Risk Factors and Injury Prevention in the Throwing Athlete.

Area of Science:

• Sports Medicine
• Biomechanics
• Injury Prevention

Background:

• Arm injuries are the most common throwing injury, with severe injuries like UCL reconstruction on the rise.
• Recurrent throwing injuries suggest increased risk after initial injury, linked to increased pitching volume and year-round play.
• Current prevention strategies focusing on pitch counts (extrinsic factors) have not reduced injury rates.

Purpose of the Study:

• To advocate for comprehensive arm injury prevention strategies.
• To highlight the need to address modifiable intrinsic factors alongside extrinsic factors.
• To propose using a directed acyclic graph (DAG) to model injury mechanisms.

Main Methods:

• Utilize a directed acyclic graph (DAG) to map interactions between internal and external factors.
• Identify key internal factors: fatigue, injury history, range of motion, and strength.
• Identify key external factors: training load and pitching exposure.

Main Results:

• Arm injury rates remain constant despite focus on pitch counts.
• Intrinsic factors (e.g., shoulder ROM, strength, trunk/lower extremity function) are associated with injury risk.
• A comprehensive approach integrating intrinsic and extrinsic factors is necessary.

Conclusions:

• Current prevention strategies are insufficient.
• Future strategies must incorporate modifiable intrinsic factors.
• A DAG can guide the development of adaptable, evidence-based injury reduction programs.