Shoulder Range of Motion Measurements and Baseball Elbow Injuries: Ambiguity in Scientific Models, Approach, and Execution is Hurting Overhead Athlete Health
Elbow injuries are a significant and increasing issue in baseball. Elbow injuries account for 16% of all injuries sustained at the professional level and collegiate level. Because of the continued rise in injury rates, loss of performance value, and medical burden, sports medicine clinicians have at...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-02-01
|
| Series: | Arthroscopy, Sports Medicine, and Rehabilitation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666061X22001596 |
| _version_ | 1828012352274956288 |
|---|---|
| author | Garrett S. Bullock, P.T., D.P.T., D.Phil. Charles A. Thigpen, P.T., Ph.D., A.T.C. Chelsea L. Martin, P.T., D.P.T., S.C.S. Justin Losciale, P.T., D.P.T., S.C.S. Lori Michener, P.T., A.T.C., Ph.D., S.C.S. Rod Whiteley, P.T., Ph.D. Brian R. Waterman, M.D. John M. Tokish, M.D. Christopher Camp, M.D. Ellen Shanley, P.T., Ph.D., O.C.S. |
| author_facet | Garrett S. Bullock, P.T., D.P.T., D.Phil. Charles A. Thigpen, P.T., Ph.D., A.T.C. Chelsea L. Martin, P.T., D.P.T., S.C.S. Justin Losciale, P.T., D.P.T., S.C.S. Lori Michener, P.T., A.T.C., Ph.D., S.C.S. Rod Whiteley, P.T., Ph.D. Brian R. Waterman, M.D. John M. Tokish, M.D. Christopher Camp, M.D. Ellen Shanley, P.T., Ph.D., O.C.S. |
| author_sort | Garrett S. Bullock, P.T., D.P.T., D.Phil. |
| collection | DOAJ |
| description | Elbow injuries are a significant and increasing issue in baseball. Elbow injuries account for 16% of all injuries sustained at the professional level and collegiate level. Because of the continued rise in injury rates, loss of performance value, and medical burden, sports medicine clinicians have attempted to research the causes underlying this injury epidemic in an attempt to help mitigate baseball elbow injuries. Shoulder range of motion (ROM) is the most researched clinical metric related to elbow injuries in baseball and has the greatest consensus as a viable prognostic factor specifically for medial elbow injury. Shoulder ROM is easy to measure, can be modified through stretching and manual therapy interventions, and can be easily assessed during preseason screening throughout all baseball levels. Despite a large number of studies and the widespread use of shoulder ROM in injury risk screening, current findings are unclear as to whether there is a true cause-effect relation with baseball elbow injuries. We argue that the conflicting findings revolving around the value of shoulder ROM measurements associated with baseball elbow injuries are the result of 4 gaps in the research approaches implemented to date: ambiguous research questions, mixed study populations, statistical models used, and shoulder ROM methodology. Specifically, there is a mismatch of methods, statistical models, and conclusions such as (1) investigating the association (i.e., correlation) between shoulder ROM measurements and injury and (2) investigating the cause-effect relation of shoulder ROM to baseball injuries. The purpose of this article is to detail the required scientific steps to evaluate whether preseason shoulder ROM is a potential causal factor for pitching elbow injury. We also provide recommendations to allow for future causal inferences to be made between shoulder ROM and elbow injury. This information will ultimately assist in informing clinical models of care and decision making for baseball throwers. |
| first_indexed | 2024-04-10T09:30:42Z |
| format | Article |
| id | doaj.art-33b30cff7df04737b7b2a9874b98606d |
| institution | Directory Open Access Journal |
| issn | 2666-061X |
| language | English |
| last_indexed | 2024-04-10T09:30:42Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy, Sports Medicine, and Rehabilitation |
| spelling | doaj.art-33b30cff7df04737b7b2a9874b98606d2023-02-19T04:27:18ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2023-02-0151e297e304Shoulder Range of Motion Measurements and Baseball Elbow Injuries: Ambiguity in Scientific Models, Approach, and Execution is Hurting Overhead Athlete HealthGarrett S. Bullock, P.T., D.P.T., D.Phil.0Charles A. Thigpen, P.T., Ph.D., A.T.C.1Chelsea L. Martin, P.T., D.P.T., S.C.S.2Justin Losciale, P.T., D.P.T., S.C.S.3Lori Michener, P.T., A.T.C., Ph.D., S.C.S.4Rod Whiteley, P.T., Ph.D.5Brian R. Waterman, M.D.6John M. Tokish, M.D.7Christopher Camp, M.D.8Ellen Shanley, P.T., Ph.D., O.C.S.9Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, North Carolina, U.S.A.; Department of Biostatistics & Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, U.S.A.; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, England; Address correspondence to Garrett S. Bullock, P.T., D.P.T., D.Phil., Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, 475 Vine St, Winston-Salem, NC 27211, U.S.A.ATI Physical Therapy, Greenville, South Carolina, U.S.A.ATI Physical Therapy, Greenville, South Carolina, U.S.A.; Department of Epidemiology, Gillings School of Global Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.Department of Physical Therapy, University of British Columbia, Vancouver, CanadaDivision of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, U.S.A.Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, QatarDepartment of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, North Carolina, U.S.A.Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A.Department of Orthopaedic Surgery, Mayo Clinic, Minneapolis, Minnesota, U.S.A.ATI Physical Therapy, Greenville, South Carolina, U.S.A.; South Carolina Center for Effectiveness Research in Orthopedics, Greenville, South Carolina, U.S.A.Elbow injuries are a significant and increasing issue in baseball. Elbow injuries account for 16% of all injuries sustained at the professional level and collegiate level. Because of the continued rise in injury rates, loss of performance value, and medical burden, sports medicine clinicians have attempted to research the causes underlying this injury epidemic in an attempt to help mitigate baseball elbow injuries. Shoulder range of motion (ROM) is the most researched clinical metric related to elbow injuries in baseball and has the greatest consensus as a viable prognostic factor specifically for medial elbow injury. Shoulder ROM is easy to measure, can be modified through stretching and manual therapy interventions, and can be easily assessed during preseason screening throughout all baseball levels. Despite a large number of studies and the widespread use of shoulder ROM in injury risk screening, current findings are unclear as to whether there is a true cause-effect relation with baseball elbow injuries. We argue that the conflicting findings revolving around the value of shoulder ROM measurements associated with baseball elbow injuries are the result of 4 gaps in the research approaches implemented to date: ambiguous research questions, mixed study populations, statistical models used, and shoulder ROM methodology. Specifically, there is a mismatch of methods, statistical models, and conclusions such as (1) investigating the association (i.e., correlation) between shoulder ROM measurements and injury and (2) investigating the cause-effect relation of shoulder ROM to baseball injuries. The purpose of this article is to detail the required scientific steps to evaluate whether preseason shoulder ROM is a potential causal factor for pitching elbow injury. We also provide recommendations to allow for future causal inferences to be made between shoulder ROM and elbow injury. This information will ultimately assist in informing clinical models of care and decision making for baseball throwers.http://www.sciencedirect.com/science/article/pii/S2666061X22001596 |
| spellingShingle | Garrett S. Bullock, P.T., D.P.T., D.Phil. Charles A. Thigpen, P.T., Ph.D., A.T.C. Chelsea L. Martin, P.T., D.P.T., S.C.S. Justin Losciale, P.T., D.P.T., S.C.S. Lori Michener, P.T., A.T.C., Ph.D., S.C.S. Rod Whiteley, P.T., Ph.D. Brian R. Waterman, M.D. John M. Tokish, M.D. Christopher Camp, M.D. Ellen Shanley, P.T., Ph.D., O.C.S. Shoulder Range of Motion Measurements and Baseball Elbow Injuries: Ambiguity in Scientific Models, Approach, and Execution is Hurting Overhead Athlete Health Arthroscopy, Sports Medicine, and Rehabilitation |
| title | Shoulder Range of Motion Measurements and Baseball Elbow Injuries: Ambiguity in Scientific Models, Approach, and Execution is Hurting Overhead Athlete Health |
| title_full | Shoulder Range of Motion Measurements and Baseball Elbow Injuries: Ambiguity in Scientific Models, Approach, and Execution is Hurting Overhead Athlete Health |
| title_fullStr | Shoulder Range of Motion Measurements and Baseball Elbow Injuries: Ambiguity in Scientific Models, Approach, and Execution is Hurting Overhead Athlete Health |
| title_full_unstemmed | Shoulder Range of Motion Measurements and Baseball Elbow Injuries: Ambiguity in Scientific Models, Approach, and Execution is Hurting Overhead Athlete Health |
| title_short | Shoulder Range of Motion Measurements and Baseball Elbow Injuries: Ambiguity in Scientific Models, Approach, and Execution is Hurting Overhead Athlete Health |
| title_sort | shoulder range of motion measurements and baseball elbow injuries ambiguity in scientific models approach and execution is hurting overhead athlete health |
| url | http://www.sciencedirect.com/science/article/pii/S2666061X22001596 |
| work_keys_str_mv | AT garrettsbullockptdptdphil shoulderrangeofmotionmeasurementsandbaseballelbowinjuriesambiguityinscientificmodelsapproachandexecutionishurtingoverheadathletehealth AT charlesathigpenptphdatc shoulderrangeofmotionmeasurementsandbaseballelbowinjuriesambiguityinscientificmodelsapproachandexecutionishurtingoverheadathletehealth AT chelsealmartinptdptscs shoulderrangeofmotionmeasurementsandbaseballelbowinjuriesambiguityinscientificmodelsapproachandexecutionishurtingoverheadathletehealth AT justinloscialeptdptscs shoulderrangeofmotionmeasurementsandbaseballelbowinjuriesambiguityinscientificmodelsapproachandexecutionishurtingoverheadathletehealth AT lorimichenerptatcphdscs shoulderrangeofmotionmeasurementsandbaseballelbowinjuriesambiguityinscientificmodelsapproachandexecutionishurtingoverheadathletehealth AT rodwhiteleyptphd shoulderrangeofmotionmeasurementsandbaseballelbowinjuriesambiguityinscientificmodelsapproachandexecutionishurtingoverheadathletehealth AT brianrwatermanmd shoulderrangeofmotionmeasurementsandbaseballelbowinjuriesambiguityinscientificmodelsapproachandexecutionishurtingoverheadathletehealth AT johnmtokishmd shoulderrangeofmotionmeasurementsandbaseballelbowinjuriesambiguityinscientificmodelsapproachandexecutionishurtingoverheadathletehealth AT christophercampmd shoulderrangeofmotionmeasurementsandbaseballelbowinjuriesambiguityinscientificmodelsapproachandexecutionishurtingoverheadathletehealth AT ellenshanleyptphdocs shoulderrangeofmotionmeasurementsandbaseballelbowinjuriesambiguityinscientificmodelsapproachandexecutionishurtingoverheadathletehealth |