Multifactorial analysis of injuries in baseball pitchers in
a national series in Cuba
Abstract
In the present study, a correlational, longitudinal and prospective investigation was
carried out between November 2018 and November 2020. The objective of the work was:
determine the relationship of the history of injuries, physical preparation and compliance
with physioprophylaxis with the occurrence of new injuries during the 59th National
Baseball Series in Cuba. The 16 pitchers who made up the pitching group of the Villa
Clara team participated, who were between 19 and 35 years old and had sports
experience between 11 and 25 years. Among the methods used were: a specific
questionnaire to obtain information on the history of injuries and a form to record the
injuries that occurred during the competition, the Mile test for the evaluation of aerobic
power and relative oxygen consumption, while to evaluate compliance with the physio-
prophylactic plan, structured observation and empirical frequency distribution were
used. A significant relationship was obtained between past injuries and the occurrence
of new injuries in the series, with those who had previously been injured being more likely
to be injured. Presenting lower aerobic power and relative oxygen consumption, as well
as performing a poor warm-up and massage was related to the occurrence of the injury.
In addition, poor stretching was related to a greater number and severity of injuries in
the series analyzed. It is essential to improve physical preparation and compliance with
physioprophylaxis in pitchers with a history of injuries in order to prevent them.
Keywords: Oxygen consumption, physioprophylaxis, sports injury, aerobic power.
Introduction
The development of Baseball is largely due to advances in applied sciences such as
physiology, cardiology, biology, psychology, kinanthropometry, biomechanics, nutrition
and biochemistry, among other disciplines, which are strongly interrelated around
improving the sports performance based on the scientific findings that support the training
methods and their functional direction (Bracic, 2017).
One of the aspects that is the object of attention of the sciences applied to this sport are
injuries, because these significantly affect the performance and health of athletes, mainly
pitchers, whose risk of injury is notably higher than the rest of the athletes. the players
(Fleisig and Riff, 2012; Malek, 2015; Ríos Garit et al., 2021).
Several studies have identified the existence of multiple risk factors that affect the
occurrence of injuries (Cebrian and Guerra, 2019; Fleisig and Riff, 2012; Malek, 2015;
Ríos, 2017; Ríos, 2021; Ríos et al., 2021). ), however, it has been specifically determined
that sports gestures in Baseball subject the body to high-speed maneuvers and explosive
force, putting the joints at risk.
Throwing is considered the most predisposing technical gesture to injury because it is
unnatural and compromises the different structures of the joint to twisting, stretching at
high speed and at acute angles; In addition, its repetition above the head produces
important mechanical overloads in the elbow and shoulder joints (Dove et al., 2021).
Several authors have determined that the lack of coordination or control of movements
leads to an increased risk of injury (Becerra and Sánchez, 2019).
The act of throwing requires a coordinated movement that progresses from the toes to the
tips of the fingers. This sequence of events is considered as a kinetic chain whose
efficiency requires sequential muscular activity, so that the energy generated in the lower
body can be transmitted to the upper body through the arm, hand and fingers and, finally,
through the upper body. the ball.
The rotation of the body, the chronology and position of the scapula are key elements of
the kinetic chain, so any physical condition that alters the components of the kinetic chain,
especially one that affects the so-called center (trunk, back and proximal part of the lower
limbs), alters the most distal segments and can cause injuries (Pilots, 2012).
In the case of baseball pitchers, it is a proven fact that the main causes of injuries are due
to overuse and stereotyped movements. Sports injuries in baseball pitchers are
significantly more frequently focused on the shoulder and elbow of the pitching arm.
Because their specifications and clinical characteristics are so particular, they have been
named "Thrower's Shoulder and Elbow" (Agresta et al., 2019).
This work is based on the need to investigate and obtain information that allows
preventing the occurrence of injuries in Baseball pitchers during fundamental
competition, so the objective is: to determine the relationship between the history of
injuries, physical preparation and compliance with physioprophylaxis with the occurrence
of new injuries during the 59th National Baseball Series in Cuba.
Methodology
Type of study
A correlational, longitudinal and prospective study was carried out with the objective of
determining the relationship between risk factors and the occurrence of injuries in
baseball pitchers from Villa Clara in the 59th National Series.
Population
We worked with the entire population made up of the 16 pitchers of the Villa Clara team
during the 59th National Baseball Series. These presented an average chronological age
of 24.18 years and an average sports experience of 15.71 years.
Techniques and instruments
The Sports Aspects and Injuries Questionnaire (Olmedilla et al., 2006) was applied to
identify the injury history in the population under study (injury history, number of
injuries, greater injury severity, injury occurrence context).
The mile test was applied to determine aerobic power and relative oxygen consumption.
A structured and participatory observation was carried out on the pitchers during training
and competition in order to detect adequate compliance with preventive measures and the
physio-prophylaxis plan (warm-up, stretching, use of cryotherapy and massage).
The injuries that occurred during the national series were recorded using a record form
designed for this purpose, allowing the pitchers who were injured, the severity of the
injuries, the quantity and the context of occurrence to be identified.
Analysis of data
Empirical frequency distribution was used to describe the injury history and new injuries
suffered by the pitchers in the analyzed series. Kendall's Tau-b non-parametric correlation
coefficient was used to identify levels of relationship between the variables under study.
The SPSS version 22.0 package for Windows was used.
Procedures
The analysis of the history of injuries, the state of the physical variables and compliance
with the physioprophylactic plan was carried out during the pre-competitive stage. The
medical records were reviewed at the Sports Medicine Center also during this stage, while
the observation was applied for three weeks in training and meetings with other teams
prior to the start of the national series.
