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Early Sport Specialization Linked to Throwing Arm Function and Upper Extremity Injury History in College Baseball
Jason Croci1, Jim Nicknair1, John Goetschius2
1Adrian College, Adrian, Michigan.
Background:
Evidence suggests that shoulder and elbow injuries account for 31% to 37% of all National Collegiate Athletic Association (NCAA) baseball injuries, and up to 69% of NCAA baseball injuries are the result of noncontact and overuse mechanisms. Early sport specialization may contribute to the high rates of upper extremity injuries in college baseball players.
Hypothesis:
Higher specialization by age 13 years would be associated with worse subjective throwing arm function and a greater history of shoulder and elbow injury.
Study Design:
Cohort study.
Level Of Evidence:
Level 2.
Methods:
Survey data were collected from college baseball players (N = 129) during midseason of the spring 2019 baseball season. Participants were stratified in low, moderate, and high specialization groups based on a 3-criteria sports specialization questionnaire. Participants' throwing arm function was measured using the Functional Arm Scale for Throwers and the Kerlan-Jobe Orthopaedic Clinic shoulder and elbow questionnaires. Participants' history of a shoulder or elbow injury that resulted in missing ≥2 weeks of baseball activity at any point in their baseball career was also collected.
Results:
The high specialization group reported worse subjective throwing arm function on the Functional Arm Scale for Throwers questionnaire than the low (P = 0.03) and moderate (P = 0.01) specialization groups. The high specialization group was over 5 times more likely to report a history of shoulder injury than the moderate (odds ratio [OR] = 5.42; 95% CI [1.71, 17.2]; P = 0.004) and low (OR = 5.20; 95% CI [1.87, 14.5]; P = 0.002) specialization groups, and over 3 times more likely to report a history of elbow injury than the moderate specialization group (OR = 3.77; 95% CI [1.05, 13.6]; P = 0.04).
Conclusion:
College baseball players that were highly specialized by age 13 years reported worse subjective throwing arm function and were more likely to have a history of upper extremity injury than players that were moderate or low specialization.
Clinical Relevance:
Early specialization in baseball may be detrimental to long-term upper extremity health in college baseball players.
