title: Shoulder Stretching Intervention Reduces the Incidence of Shoulder and Elbow Injuries in High School Baseball Players: a Time-to-Event Analysis.
abstract: We prospectively evaluated the effects of a prevention program on the incidence of shoulder and elbow injuries in high school baseball pitchers. Ninety-two pitchers participated in this study and were taught to perform stretching and strength exercises aimed at improving shoulder external rotation strength in the preseason. The pitchers freely chose to participate in one of four groups [SM-group: performed both exercises, S-group: performed stretching exercise only, M-group: performed strength training only, and N-group: performed neither intervention]. Injury was defined as inability to play for ≥8 days because of shoulder/elbow symptoms. Kaplan-Meier survival curves were generated and hazard ratios (HRs) for injury occurrence were calculated using multivariate Cox regression. Log-rank test was used for between-group comparisons of survival distributions. The injuries occurred in 25, 35, and 57% of participants and median times to injury were 89, 92, and 29.5 days in the S- (n = 32), SM- (n = 46), and N- (n = 14) group, respectively. Nobody chose M-group. HRs were 0.36 and 0.47 for the S- and SM-group, respectively, based on the N-group. The incidence of injury was significantly lower in the S-group than in the N-group (p = 0.04). Daily posterior shoulder stretching may reduce the incidence of the injuries in high school baseball pitchers.
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shitara
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamamoto
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Shimoyama
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ichinose
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Noritaka
authors.initials: N
authors.lastname: Hamano
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ueno
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Endo
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Atsufumi
authors.initials: A
authors.lastname: Oshima
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Sakane
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tachibana
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tomomatsu
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tajika
authors.affiliation: Department of Physical Therapy, Takasaki University of Health and Welfare, 37-1 Nakaorui, Takasaki, Gunma 370-0033, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopedic Surgery, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu, Takasaki, Gunma 370-0829, Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Osawa
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
authors.forename: Haku
authors.initials: H
authors.lastname: Iizuka
authors.affiliation: Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.|Department of Orthopedic Surgery, Saint Pierre Hospital, 786-7 Kamisano, Takasaki, Gunma 370-0857, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Takagishi
mesh_terms: D000293:Adolescent; D001484:Baseball / Q000502:physiology*; D004550:Elbow / Q000502:physiology*; D004551:Elbow Joint / Q000502:physiology; D006801:Humans; D015994:Incidence; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D012574:Schools; D012782:Shoulder / Q000502:physiology*; D014947:Wounds and Injuries / Q000503:physiopathology*