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  • SAGE Publications  (10)
  • Kobayashi, Tsutomu  (10)
  • 1
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    Risk Factors for Throwing-Related Shoulder and Elbow Pain in Adolescent Baseball Players: A Prospective Study of Physical and Developmental Factors
    SAGE Publications ; 2021
    In:  Orthopaedic Journal of Sports Medicine Vol. 9, No. 9 ( 2021-09-01), p. 232596712110171-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 9, No. 9 ( 2021-09-01), p. 232596712110171-
    Abstract: Throwing-related shoulder and elbow pain continues to be reported among adolescent baseball players. Few prospective studies have specifically examined the association between throwing-related shoulder and elbow pain and physical and developmental changes. Purpose: To evaluate the changes in physical and developmental characteristics during 1 year with respect to throwing-related shoulder and elbow pain in adolescent baseball players. Study Design: Case-control study; Level of evidence, 3. Methods: This 1-year prospective follow-up study investigated 164 baseball players aged 7 to 13 years. Player data (age, height, weight, field position, and pitch count), lower extremity muscle tightness, and range of motion (ROM) of the shoulder, elbow, and hip joints were assessed during the 2016 and 2017 preseason medical examinations. After the 2016 season, the participants completed questionnaires related to throwing-related shoulder and elbow pain, defined as an inability to play for ≥1 week because of elbow or shoulder difficulties. For study participants with and without throwing-related shoulder or elbow pain during the 2016 season, we conducted univariate and multivariate logistic regression analysis to identify risk factors for throwing-related shoulder or elbow pain. Results: Overall, 21 players (12.8%) reported a shoulder pain episode, 56 players (34.1%) had an elbow pain episode, and 70 players (42.7%) reported having experienced shoulder and/or elbow pain during the 2016 season. In multivariate logistic regression analysis, (1) shoulder pain was associated with 2016 preseason height (odds ratio [OR], 1.06; 95% CI, 1.01-1.11; P = .01) and change in dominant-side elbow extension ROM from 2016 to 2017 (OR, 1.12; 95% CI, 1.02-1.24; P = .02); (2) elbow pain was associated with change in weight from 2016 to 2017 (OR, 1.21; 95% CI, 1.04-1.41; P = .014); and (3) throwing-related shoulder and/or elbow pain was associated with greater 2016 preseason height (OR, 1.04; 95% CI, 1.003-1.68; P = .03) and an increase in height from 2016 to 2017 (OR, 1.17; 95% CI, 1.01-1.35; P = .03). Conclusion: Our results indicated that adolescent baseball players who were taller in the preseason and those with an increase in height over the 1-year study period faced significant risks for developing throwing-related shoulder and/or elbow pain.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/23259671211017129
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 2
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    Diagnosis of Radiographically Occult Lumbar Spondylolysis in Young Athletes by Magnetic Resonance Imaging
    SAGE Publications ; 2013
    In:  The American Journal of Sports Medicine Vol. 41, No. 1 ( 2013-01), p. 169-176
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 41, No. 1 ( 2013-01), p. 169-176
    Abstract: The early stages of spondylolysis are extremely difficult to diagnose on plain radiography. Although several studies have examined changes in active spondylolysis on magnetic resonance imaging (MRI), no studies to date have determined the onset frequency of active spondylolysis detectable on MRI but occult on plain radiography. Moreover, the clinical features of active spondylolysis described in the literature do not facilitate the differentiation of this condition from other causes of low back pain. Purpose: This study aimed to evaluate the usefulness of MRI in diagnosing active spondylolysis early and in determining the prevalence of active spondylolysis in cases where findings were not detected on plain radiography. In addition, specific clinical features to aid in the early detection of active spondylolysis were evaluated. Study Design: Cohort study; Level of evidence, 3. Methods: Patients were 200 consecutive young athletes (144 boys and 56 girls; mean age, 14.1 ± 1.5 y) with low back pain. All patients were examined by plain radiography (188 with negative findings and 12 with unclear findings of spondylolysis) and MRI. Computed tomography (CT) was performed only for patients with high intensity changes of the pedicle observed on MRI. The presence or absence of low back pain was examined during lumbar spine extension and flexion. The Kemp test on the right and left sides and percussion of the vertebral spinous process were also performed. Results: Ninety-seven (48.5%) patients showed evidence of active spondylolysis on MRI, findings that had been missed by plain radiography. These pars defects were organized into the following categories based on CT findings: nonlysis stage, 52; very early stage, 37; late early stage, 22; progressive stage, 10; and terminal stage, 0. No significant physical examination factors were identified that could assist in the early detection of active spondylolysis. Conclusion: The MRI results suggest a high rate of active spondylolysis in young athletes with low back pain who test negative for spondylolysis on plain radiography. Magnetic resonance imaging appears to be useful in the early diagnosis of active spondylolysis, especially as we found no significant physical examination factors that could assist in early detection.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546512464946
