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, 42 (11), 2734-40

Lumbopelvic Control and Days Missed Because of Injury in Professional Baseball Pitchers

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Lumbopelvic Control and Days Missed Because of Injury in Professional Baseball Pitchers

Ajit M W Chaudhari et al. Am J Sports Med.

Abstract

Background: Recently, lumbopelvic control has been linked to pitching performance, kinematics, and loading; however, poor lumbopelvic control has not been prospectively investigated as a risk factor for injuries in baseball pitchers.

Hypothesis: Pitchers with poor lumbopelvic control during spring training are more likely to miss ≥30 days because of an injury through an entire baseball season than pitchers with good lumbopelvic control.

Study design: Cohort study; Level of evidence, 2.

Methods: A total of 347 professional baseball pitchers were enrolled into the study during the last 2 weeks of spring training and stayed with the same team for the entire season. Lumbopelvic control was quantified by peak anterior-posterior deviation of the pelvis relative to the starting position during a single-leg raise test (APScore). Days missed because of an injury through the entire season were recorded by each team's medical staff.

Results: A higher APScore was significantly associated with a higher likelihood of missing ≥30 days (P = .023, χ(2) test). When divided into tertiles based on their APScore, participants in the highest tertile were 3.0 times and 2.2 times more likely to miss at least 30 days throughout the course of a baseball season relative to those in the lowest or middle tertiles, respectively. A higher APScore was also significantly associated with missing more days because of an injury within participants who missed at least 1 day (P = .018, ANOVA), with participants in the highest tertile missing significantly more days (mean, 98.6 days) than those in the middle tertile (mean, 45.8 days; P = .017) or lowest tertile (mean, 43.8 days; P = .017).

Conclusion: This study found that poor lumbopelvic control in professional pitchers was associated with an increased risk of missing significant time because of an injury.

Keywords: athlete; balance; core stability; lumbar spine; pelvis.

Conflict of interest statement

Conflict of interest statement: A. Chaudhari and C. McKenzie are co-owners of Perfect Practice, Inc., the producer of the Level Belt Pro app used to make measurements of pelvic motion in this study. The other authors report no potential conflict of interest.

Figures

Figure 1
Figure 1
Single leg raise test description
Figure 2
Figure 2
Plot of anterior-posterior pelvic tilt during a single leg raise test for a typical pitcher. APScore is defined as the largest deviation away from zero. In this example, the peak anterior tilt was 4.3° while the peak posterior tilt was -0.6°, leading to an APScore of 4.3°.
Figure 3
Figure 3
Plot of anterior-posterior pelvic tilt during ROM and single leg raise movements measured by the iPod-based sensor v. the 3D motion analysis system with linear regression equation displayed. Reproduced from Chaudhari et al.
Figure 4
Figure 4
Histogram of APScore showing uneven distribution of pitchers into the three tertiles of LO, MD, and HI amounts of pelvic movement during the single leg raise test. Pie charts show the percentage of pitchers in each tertile who missed 30 or more days due to injury during the season.
Figure 5
Figure 5
Box-and-whisker plots of total number of days missed for all participants who missed at least one day due to injury (108 out of 347 participants). Boxes indicate the interquartile range, whiskers indicate 1.5* the interquartile range, and outliers are marked by (+).Those with poor lumbopelvic control (HI APScore in the single leg raise test) missed more days due to injury (mean 98.6 days) than those with moderate (MD group, mean 45.8 days, p=0.017) or good (LO group, mean 43.8 days, p=0.017) lumbopelvic control. * indicates a significant difference between groups (p<0.05).

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