The Preseason Functional Movement Screen as a Predictive Tool for Shoulder and Elbow Injuries in High School Baseball Pitchers: A Prospective Cohort Study.

Abstract

Background: The Functional Movement Screen (FMS) is used to evaluate fundamental movement patterns in patients. It is unknown whether the FMS can be used as a predictive tool for the occurrence of pitching injuries in baseball players.

Purpose: To prospectively investigate the relationship between shoulder and elbow injuries and individual components of the FMS during the preseason in high school baseball pitchers and determine which components of the FMS can be used as screening tools to predict shoulder and elbow injuries.

Study design: Cohort study; Level of evidence, 2.

Methods: Eligible participants comprised 133 male high school baseball pitchers aged 15 to 17 years who underwent a preseason medical examination in 2017. Included participants were right-handed pitchers who had been involved in preseason practices without restrictions in baseball activities. The physical examination included assessments of background factors, bilateral shoulder and elbow range of motion, and grip and shoulder strength as well as the FMS. A shoulder or elbow injury was defined as any condition causing the inability to pitch for ≥8 days. Injuries occurring in the season immediately after the preseason medical examination were recorded. Logistic regression analysis was performed to identify risk factors associated with an injury.

Results: Overall, 90 high school baseball pitchers were enrolled in this study. The incidence of injuries was 22.2%. A comparison of FMS scores revealed significantly higher values for shoulder mobility on both sides (dominant side: P = .025; nondominant side: P = .034) and lower values for rotary stability on the dominant side (P < .001) in the injured versus noninjured group. Logistic regression analysis identified poor rotary stability on the dominant side as a significant independent risk factor for baseball injuries (odds ratio, 5.30; P = .009).

Conclusion: In right-handed high school baseball pitchers, a low FMS score for rotary stability on the dominant side during the preseason was a significant independent risk factor for injuries in the following season. The FMS score for rotary stability may be used as a predictive tool for the occurrence of pitching injuries in high school baseball pitchers.