Immediate Changes and Recovery of the Supraspinatus, Long Head Biceps Tendon, and Range of Motion after Pitching in Youth Baseball Players: How Much Rest Is Needed after Pitching? Sonoelastography on the Supraspinatus Muscle-Tendon and Biceps Long Head Tendon

Background: Baseball players are subjected to repeated loads on the supraspinatus and long head biceps tendon from youth, and repetitive pitching motions can cause shoulder injuries. The purpose of this study was to evaluate the immediate changes caused by pitching in the supraspinatus muscle-tendon, long head of the bicep tendon (LHBT), and shoulder range of motion (ROM) and to verify their recovery over time in youth baseball players. Methods: Fifteen youth baseball players (mean age, 11.5 +/- 1.3 years) were enrolled. The thicknesses of the supraspinatus tendon and LHBT and the strain ratios (SRs) of supraspinatus muscle and tendon were measured by sonoelastography. ROMs of shoulder joints (abduction, external rotation at 90 degrees of abduction [ABER], and internal rotations at 90 degrees of abduction [ABIR]) and horizontal adduction (HA) were measured using a goniometer. All measurements were performed on the throwing shoulders before and immediately after pitching (mean pitch count, 78.3 +/- 13.3) and at 30 minutes, 24 hours, and 72 hours after pitching. Results: The thickness of supraspinatus tendon (6.64-6.27 mm, p = 0.026) and that of LHBT (2.56-2.26 mm, p = 0.021) significantly decreased immediately after pitching. The SRs of supraspinatus muscle tended to decrease, whereas SRs of supraspinatus tendon tended to increase immediately after pitching. ABER increased (119.7 degrees-127.3 degrees, p = 0.001) and HA decreased (34.7 degrees-29.3 degrees, p = 0.023) immediately after pitching. All immediate changes recovered 72 hours after pitching. Conclusions: The immediate effects of pitching on the supraspinatus muscle-tendon, LHBT, and shoulder ROM in youth baseball players were confirmed in the current study. These changes were recovered to pre-pitch levels 72 hours after pitching. Therefore, we recommend that youth baseball players should rest for three days after pitching to minimize the risk of shoulder injury.