By Dev Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
I’m a big believer in prevention programs for sports injury risk reduction and this week we’ll discuss a program to reduce elbow injury risk in baseball.
I’ve written before about the usefulness of the 11+ warmup program for lower extremity risk reduction in soccer. That program is highly effective. Prevention programs are great in theory but actually proving the usefulness can be difficult. What are required are often lengthy scientific studies with large numbers of individuals. Those types of studies have been done with the 11+ but are lacking for elbow injury prevention programs in baseball. But a recently published study from Japan offers some hope.
The study authors devised the Yokohama Baseball-9 (YB9) program, which consists of 9 flexibility exercises focused on the wrist, elbow, shoulder, and hips.
There were 275 players age 8 to 11 divided into a non-YB9 group and a YB9 group. Players were asked to complete the program at least once a week.
At 1-year, the YB9 exercise group had significantly lower rates of elbow injury and significantly better total range of motion at the shoulder. In a statistical analysis, increased shoulder total rotation, increased nondominant hip internal rotation and improved spine posture predicted lower rates of elbow injury.
This is a good study but there are some weaknesses. 28% of the original group was excluded due to prior shoulder or elbow pain and an additional 15% were lost to follow up. And it is a relatively small number of players who participated.
We need more studies like this so I hope it can be repeated by others, and with larger numbers of players. The fact that 28% of the young players in the original group of potential players were excluded because they already had pain in pretty alarming, and good evidence that we need some solutions to the problem of overuse injuries in baseball pitchers.
Overall, the study is encouraging and provides an interesting new potential avenue for injury prevention.