Association of Head-Neck Rotation With History of Pitching-Related Elbow Pain in Youth Baseball Players

Background: Prevention of pitching-related elbow pain in youth baseball players is important. Overhead pitching involves a whole-body motion, including head-neck rotation. A limited range of motion of head-neck rotation may cause inefficient pitching motion; however, this association is unclear.Purpose: To determine whether the range of motion of head-neck rotation is associated with the history of pitching-related elbow pain in youth baseball players.Study Design: Cross-sectional study; Level of evidence, 3.Methods: A total of 311 youth baseball players were selected and asked to complete a questionnaire survey about their age, weight, height, sex, baseball experience, main position, pitching side, and previous/current elbow pain during pitching. The range of motion of the upper and lower limb joints, head-neck rotation, and thoracic kyphosis angle were measured. Binomial logistic regression analysis was used to identify factors associated with the history of elbow pain related to pitching.Results: There were 101 players with a history of pitching-related elbow pain (history group) and 142 players with no pitching-related elbow pain (no-history group). The history group had significantly lower values than the no-history group regarding the range of motion of head-neck rotation on the nondominant side (74.9 degrees +/- 9 degrees vs 77.7 degrees +/- 9.6 degrees; P = .02) and overall head-neck rotation (150.6 degrees +/- 14.7 degrees vs 154.9 degrees +/- 18.4 degrees; P = .04). Binomial logistic regression analysis identified head-neck rotation on the nondominant side (odds ratio [OR], 0.97 [95% CI, 0.94-1.00]), shoulder horizontal adduction on the dominant side (OR, 0.98 [95% CI, 0.96-1.00]), height (OR, 1.04 [95% CI, 1.00-1.08]), and playing position (pitcher) (OR, 0.40 [95% CI, 0.21-0.76]) as factors associated with a history of pitching-related elbow pain.Conclusion: Our cross-sectional analysis demonstrated that youth baseball players with a history of pitching-related elbow pain had limited head-neck rotation range of motion on the nondominant side, and this was a significant factor associated with the history of pitching-related elbow pain.