Preseason Neck Mobility and Risk of Shoulder and Elbow Injury in College Baseball Pitchers.

CONTEXT: Shoulder and elbow injuries cause pain and disability at all levels of baseball competition. Emerging evidence suggests that limited neck mobility is associated with development of arm injury in baseball pitchers.

OBJECTIVES

To evaluate group differences in neck mobility of collegiate baseball pitchers and explore group differences by injury history, hand dominance, and pitcher position and investigate the association of preseason neck mobility and throwing-related arm injury.

DESIGN

Prospective cohort study.

SETTING

Seven college baseball programs in 2023.

PATIENTS OR OTHER

PARTICIPANTS

Healthy college baseball pitchers age 18 and older.

MAIN OUTCOME MEASURES: Neck active range of motion and the cervical flexion rotation test (CFRT) were primary exploratory measures. Primary outcomes included time-loss arm injury, Single Assessment Numerical Evaluation (SANE), and Functional Arm Scale for Throwers.

RESULTS

Of 126 pitchers, 68 (54%) reported a previous arm injury, and 25 (20% [95% CI = 13, 27]) arm injuries occurred during the season. Arm injury rates were 3.5 (95% CI = 2.3, 4.7) per 1000 baseball exposure days and 21.6 (95% CI = 13.7, 30.6) per 1000 pitching appearances. There was a small positive association (mean deviation [MD]: 0.1 [0.0, 0.2]) for dominant and nondominant CFRT and baseline SANE elbow scores. There was a small positive association (incident rate ratios: 0.98 [95% CI = 0.97, 1.00]) in the difference in dominant versus nondominant CFRT and time-loss arm injury. Starting pitchers demonstrated significant differences (MD: 0.3 [95% CI = 0.1, 0.5]; MD: 0.3 [95% CI = 0.1, 0.7]) for dominant and nondominant CFRT versus relief pitchers, and left-handed pitchers demonstrated a significant difference (MD: 0.3 [95% CI = 0.1, 0.6]) in nondominant CFRT compared with right-handed pitchers; however, these results were below standard error of measures.

CONCLUSIONS

Pitchers with less CFRT mobility were more likely to sustain pitching related time-loss injury and reported worse overall function, but effect sizes were small.