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2063945-4
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  • 3
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    Relationship Between Upper Limb Injuries and Hip Range of Motion in Elementary and Junior High School Baseball Players
    SAGE Publications ; 2021
    In:  Orthopaedic Journal of Sports Medicine Vol. 9, No. 2 ( 2021-02-01), p. 232596712097091-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 9, No. 2 ( 2021-02-01), p. 232596712097091-
    Abstract: Shoulder and elbow injuries are major problems in baseball players. Tightness of the upper extremities has been reported as a risk factor for shoulder and elbow injuries in elementary and junior high school baseball players. However, few studies have been conducted on the relationship between decreased hip range of motion (ROM) and shoulder and elbow injuries. Purpose/Hypothesis: This study aimed to prospectively examine the relationship between hip ROM and throwing-related shoulder and elbow injuries in elementary and junior high school baseball players. The hypothesis was that players with unrestricted ROM in the hip would have a reduced risk of upper extremity injuries. Methods: The study included 263 baseball players (mean ± SD age, 10.5 ± 1.3 years; range, 7-14 years). The following physical parameters were assessed: (1) hip flexion ROM measured in the supine position and (2) hip internal and external rotation in the prone position. After the season, players completed questionnaires regarding shoulder and/or elbow injuries. For comparison, the players were classified as injured (not able to play for ≥8 days because of shoulder and/or elbow problems) or noninjured. Results: During the season, 52 players had shoulder and/or elbow injuries. When the injured and noninjured groups were compared, hip flexion on the dominant side (121.5° ± 12.0° vs 126.7° ± 9.8°, respectively; P 〈 .01), hip flexion on the nondominant side (119.6° ± 11.7° vs 126.0° ± 9.9°, respectively; P 〈 .01), and internal rotation on the dominant side (52.5° ± 11.3° vs 56.8° ± 10.8°, respectively; P = .01) were significantly reduced in the injured group. Conclusion: We identified preseason decreases in flexion bilaterally and internal rotation on the dominant side as risk factors for shoulder and elbow injuries in elementary and junior high school baseball players. Further studies are required to prevent disabilities in elementary and junior high school baseball players through development of prevention and intervention programs.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967120970916
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 4
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    Asymptomatic Medial Elbow Ultrasound Abnormality in Youth Baseball Players Is an Independent Risk Factor for Elbow Injury: A Prospective Cohort Study
    SAGE Publications ; 2021
    In:  Orthopaedic Journal of Sports Medicine Vol. 9, No. 4 ( 2021-04-01), p. 232596712098679-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 9, No. 4 ( 2021-04-01), p. 232596712098679-
    Abstract: Youth baseball players who experience elbow pain during the season frequently exhibit radiographic elbow abnormalities. However, it is unknown whether asymptomatic elbow abnormalities are risk factors for in-season elbow injuries. Purpose: To determine whether the preseason presence of asymptomatic medial epicondyle apophysitis is a risk factor for in-season elbow injuries in youth baseball players. Study Design: Cohort study; Level of evidence, 2. Methods: Youth baseball players (N = 210; age range, 7-12 years) with no pain or history of injury in their throwing arms underwent preseason evaluations that included shoulder and elbow range of motion measurements, shoulder muscle strength testing, and ultrasound elbow scans with a multifrequency 13-MHz linear array transducer. Over 1 year of play, the players and their parents maintained daily elbow pain diaries. Elbow injuries were defined as medial elbow symptoms that prevented ball throwing for ≥8 days. Results: The preseason ultrasound evaluation revealed medial epicondyle apophysitis in 59 players. In the year following, elbow injuries occurred in 17 (28.8%) players with preseason medial epicondyle apophysitis and 18 (11.9%) players without apophysitis. Independent predictors of elbow injuries were preseason medial epicondyle apophysitis (odds ratio [OR], 2.488; 95% confidence interval [CI] , 1.152-5.376; P = .02) and deficits of abduction (ABD) and external rotation of the dominant shoulder (OR, 0.963; 95% CI, 0.936-0.992; P = .012). Conclusion: Asymptomatic medial epicondyle apophysitis and ABD and external rotation deficits in the dominant shoulder were risk factors for elbow injuries in 7- to 12-year-old youth baseball players. These findings may aid in the design of programs to prevent elbow injuries in this population.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967120986791
