Increased Upper Arm Length and Loading Rate Identified as Potential Risk Factors for Injury in Youth Baseball Pitchers

Abstract

Background: In the throwing elbow, increased elbow torque has been correlated with increased injury risk. Additional insight into the relationships between anthropometric factors and elbow joint loading is warranted. Purpose: To investigate the relationship among physical limb length characteristics, elbow kinetics, and elbow kinematics in youth baseball pitchers and to examine the relationship between elbow varus loading rate and elbow kinetics. Design: Descriptive laboratory study. Methods: A total of 27 male youth baseball pitchers participated (mean ± SD: age, 15.8 ± 2.7 years; height, 176.3 ± 13.0 cm; weight, 71.7 ± 16.4 kg). Upper arm (UA) and forearm (FA) lengths were measured using a moveable sensor to digitize bony landmarks. Kinematic data were collected at 240 Hz using an electromagnetic tracking system. Participants threw 3 fastballs to a catcher at a regulation distance (60 ft 6 in), and the fastest velocity trial was used for analysis. Linear regression was used to determine the relationship among limb length characteristics, elbow kinetics, and elbow kinematics after accounting for the effects of body weight and height. Results: Pitchers with longer UA length experienced increased maximum elbow varus torque ( P = .005) and maximum net elbow force ( P = .001). Pitchers with an increased forearm to UA ratio had decreased elbow compression force ( P < .001) and exhibited a more flexed elbow at foot contact ( P = .001). Pitchers with greater maximum loading rates experienced greater elbow varus torque ( P = .002). Conclusion: In youth baseball pitchers, longer UA length and greater loading rate increase varus torque about the elbow during a fastball pitch. Clinical Relevance: Longer UA length and greater loading rate may place pitchers at risk of injury because of their relationship with kinetic values.