Restriction in the hip internal rotation of the stride leg is associated with elbow and shoulder pain in elite young baseball players

J Shoulder Elbow Surg. 2020 Jan;29(1):139-145. doi: 10.1016/j.jse.2019.07.004. Epub 2019 Sep 11.


Background: Evidence is scarce concerning the relationship of physical dysfunction of the trunk and lower extremities with elbow and shoulder pain in young baseball players. This study aimed to examine the association of joint flexibility of the trunk and lower extremities and dynamic postural control with elbow and shoulder pain among elite young baseball players.

Methods: We analyzed baseball players (aged 9-12 years) who participated in the National Junior Sports Clubs Baseball Festival. Range of motion in external rotation and internal rotation (IR) of the hip, as well as the finger-to-floor distance and heel-to-buttock distance, was measured. The straight-leg-raise test was also conducted. Dynamic postural control was evaluated using the Star Excursion Balance Test. Multivariable logistic regression analyses were conducted to examine the association of physical function with the elbow or shoulder pain incidence.

Results: Of 210 players surveyed, 177 without elbow or shoulder pain were included in the analysis. Of the participants, 16 (9.0%) reported having elbow or shoulder pain during the tournament. Participants with the incidence of elbow or shoulder pain had a significant restriction in hip IR of the stride leg compared with those without pain (35.8° vs. 43.7°, P = .022). There were no significant associations of other joint flexibilities and the Star Excursion Balance Test with elbow or shoulder pain.

Conclusion: Decreased hip IR range of motion of the stride leg was significantly associated with the elbow or shoulder pain incidence. Players, coaches, and clinicians should consider the physical function of the trunk and lower extremities for the prevention of elbow and shoulder pain.

Keywords: Baseball; elbow; hip range of motion; postural control; shoulder; young.

MeSH terms

  • Athletic Injuries / epidemiology
  • Baseball / injuries*
  • Case-Control Studies
  • Child
  • Elbow
  • Hip Joint / physiology*
  • Humans
  • Incidence
  • Male
  • Musculoskeletal Pain / epidemiology*
  • Postural Balance
  • Range of Motion, Articular
  • Rotation*
  • Shoulder Pain / epidemiology*