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 5
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    Assessment of Osgood-Schlatter Disease and the Skeletal Maturation of the Distal Attachment of the Patellar Tendon in Preadolescent Males
    SAGE Publications ; 2014
    In:  Orthopaedic Journal of Sports Medicine Vol. 2, No. 7 ( 2014-07-01), p. 232596711454208-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 2, No. 7 ( 2014-07-01), p. 232596711454208-
    Abstract: Osgood-Schlatter disease (OSD) is a traction apophysitis of the tibial tuberosity. Ultrasonography (US) is able to detect pathologic changes, such as cartilage swelling and fragmentation of the tibial tubercle ossification center. Purpose: To compare the US stages of tibial tuberosity development and the physical features and prevalence of OSD in this patient cohort. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Subjects included 238 males (n = 476 joints) with a mean age of 11.4 ± 1.6 years (range, 7-14 years). The tibial tuberosity development on US was divided into 3 stages: the cartilaginous stage (stage C), apophyseal stage (stage A), and epiphyseal stage (stage E). It was then investigated whether the subjects had pain in the tibial tuberosity on application of pressure. Age, height, body weight, body mass index (BMI), heel-buttock distance (HBD, cm), and straight-leg raise angle (SLRA) were evaluated. To confirm the diagnosis of OSD, the participant had to fulfill the following clinical criteria: pain with direct pressure on the tibial apophysis, fragmentation of the bone, and irregularity of the ossification center detected by US. Results: The tibial tuberosity was stage C in 195 knees, stage A in 105 knees, and stage E in 176 knees. The subjects’ heights, weights, and BMIs significantly increased with advancing development of the tibial tuberosity. The HBD increased in stage E ( P 〈 .01). The SLRA was not significantly different among groups. There was fragmentation of the bone and irregularity of the ossification center in 32 knees (6.8%): 0 in stage C, 21 (4.3%) in stage A, and 11 (2.3%) in stage E. Fragmentation of the bone and irregularity were observed significantly more often in stage A ( P 〈 .01). On the other hand, there were 10 joints with OSD (2.1%): 0 in stage C, 3 (0.6%) in stage A, and 7 (1.5%) in stage E. OSD was observed significantly more often in stage E than in the other stages ( P 〈 .05). Conclusion: The present study showed that the HBD increased from stage A to stage E. The prevalence of OSD was highest in stage E.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967114542084
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
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  • 6
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    Relationship between upper limb injuries and hip range of motion and strength in high school baseball pitchers
    SAGE Publications ; 2021
    In:  Journal of Orthopaedic Surgery Vol. 29, No. 1 ( 2021-01-01), p. 230949902110033-
    Details
    In: Journal of Orthopaedic Surgery, SAGE Publications, Vol. 29, No. 1 ( 2021-01-01), p. 230949902110033-
    Abstract: We aimed to examine the relationship between hip range of motion (ROM) and abduction strength and throwing-related shoulder/elbow injuries in high school baseball pitchers. The study included 135 baseball pitchers. We asked them to fill out a questionnaire at the checkups, that included the dominant arm and the years of baseball experience. To avoid a confirmation bias, the examiners were blinded to the participants’ hand dominance. All players underwent physical function measurements, such as height, weight, shoulder and hip strength, and shoulder and hip ROM. Shoulder and elbow injury was defined as shoulder and elbow pain that the patient had been aware of in the past 3 years. The results of injured and non-injured pitchers were compared. Eighty-five pitchers had experienced a shoulder or elbow injury in the past 3 years. The shoulder ROM and strength in the injured and non-injured groups did not differ to a statistically significant extent. The hip external rotation ROM on the dominant side, the hip abduction strength on the non-dominant side, and the hip abduction strength on the dominant side were significantly lower in the injured group than in the non-injured group. The results may contribute to reducing the incidence of these injuries.
