title: A survey examining the correlations between Japanese little league baseball coaches' knowledge of and compliance with pitch count recommendations and player elbow pain.
abstract: BACKGROUND
  With the incidence of Little League elbow increasing, pitch limit recommendations for preventing throwing injuries have been developed in both the United States and Japan. However, levels of knowledge of and compliance with these recommendations among coaches of young baseball teams in Japan remain unknown. The relationship between these levels and elbow pain among players has not been adequately studied.
  
  
  OBJECTIVE
  Knowledge of and compliance with these recommendations is similar in the United States and Japan. Greater knowledge and higher levels of compliance have a significant correlation with reduced elbow pain in Little League baseball players.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Coaches of youth baseball teams in Kyoto, Japan, completed a questionnaire assessing knowledge of and compliance with recommendations. Team variables and coach-related factors concerning elbow pain among young baseball players were surveyed, and the questionnaire investigated demographic data and elbow pain history in the previous 12 months.
  
  
  RESULTS
  In total, 123 baseball coaches and 654 baseball players aged 6 to 12 years participated in this study; data were analyzed for 113 coaches and 339 players. Among coaches, 39.8% had accurate knowledge of the recommendations (similar to the US data) and 28.3% complied with them (lower than the US data). There was no correlation between elbow pain and knowledge of and compliance with the recommendations, but coaches' opinions on the number of games were indicated as a significant risk factor for elbow pain; the more coaches considered the number of games played, the fewer the number of players who experienced elbow pain.
  
  
  CONCLUSIONS
  The level of knowledge of recommendations in Japan was similar to that in the United States, but compliance levels were far lower. There was no correlation between elbow pain and knowledge and compliance.
  
  
  CONCLUSIONS
  The Little League elbow problem should be addressed at global and national levels.
authors.affiliation: Kyoto University, Kyoto, Japan.
authors.forename: Taiki
authors.initials: T
authors.lastname: Yukutake
authors.affiliation: Kyoto University, Kyoto, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Yamada
authors.affiliation: Kyoto University, Kyoto, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Aoyama
keywords: Little League; coaches; elbow pain; pitch count recommendation