bilaterally: *trail leg, P = .0005, power = 0.96; **plant leg: P = .0013, power = 0.95.

Mentions: Thirty-three (27.0%) of 122 players had elbow pain. The mean ages of both groups were similar (normal group, 11.9 ± 2.0 years; pain group, 12.5 ± 1.4 years; P = .24). Twenty-seven players had pain on the medial side of the elbow, 4 had pain on the lateral side of the elbow, and 2 had pain on both the medial and lateral sides. Two of 6 players were diagnosed radiographically as having osteochondritis dissecans. All players could achieve 0° of hip extension during ROM measurements. Descriptive statistics for hip ROM are shown in Table 1. There were 2 participants in the pain group for whom IR0 measurements were not recorded; these participants were excluded from the statistical comparison of IR0 and IR90 in the pain group. There were no significant differences in SLR between the pain group and the normal group on either the trail leg or the plant leg side (P = .061, power = 0.50 and P = .18, power = 0.25, respectively). The hip flexion of the pain group was significantly lower than that of the normal group in both the trail leg (P = .0001, power = 0.96) and the plant leg (P = .0014, power = 0.92) (Figure 2). However, the IR0 angle did not differ between the 2 groups in either leg (trail leg, P = .16, power = 0.26; plant leg, P = .67, power = 0.052). The IR90 angle of the pain group was significantly lower than that of the normal group in both the trail leg and the plant leg (P = .0005, power = 0.96 and P = .0013, power = 0.95, respectively) (Figure 3). In the normal group, there were no significant differences between the IR90 and the IR0 angles in either leg (trail leg, P = .19, power = 0.26; plant leg, P = .23, power = 0.23). However, in the pain group, the IR90 angle was significantly lower than the IR0 angle in both the trail leg (P = .0057, power = 0.81) and the plant leg (P = .0075, power = 0.78) (Figure 4).


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)

Comparison of internal rotation at 0° of hip flexion (IR0) and internal rotation at 90° of hip flexion (IR90) between the normal group and the pain group. There were no differences in IR0 between the normal group and the pain group on either side (trail leg: P = .16, power = 0.26; plant leg: P = .67, power = 0.052). Significant differences in IR90 between the 2 groups were observed bilaterally: *trail leg, P = .0005, power = 0.96; **plant leg: P = .0013, power = 0.95.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4555537&req=5

fig3-2325967114532424: Comparison of internal rotation at 0° of hip flexion (IR0) and internal rotation at 90° of hip flexion (IR90) between the normal group and the pain group. There were no differences in IR0 between the normal group and the pain group on either side (trail leg: P = .16, power = 0.26; plant leg: P = .67, power = 0.052). Significant differences in IR90 between the 2 groups were observed bilaterally: *trail leg, P = .0005, power = 0.96; **plant leg: P = .0013, power = 0.95.
Mentions: Thirty-three (27.0%) of 122 players had elbow pain. The mean ages of both groups were similar (normal group, 11.9 ± 2.0 years; pain group, 12.5 ± 1.4 years; P = .24). Twenty-seven players had pain on the medial side of the elbow, 4 had pain on the lateral side of the elbow, and 2 had pain on both the medial and lateral sides. Two of 6 players were diagnosed radiographically as having osteochondritis dissecans. All players could achieve 0° of hip extension during ROM measurements. Descriptive statistics for hip ROM are shown in Table 1. There were 2 participants in the pain group for whom IR0 measurements were not recorded; these participants were excluded from the statistical comparison of IR0 and IR90 in the pain group. There were no significant differences in SLR between the pain group and the normal group on either the trail leg or the plant leg side (P = .061, power = 0.50 and P = .18, power = 0.25, respectively). The hip flexion of the pain group was significantly lower than that of the normal group in both the trail leg (P = .0001, power = 0.96) and the plant leg (P = .0014, power = 0.92) (Figure 2). However, the IR0 angle did not differ between the 2 groups in either leg (trail leg, P = .16, power = 0.26; plant leg, P = .67, power = 0.052). The IR90 angle of the pain group was significantly lower than that of the normal group in both the trail leg and the plant leg (P = .0005, power = 0.96 and P = .0013, power = 0.95, respectively) (Figure 3). In the normal group, there were no significant differences between the IR90 and the IR0 angles in either leg (trail leg, P = .19, power = 0.26; plant leg, P = .23, power = 0.23). However, in the pain group, the IR90 angle was significantly lower than the IR0 angle in both the trail leg (P = .0057, power = 0.81) and the plant leg (P = .0075, power = 0.78) (Figure 4).

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