    Type of Medium: Online Resource
    ISSN: 2309-4990 , 2309-4990
    URL: Article
    DOI: 10.1177/23094990211003347
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 7
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    What Is the Appropriate Reference for Evaluating the Recovery of Supraspinatus Muscle Atrophy After Arthroscopic Rotator Cuff Repair? The Occupation Ratio of the Supraspinatus May Change After Rotator Cuff Repair Without Volumetric Improvement
    SAGE Publications ; 2018
    In:  The American Journal of Sports Medicine Vol. 46, No. 6 ( 2018-05), p. 1416-1423
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 46, No. 6 ( 2018-05), p. 1416-1423
    Abstract: Supraspinatus muscle atrophy is typically assessed by the occupation ratio of the cross-sectional area of the muscle belly to the supraspinatus fossa at the medial border of the coracoid process in a slice along the oblique-sagittal plane on MRI. Previous studies have shown that the occupation ratio of the supraspinatus changed soon after rotator cuff repair compared with before surgery. However, no studies have examined the perioperative change in the muscle volume assessed with 3-dimensional measurement. Purpose: To compare the volume of the supraspinatus muscle before and soon after surgery by using 3-dimensional imaging and to elucidate whether the changes in the occupation ratio represent corresponding changes in the muscle volume. Study Design: Cohort study; Level of evidence, 3. Methods: Thirty shoulders of patients who underwent arthroscopic rotator cuff repair were evaluated. T2-weighted images were obtained before surgery and 2 weeks after surgery. After the muscle and its tendon borders were plotted, the supraspinatus and its tendon were segmented with interactive thresholding in all slices. The 3-dimensional images were then reconstructed and the volumes calculated. Changes in the muscle volume and the occupation ratio were evaluated via 3-dimensional and 2-dimensional image assessments. The 3-dimensional and 2-dimensional findings before and after surgery were compared by use of paired t tests. Results: The mean muscle volume did not change significantly at a time point soon after surgery in any group. In patients with little medial retraction (n = 7) or isolated detachment at the superior facet (n = 17), no significant differences were noted in the occupation ratio after surgery compared with before surgery. In contrast, in patients with moderate medial retraction (n = 23) or extended tearing in the transverse direction (n = 13), the occupation ratio increased significantly. Conclusion: Although the muscle volume did not change soon after surgery compared with the preoperative values, in patients with moderate medial retraction or extended tearing in the transverse direction, the occupation ratio increased, probably due to lateral traction of the supraspinatus muscle. We recommend that MRI findings obtained soon after surgery be used as the time-zero reference for evaluating the postoperative changes in the supraspinatus.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546518758313
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2063945-4
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  • 8
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    The Relationship Between Dynamic Balance Ability and Shoulder Pain in High School Baseball Pitchers
    SAGE Publications ; 2022
    In:  Sports Health: A Multidisciplinary Approach Vol. 14, No. 3 ( 2022-05), p. 397-403
    Details
    In: Sports Health: A Multidisciplinary Approach, SAGE Publications, Vol. 14, No. 3 ( 2022-05), p. 397-403
    Abstract: Dynamic balance is essential for pitching motion because pitching kinematics requires whole body coordination. The Star Excursion Balance Test (SEBT) and the Y balance test (YBT) evaluate dynamic balance quantitatively. There are some reports that investigated the relationship between SEBT/YBT and pain in upper and lower extremities, but there is no study among high school baseball pitchers. Hypothesis: Dynamic balance deficiency is associated with shoulder pain among high school baseball pitchers. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: A total of 259 male high school pitchers who participated in the preseason medical checkups were included in the study. YBT was used to measure their dynamic balance. The participants completed a questionnaire which asked if they were currently experiencing shoulder pain. Results: Twenty-two pitchers had shoulder pain during the preseason medical checkups. In the YBT, the posterolateral balance while standing with the axis leg as well as the posteromedial and posterolateral balance while standing with the step leg were significantly lower in the pain group than in the nonpain group ( P = 0.05, 0.04, and 0.001, respectively). A logistic regression analysis showed that posterolateral balance when standing with the step leg was an independent risk factor for current shoulder pain ( P = 0.04, odds ratio 0.942, 95% CI 0.892-0.996). Conclusion: The dynamic balance of high school baseball pitchers with shoulder pain was lower than that of participants without shoulder pain. In particular, posterolateral direction with the step leg standing was significantly related to shoulder pain. Clinical Relevance: Among high school baseball pitchers, decreased dynamic balance was related to current shoulder pain. YBT maybe recommended in preseason medical checkups for high school baseball pitchers.
