title: Impact of psychosocial factors, pain, and functional limitations on throwing athletes who return to sport following elbow injuries: a case series.
abstract: OBJECTIVE
  The purpose of this case series is to explore the possibility that: (1) throwing athletes respond to fear-avoidance model (FAM) measures differently than patients in other orthopedic populations; and (2) there is an association between the FAM measures, pain and function scores.
  
  
  METHODS
  Five competitive throwing athletes with elbow pain between the ages of 17-23 were included. Patients were given the Fear Avoidance Belief Questionnaire (FABQ), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK-11), QuickDash, and Numeric Pain Rating Scale (NPRS) at initial evaluation and at 4 weeks.
  
  
  RESULTS
  Subjects all demonstrated low levels of fear on initial evaluation and all returned to sport. FABQ-PA, TSK, and PCS subscales were all highly associated with the initial total scales (r = >0.80) with the exception of the PCS helplessness subscale (r = 0.61). Subjects demonstrated an average decrease in the NPRS score of 2.3 points and average improvement of 23.6 points in their QuickDash score. There was a fair association between initial TSK fear of injury (FOI) subscale and initial QuickDash scores (r = 0.47) and a moderate association between initial TSK-11 FOI subscale and initial pain scores (r = 0.61).
  
  
  CONCLUSIONS
  Subjects in this case study appeared to respond to the FAM questionnaires differently than patients in other orthopedic populations. The TSK FOI subscale may be the most beneficial to use with throwing athletes.
authors.affiliation: Kinetix Physical Therapy, 2783 SW 87th Drive, Gainesville, FL, USA. jwprugh@gmail.com
authors.forename: Jennifer
authors.initials: J
authors.lastname: Prugh
authors.forename: Giorgio
authors.initials: G
authors.lastname: Zeppieri
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: George
mesh_terms: D000293:Adolescent; D056352:Athletes / Q000523:psychology*; D001484:Baseball / Q000293:injuries*; D001696:Biomechanical Phenomena; D058443:Catastrophization; D004550:Elbow / Q000503:physiopathology; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*; D010146:Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult; D000092464:Elbow Injuries