A Preseason Checklist for Predicting Elbow Injury in Little League Baseball Players

BACKGROUND: Despite pitch count limits, the incidence of Little League elbow is increasing. A risk-evaluation tool capable of predicting which players are predisposed to throwing injury could potentially prevent injuries. PURPOSE: To investigate the effectiveness of a risk factor checklist for predicting elbow injury in Little League baseball players during 1 season. The hypothesis was that a preseason risk-evaluation checklist could predict which players were predisposed to elbow injury. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A preseason risk-evaluation checklist was distributed to Little League baseball teams in Japan. Six months later, a follow-up questionnaire was mailed to determine injuries sustained during the season. Logistic regression analysis was performed, assigning presence or absence of elbow injury during the season as the dependent variable, and an injury risk score (IRS) was developed based on the statistically significant variables. Receiver operating characteristic (ROC) curve analysis was conducted to determine the predictive validity of the checklist and the optimal cutoff IRS. RESULTS: Data from 389 Little League players were analyzed. Among them, 53 players experienced an elbow injury requiring medical treatment during the season. Six checklist items associated with a medical history of throwing injury, pitch volume, and arm fatigue were found to be significant. Responses to the items could predict the players who were susceptible to injury during the season, with a two-thirds cutoff value for a 6-item checklist (area under the curve, 0.810; sensitivity, 0.717; specificity, 0.771). CONCLUSION: Results from a 6-item preseason checklist can predict which Little League players are to sustain an elbow injury by the end of the season. CLINICAL RELEVANCE: The ability to predict which Little League baseball players are predisposed to elbow injury allows parents and coaches to initiate preventive measures in those players prior to and during the baseball season, which could lead to fewer elbow injuries.