    Type of Medium: Online Resource
    ISSN: 1941-7381 , 1941-0921
    URL: Article
    DOI: 10.1177/19417381211019682
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2474978-3
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  • 9
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    A Clinical and Ultrasonographic Study of Risk Factors for Elbow Injury in Young Baseball Players
    SAGE Publications ; 2016
    In:  Journal of Orthopaedic Surgery Vol. 24, No. 1 ( 2016-04), p. 45-50
    Details
    In: Journal of Orthopaedic Surgery, SAGE Publications, Vol. 24, No. 1 ( 2016-04), p. 45-50
    Abstract: To determine the risk factors for elbow injury and its association with glenohumeral internal rotation deficit among young baseball players. Methods. 229 baseball players aged 9 to 14 (mean, 11) years completed a self-administered questionnaire with items related to years of playing baseball, hours of training per weekday, days of training per week, and past and present experience of elbow pain. Two orthopaedic surgeons measured the range of motion of both shoulders and elbows. Another 2 orthopaedic surgeons performed ultrasonography to detect any elbow abnormality such as fragmentation of the medial epicondylar apophysis and osteochondritis dissecans of the capitellum. Using univariate and multivariable analyses, participants with or without elbow abnormality were compared to determine the risk factors for elbow abnormality. Results. Elbow abnormality was detected in 100 of the participants and comprised osteochondritis dissecans of the capitellum (n=18) and fragmentation of the medial epicondylar apophysis (n=82). Elbow abnormality was associated with being a pitcher, past and present experience of elbow pain, loss of elbow extension, and the side-to-side internal rotation difference. The 100 participants with elbow abnormality were stratified into symptomatic (n=57) or asymptomatic (n=43) of elbow pain. Those with elbow abnormality and elbow pain was associated with being a pitcher. Conclusion. Being a pitcher was a risk factor for both elbow abnormality and elbow pain. Nonetheless, 43% of baseball players with elbow abnormality were asymptomatic. The use of ultrasonography was effective in detecting elbow abnormality and enabling early treatment.
    Type of Medium: Online Resource
    ISSN: 2309-4990 , 2309-4990
    URL: Article
    DOI: 10.1177/230949901602400112
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
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  • 10
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    Prevalence and Risk Factors of Lateral Epicondylitis in a Mountain Village in Japan
    SAGE Publications ; 2014
    In:  Journal of Orthopaedic Surgery Vol. 22, No. 2 ( 2014-08), p. 240-243
    Details
    In: Journal of Orthopaedic Surgery, SAGE Publications, Vol. 22, No. 2 ( 2014-08), p. 240-243
    Abstract: To determine the prevalence and risk factors of lateral epicondylitis in a mountain village in Japan. Methods. 176 men and 246 women aged 24 to 86 (mean, 61) years from a mountain village in Japan underwent regular medical examination and completed a self-administered questionnaire with items related to gender, weight, height, dominant hand, heaviness of labour (no job, light, intermediate, and heavy), presence of elbow pain 2 weeks before examination, and smoking and drinking experience. The diagnosis of lateral epicondylitis was based on self-reported symptoms and clinical signs. Results. The prevalence of lateral epicondylitis in a mountain village in Japan was 3.8% (95% confidence interval [CI], 2.2%-6.1%). Of the 422 subjects, 47 had elbow pain and 16 of them were diagnosed to have definite lateral epicondylitis. 15 of them were right-handed and had involvement of the left (n=8) and right (n=7) sides; the remaining one was left-handed and had involvement of the left side. The dominant hand was not associated with the affected side (p=1.00). Heaviness of labour was not associated with the elbow pain scores. The prevalence was highest in subjects aged 50 to 59 years (9% [95% CI, 3.8%-17.1%] ) and those with no job (14% [95% CI, 1.1%-44.1%]). Conclusion. Lateral epicondylitis was not associated with gender, age, body mass index, dominant hand, heaviness of labour, smoking, or drinking.
    Type of Medium: Online Resource
    ISSN: 2309-4990 , 2309-4990
    URL: Article
    DOI: 10.1177/230949901402200227
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
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