Ethical Considerations
The research was carried out in compliance with the ethical principles contained in the
Declaration of Helsinki and subsequent revisions. The principles that regulate ethics
during the scientific research process were complied with, taking into account the four
basic principles of research on human subjects (beneficence, non-maleficence, justice and
respect for the person).
To undertake this work, the approval and consent of the baseball team management, the
ethics committee and the scientific council of the institution were taken into account.
Informed consent was obtained from all participants, clarifying the voluntary nature of
participation.
Results and Discussion
Table 1 shows the history of injuries of the pitchers analyzed. It is evident that most of
these athletes have suffered injuries, although with a low frequency of repetition. The
significant presence of serious injuries is striking, most of which have occurred during
the competition.
Table 1
History of injuries of pitchers from Villa Clara in the 59th National Baseball Series
Variables
N
Percentage
History of injury
Has not been injured
4
25.0
Has been injured
12
75.0
Number of injuries
More fingers
1
8.3
Two
3
25.0
One
8
66.7
Greater severity of injury
Serious
7
58.3
Moderate
2
16.7
Mild
3
25.0
Injury occurrence context
Training
1
8.3
Competing
11
91.7
Source: self made
Table 2 shows the behavior of the injuries during the national series under study where
the majority of the pitchers did not suffer any injury, although the injured suffered more
than one injury between moderate and very serious, occurring only during competitive
games.
Table 2
Distribution of new injuries in pitchers from Villa Clara in the 59th national series
Variables
N
New injuries
He wasn't injured
11
he was injured
5
Number of new injuries
Two
2
One
3
Severity of injuries
Moderate
3
Very severe
2
Injury occurrence context
Competing
5
Source: self made
Table 3 shows the relationships determined between variables. It is observed that having
previously been injured is positively related to the new injury in the series, as well as the
severity of past injuries. Aerobic power, relative oxygen consumption, warm-up and
massage are inversely related to the occurrence of the injury in the national series.
Furthermore, stretching is negatively related to the number of injuries and their severity.
Table 3
Correlation of injury history, physical preparation and physioprophylaxis with new
injuries
Variables
Occurrence SI
Number of SI
Gravity SI
Tau_b de
Kendall
p.
Tau_b de
Kendall
p.
Tau_b de
Kendall
p.
History of injury
.389*
.044
-
-
-
-
Number of injuries
.105
.773
-.500
.221
.500
.221
Greater severity of injury
.577**
.007
-
-
-
-
Injury occurrence context
-.250
.289
-
-
-
-
Aerobic power
-.502*
.032
.500
.221
-.500
.221
VO
2
Relative
-.496*
.027
-.500
.221
.500
.221
Poor heating
-.612**
.012
-
-
-
-
Poor stretch
-.423
.074
-1.00**
.014
-1.00**
0.14
Use of Cryotherapy
-.265
.105
-
-
-
-
Use of massage
-.373*
.044
-
-
-
-
Note. *p≤ 0.05; ** p≤ 0.01 (Sig. bilateral); SI= sports injury; VO
2
Relative = Relative oxygen consumption
Source: self made
The presence of a higher proportion of pitchers with a history of injury, the low frequency
of reiteration and its predilection for occurrence in competitions coincide with findings
obtained in other investigations carried out in this population at different times (Ríos et
al., 2019; Ríos et al ., 2021; Ríos, 2021), however, they differ from those studies in terms
of the severity of the injuries suffered, since in this case a greater presence of serious
injuries was found.
In a longitudinal study carried out with pitchers from Villa Clara under 23 and 1st
category in several national series between 2017 and 2019 (Ríos et al., 2021), its authors
identified that the majority of these athletes suffered injuries during competitive games,
fundamentally coinciding with the results of the present study in terms of the context of
occurrence, but differing in the proportion of injured pitchers, since it was obtained that
the majority of the pitchers in the 59 national series were not injured, although more
serious injuries occurred. These differences may be due to the fact that in the present
study only one national series was analyzed in a single team of the highest level in the
province.
A lower incidence of injuries was obtained during the 59th national series in relation to
prevalence, predominating those who suffered a single injury, an aspect that supports the
good work done in this regard, although by not classifying the team in the post season the
work of pitchers was lower than at other times.
The relationships obtained between the variables of preparation and injuries show that the
higher the aerobic power and the relative oxygen consumption of the pitchers, the lower
the occurrence of injuries. Regarding technical preparation, the results do not show a
significant relationship with the variables related to injuries in this series.
A significant relationship was also obtained between the history of injury and those
injured in the series, with those pitchers who had previous injuries being more likely to
be injured. This aspect coincides with other studies (Ríos, 2017; Ríos et al., 2019), which
suggest that having been injured represents the first risk factor for re-injury and the new
injury that occurs on an old one is the main one. risk factor depending on its severity.
Another relevant result to discuss is that it was possible to show that the better the
compliance with the warm-up and the massage, the fewer injuries these pitchers present.
While stretching has a significant relationship with the number and severity of injuries in
the series, showing that those pitchers who do not stretch correctly are likely to suffer
more injuries of a higher degree of severity, coinciding with the findings of previous
studies (Becerra and Sanchez, 2019; Dove et al., 2021).
Conclusions
The results obtained demonstrate the importance of physical preparation and adequate
compliance with physioprophylactic plans for the prevention of injuries in these Baseball
pitchers, as well as the need to establish preventive work with emphasis on pitchers with
the highest injury burden.
Despite the usefulness of the findings, they are insufficient to guide injury prevention due
to the low representativeness of the population analyzed, since a particular pitching group
was studied within the framework of a single national competition.
Due to the above, it is considered that the research should be extended both temporally
and population-wise to obtain data that allow improving the primary and secondary
prevention of injuries in these athletes from Villa Clara.
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Conflict of interest: the article is original and has not been previously published, the
authors declare no conflict of interest.