Elbow Joint Active Replication in College Pitchers Following Simulated Game Throwing

Abstract

Background: Elbow injuries are common in college baseball players. Pitching creates stress and fatigue in and around the elbow. Lack of joint proprioception can contribute to nonphysiological joint loading and injury. Hypothesis: There will be no difference in elbow joint active reproduction sense following a simulated 3-inning pitching sequence. Study Design: Cross-sectional study. Methods: Seventeen collegiate pitchers participated. Each pitcher was bilaterally tested for active elbow range of motion using goniometric technique. Percentages of motion determined positions for further study of elbow joint active replication sense (20%, 35%, 50%, 80%). The elbow was passively taken to a position and held for 10 seconds, then returned to full extension. Pitchers were asked to actively reproduce the angle. The opposite elbow was tested in the same manner. One week later, prethrowing joint position reproduction was tested; then a simulated 3-inning game was thrown. Immediately afterward, elbow joint active replication testing was performed. A repeated-measures analysis of variance analyzed differences. Results: No change in active joint reproduction occurred in the nondominant elbow at any angle tested. Dominant elbows demonstrated significant losses of active joint reproduction following throwing. Significant differences occurred at the 35% and 80% angles ( P < .05). Conclusion: Active elbow joint replication sense may be compromised following 3 innings of throwing. Because joint proprioception is thought to be an important component of joint stabilization, an alteration in joint position sense may increase the risk of elbow injury during throwing. Clinical Relevance: Pitching may cause a loss of active elbow joint replication.