Preventive interventions for throwing injuries in baseball players: a scoping review

Background: Shoulder and elbow pain are the common complaints associated with throwing injuries in baseball players. Prospective studies evaluating the effectiveness of stretching in increasing posterior shoulder flexibility or strengthening the external rotator muscles as preventive strategies for throwing injuries in baseball players have been published. However, there are limited reviews highlighting the role of preventive interventions for throwing injuries in baseball players. Therefore, this scoping review aimed to summarize the existing literature on preventive interventions for throwing injuries in baseball players. Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Scopus databases on 3 March 2023. Two independent reviewers screened the studies based on the eligibility criteria. We extracted existing literature on preventive interventions and effectiveness for throwing injuries in baseball players, and participants' characteristics and results were extracted from the studies. This scoping review was performed in accordance with the Extended Preferred Reporting Items for Systematic Reviews and MetaAnalyses Statement for Scoping Reviews. Results: The initial database search yielded 1170 articles, four of which met the eligibility criteria. Of the included studies, two were randomized controlled trials, and the remaining two were prospective cohort studies. Eligible studies targeted youth-to high school-level players and focused on preventive programs for throwing injuries that manifest in the upper extremities of baseball players. The outcome measure most commonly used to quantify the effectiveness of prevention programs was the incidence of shoulder and elbow injuries, although the definitions vary among studies. The prevention program included sleeper stretching, shoulder external rotation strengthening exercises, and comprehensive prevention programs (focusing on improving the elbow, shoulder, and hip range of motion; rotator cuff and periscapular muscle strength; posture; and lower extremity balance). Each prevention program was reported to have the potential to reduce the incidence of throwing injuries in baseball players, and two studies suggested that high compliance with the program led to a lower injury risk. Conclusion: This scoping review confirmed the presence of studies that examined preventive interventions for throwing injuries in baseball players. Preventive interventions that may reduce throwing injuries in baseball players include sleeper stretching, shoulder external rotation strengthening exercises, and comprehensive prevention programs. However, the characteristics of participants (eg, age, sports level, and position) and the definition of injury varied among previous studies. Injury profiles and prevention strategies may differ according to age, sport level, and position of players, and more studies are needed to prove this issue. Level of evidence: Scoping Review (c) 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.