Increased Elbow Valgus Torque During Pitching Is Not a Risk Factor for Medial Elbow Injuries in Young Baseball Pitchers: A Prospective Cohort Study.

PURPOSE: To examine the relationship between elbow valgus torque during pitching and the occurrence of medial elbow injuries in young baseball pitchers prospectively.

METHODS

Between 2019 and 2023, 361 male pitchers aged 9 to 12 years were enrolled. Pitchers with a history of elbow injury or who had not served as pitchers in baseball games for ≥1 year were excluded. Each participant pitched three fastballs, while an inertial measurement unit recorded the elbow valgus torque. Additionally, participants completed a questionnaire assessing age, height, weight, months of baseball experience, catcher participation, and daily pitch count. Furthermore, elbow extension range of motion was measured. One year following the initial measurements, new medial elbow injuries were identified based on pain and ultrasonographic abnormalities. Baseline elbow valgus torque was compared between the injured and non-injured groups. Multivariate logistic regression analysis was used to determine the relationship between elbow valgus torque at baselines and the occurrence of medial elbow injuries within 1 year of the study.

RESULTS

Of 202 pitchers analyzed, 62 (30.7%) were diagnosed with medial elbow injuries. The elbow valgus torque was not significantly different between the injured and non-injured groups (16.0 ± 4.6 Nm vs 15.0 ± 4.8 Nm, P = .143). Multivariate logistic regression analysis indicated that age (odds ratio, 1.791; 95% confidence interval, 1.072-2.993) and pitch count per day (odds ratio, 1.013; 95% confidence interval, 1.001-1.026) were significantly associated with medial elbow injuries.

CONCLUSIONS

Greater elbow valgus torque during pitching is not a significant risk factor for medial elbow injury in young pitchers. Older age and higher pitch count per day were associated with the occurrence of medial elbow injuries in elementary school-aged pitchers.

LEVEL OF EVIDENCE: Level II, prospective cohort study.