A Proposal for Functional Screening of the Throwing Kinetic Chain in Baseball Pitchers to Assess Shoulder and Elbow Injury Risk

Shawn Cole, Tom Sanderson, Brian McNeill and Jonathan C. Sum*

A Proposal for Functional Screening of the Throwing Kinetic Chain in Baseball Pitchers to Assess Shoulder and Elbow Injury Risk.

Overhead throwing athletes are susceptible to overuse injuries in the upper extremity, specifically of the shoulder and elbow. These injuries can include rotator cuff tears, labral tears, and ulnar collateral ligament sprains and can affect athletes at all levels of their sport. To address this growing epidemic, musculoskeletal screens and assessments are used to identify risk factors associated with injuries. Though the baseball pitching delivery has been extensively studied in biomechanical laboratories, a clear consensus agreement of the essential tests and measures is still lacking, both as a pre-participation assessment of injury risk and for return to sport criteria.

Overhead throwing athletes are at an increased risk for overuse injuries primarily of the shoulder and elbow due to the cumulative microtrauma associated with repetitive throwing.1-4 In Major League Baseball pitchers, injuries to the shoulder account for 28% of all injuries, injuries to the elbow account for 22-26%, and combined account for more missed games than injury to any other anatomical region.5-7 Injuries at the professional level appear to be on the rise. In May of 2014, Jose Fernandez of the Miami Marlins became the 18th player to undergo Tommy John surgery to repair the Ulnar Collateral Ligament (UCL) of his pitching elbow since the start of that Major League Baseball (MLB) season. At this rate, the 2014 season was on pace to surpass the record setting 2012 season of 36 surgeries; ultimately finishing with 29 players undergoing surgery.

Sport Exerc Med Open J. 2015; 1(5): 150-157. doi: 10.17140/SEMOJ-1-122