CONTEXT: Baseball pitching requires fast and coordinated motions of the whole body to reach high ball speeds, putting considerable strain on the musculoskeletal system, particularly the shoulder and elbow. OBJECTIVE: To describe musculoskeletal symptoms and the functional status of the shoulder and elbow in male high school baseball pitchers. DESIGN: Descriptive epidemiology study. SETTING: Dutch baseball talent academies. PATIENTS OR OTHER PARTICIPANTS: One hundred twenty-five male high school baseball pitchers aged 12 to 18 years who participated in 1 of the 6 Dutch baseball talent academies and the Dutch National U-18 team were recruited and enrolled. MAIN OUTCOME MEASURE(S): Musculoskeletal symptoms, functional status of the shoulder and elbow were registered for each player every 6 months over 2 consecutive baseball seasons through self-assessment questionnaires, including the Kerlan-Jobe Orthopaedic Clinic (KJOC) and the Western Ontario Shoulder Instability Index (WOSI) questionnaires. RESULTS: Five hundred seventy musculoskeletal (MSS) symptoms in 93 of the 125 players were reported. The average 6-month prevalence for symptoms of the throwing shoulder was 37% (95% CI = 33%-41%), and for the elbow 37% (95% CI = 31%-42%), followed by the lower back with 36% (95% CI = 26%-45%). The baseball pitchers who experienced only shoulder symptoms had an average KJOC score of 80.0 (95% CI = 75.3-84.7) points, whereas those with only elbow symptoms reported a score of 90.2 (95% CI = 89.2-95.3). On the WOSI questionnaire, baseball pitchers scored an average of 421.2 (95% CI = 200.1-642.4) points. CONCLUSIONS: In a cohort of Dutch high school baseball pitchers, one-third reported shoulder and elbow symptoms on the throwing side, with reduced functional status and lower back symptoms. Future efforts should focus on developing preventive strategies through early symptom detection, aiming to prevent symptom progression and, ultimately, the development of severe injuries.

Monitoring the performance and functional status of baseball pitchers’ upper extremity is important in maintaining the athlete’s health and performance. This study validated a Dutch translation of the original English Kerlan-Jobe Orthopaedic Clinic (KJOC) against the previously validated Disabilities of the Arm, Shoulder and Hand (DASH) and Western Ontario Shoulder Instability Index (WOSI) questionnaires in a group of talented juvenile Dutch baseball pitchers. Three times, from 2014–2016, 107 pitchers completed the Dutch KJOC, DASH and WOSI questionnaires. Participants’ questionnaire scores were analysed for the whole group and the symptomatic player subgroup separately. Internal consistency, construct validity and ceiling and floor effects were examined. Cronbach’s alpha was consistently above 0.8 for the three time periods for the whole group, and ranged between 0.62 and 0.86 for the symptomatic subgroup. Spearman’s rank correlation coefficients ranged from 0.47 to 0.67 for the whole group and 0.32 to 0.99 for the symptomatic subgroup. No floor effects were observed in the scores of the KJOC and only a ceiling effect for the whole group (15.2%) at one time period. The Dutch version of the KJOC has shown acceptable internal consistency and construct validity and can be used to assess overhead athletes’ shoulder and elbow functionality.

The pitching motion is an asymmetric action by which coordination of scapular rotation in the dominant arm might be affected in time and in comparison with the non-dominant arm. The study aimed to compare asymmetry and the evolution of scapular upward rotation over a one-year period. Data were collected twice, before and after a one-year period, from 92 participants (age = 15.1 SD 1.4 years, body height = 177.3 SD 10.9 cm, body weight 69.2 SD 14.5 kg). Scapular motion was tracked at different glenohumeral angles of elevation in the scapular plane: anatomical position (0°), 45°, 90° and 135°. Scapular upward rotation was calculated as the angle between the spinae scapula and the spine. Scapular upward rotation of the dominant arm was 5.1° (95% CI: 2.1°−8.1°) more compared to the non-dominant arm. Age group or glenohumeral angles of elevation did not affect this difference. Scapular upward rotation of the dominant arm decreased 1.9° (95% CI: −0.5° to 4.3°) after a one-year period, however, neither this observation, nor the interaction with age group or elevation angle was significant. These findings may indicate that pitchers could be at risk to develop shoulder injuries especially those that have been associated with scapular asymmetry.