{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T20:40:57Z","timestamp":1776285657100,"version":"3.50.1"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Japan Sports Medicine Foundation 2012"},{"name":"Kozuki Foundation 2012"},{"name":"Japanese Orthopedic Society for Sports Medicine"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The relationship between ankle joint function and throwing-related injuries has not been demonstrated. We hypothesized that limited ankle joint range of motion (ROM) was related to risk factors for shoulder and elbow injuries in young baseball players. This 12-month prospective cohort study evaluated the age, height, weight, playing position, shoulder, elbow, and ankle function of 228 enrolled baseball players. Shoulder and elbow injuries were tracked during the season. Univariate and multivariate analyses were performed to identify risk factors for shoulder and elbow injuries among participants divided into non-injured and injured groups. Univariate analysis showed that age, height, weight, ROM of elbow flexion in the dominant arm, muscle strength ratio of shoulder abduction, and the likelihood of being a pitcher or a catcher were significantly greater in the injured group than in the non-injured group. ROM of shoulder abduction-external\/internal rotation, shoulder total arc on the dominant arm, ankle joint dorsiflexion, and plantar flexion on the back (non-lead) and front (lead) legs were significantly less in the injured group than in the non-injured group. In conclusion, ROM dorsiflexion deficits in the back leg, shoulder abduction-external rotation in the dominant arm, ROM increase in elbow flexion on the dominant side, older age, and being a pitcher were significant independent risk factors for injury.<\/jats:p>","DOI":"10.1038\/s41598-021-85079-8","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T11:03:14Z","timestamp":1615287794000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Ankle dorsiflexion deficit in the back leg is a risk factor for shoulder and elbow injuries in young baseball players"],"prefix":"10.1038","volume":"11","author":[{"given":"Hitoshi","family":"Shitara","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Tajika","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuro","family":"Kuboi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Ichinose","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noritaka","family":"Hamano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takafumi","family":"Endo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masataka","family":"Kamiyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Honda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryosuke","family":"Miyamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurumi","family":"Nakase","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsutomu","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Takagishi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotaka","family":"Chikuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"85079_CR1","first-page":"183","volume":"42","author":"R Dick","year":"2007","unstructured":"Dick, R. et al. Descriptive epidemiology of collegiate men\u2019s baseball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988\u20131989 through 2003\u20132004. J. Athl. Train. 42, 183\u2013193 (2007).","journal-title":"J. Athl. Train."},{"key":"85079_CR2","doi-asserted-by":"publisher","first-page":"1803","DOI":"10.1097\/00005768-200111000-00002","volume":"33","author":"S Lyman","year":"2001","unstructured":"Lyman, S. et al. Longitudinal study of elbow and shoulder pain in youth baseball pitchers. Med. Sci. Sports Exerc. 33, 1803\u20131810 (2001).","journal-title":"Med. Sci. Sports Exerc."},{"key":"85079_CR3","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1016\/j.jos.2018.12.018","volume":"24","author":"K Takagishi","year":"2019","unstructured":"Takagishi, K. et al. Shoulder and elbow pain in junior high school baseball players: Results of a nationwide survey. J. Orthop. Sci. 24, 708\u2013714. https:\/\/doi.org\/10.1016\/j.jos.2018.12.018 (2019).","journal-title":"J. Orthop. Sci."},{"key":"85079_CR4","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1177\/0363546509360404","volume":"38","author":"IR Byram","year":"2010","unstructured":"Byram, I. R. et al. Preseason shoulder strength measurements in professional baseball pitchers: Identifying players at risk for injury. Am. J. Sports Med. 38, 1375\u20131382. https:\/\/doi.org\/10.1177\/0363546509360404 (2010).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR5","doi-asserted-by":"publisher","first-page":"1993","DOI":"10.1177\/0363546514535070","volume":"42","author":"TF Tyler","year":"2014","unstructured":"Tyler, T. F., Mullaney, M. J., Mirabella, M. R., Nicholas, S. J. & McHugh, M. P. Risk factors for shoulder and elbow injuries in high school baseball pitchers: The role of preseason strength and range of motion. Am. J. Sports Med. 42, 1993\u20131999. https:\/\/doi.org\/10.1177\/0363546514535070 (2014).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR6","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1177\/0363546510384223","volume":"39","author":"KE Wilk","year":"2011","unstructured":"Wilk, K. E. et al. Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers. Am. J. Sports Med. 39, 329\u2013335. https:\/\/doi.org\/10.1177\/0363546510384223 (2011).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR7","doi-asserted-by":"publisher","first-page":"3303","DOI":"10.1007\/s00167-015-3731-4","volume":"25","author":"H Shitara","year":"2017","unstructured":"Shitara, H. et al. Prospective multifactorial analysis of preseason risk factors for shoulder and elbow injuries in high school baseball pitchers. Knee Surg. Sports Traumatolol. Arthrosc. 25, 3303\u20133310. https:\/\/doi.org\/10.1007\/s00167-015-3731-4 (2017).","journal-title":"Knee Surg. Sports Traumatolol. Arthrosc."},{"key":"85079_CR8","doi-asserted-by":"publisher","first-page":"e198","DOI":"10.5435\/jaaos-d-17-00223","volume":"26","author":"CL Camp","year":"2018","unstructured":"Camp, C. L. et al. Decreased hip internal rotation increases the risk of back and abdominal muscle injuries in professional baseball players: Analysis of 258 player-seasons. J. Am. Acad. Orthop. Surg. 26, e198\u2013e206. https:\/\/doi.org\/10.5435\/jaaos-d-17-00223 (2018).","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"85079_CR9","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1589\/jpts.26.689","volume":"26","author":"Y Endo","year":"2014","unstructured":"Endo, Y. & Sakamoto, M. Correlation of shoulder and elbow injuries with muscle tightness, core stability, and balance by longitudinal measurements in junior high school baseball players. J. Phys. Ther. Sci. 26, 689\u2013693. https:\/\/doi.org\/10.1589\/jpts.26.689 (2014).","journal-title":"J. Phys. Ther. Sci."},{"key":"85079_CR10","doi-asserted-by":"publisher","first-page":"814","DOI":"10.2519\/jospt.2013.4504","volume":"43","author":"LA Feigenbaum","year":"2013","unstructured":"Feigenbaum, L. A., Roach, K. E., Kaplan, L. D., Lesniak, B. & Cunningham, S. The association of foot arch posture and prior history of shoulder or elbow surgery in elite-level baseball pitchers. J. Orthop. Sports Phys. Ther. 43, 814\u2013820. https:\/\/doi.org\/10.2519\/jospt.2013.4504 (2013).","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"85079_CR11","first-page":"356","volume":"9","author":"J Hannon","year":"2014","unstructured":"Hannon, J., Garrison, J. C. & Conway, J. Lower extremity balance is improved at time of return to throwing in baseball players after an ulnar collateral ligament reconstruction when compared to pre-operative measurements. Int. J. Sports Phys. Ther. 9, 356\u2013364 (2014).","journal-title":"Int. J. Sports Phys. Ther."},{"key":"85079_CR12","doi-asserted-by":"publisher","first-page":"752","DOI":"10.2519\/jospt.2013.4680","volume":"43","author":"JC Garrison","year":"2013","unstructured":"Garrison, J. C., Arnold, A., Macko, M. J. & Conway, J. E. Baseball players diagnosed with ulnar collateral ligament tears demonstrate decreased balance compared to healthy controls. J. Orthop. Sports Phys. Ther. 43, 752\u2013758. https:\/\/doi.org\/10.2519\/jospt.2013.4680 (2013).","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"85079_CR13","doi-asserted-by":"publisher","first-page":"920","DOI":"10.26603\/ijspt20190920","volume":"14","author":"J Craig Garrison","year":"2019","unstructured":"Craig Garrison, J., Hannon, J. & Conway, J. No differences in hip range of motion exists between baseball players with an ulnar collateral ligament tear and healthy baseball players. Int. J. Sports Phys. Ther. 14, 920\u2013926 (2019).","journal-title":"Int. J. Sports Phys. Ther."},{"key":"85079_CR14","doi-asserted-by":"publisher","first-page":"232596711880070","DOI":"10.1177\/2325967118800704","volume":"6","author":"DE Kantrowitz","year":"2018","unstructured":"Kantrowitz, D. E., Trofa, D. P., Woode, D. R., Ahmad, C. S. & Lynch, T. S. Athletic hip injuries in major league baseball pitchers associated with ulnar collateral ligament tears. Orthop. J. Sports Med. 6, 2325967118800704. https:\/\/doi.org\/10.1177\/2325967118800704 (2018).","journal-title":"Orthop. J. Sports Med."},{"key":"85079_CR15","doi-asserted-by":"publisher","first-page":"232596711453242","DOI":"10.1177\/2325967114532424","volume":"2","author":"M Saito","year":"2014","unstructured":"Saito, M. et al. Relationship between tightness of the hip joint and elbow pain in adolescent baseball players. Orthop. J. Sports Med. 2, 2325967114532424. https:\/\/doi.org\/10.1177\/2325967114532424 (2014).","journal-title":"Orthop. J. Sports Med."},{"key":"85079_CR16","doi-asserted-by":"publisher","first-page":"2709","DOI":"10.1177\/0363546519861378","volume":"47","author":"J Sakata","year":"2019","unstructured":"Sakata, J. et al. Throwing injuries in youth baseball players: Can a prevention program help? A randomized controlled trial. Am. J. Sports Med. 47, 2709\u20132716. https:\/\/doi.org\/10.1177\/0363546519861378 (2019).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR17","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1177\/0363546517738003","volume":"46","author":"J Sakata","year":"2018","unstructured":"Sakata, J. et al. Efficacy of a prevention program for medial elbow injuries in youth baseball players. Am. J. Sports Med. 46, 460\u2013469. https:\/\/doi.org\/10.1177\/0363546517738003 (2018).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR18","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1177\/0363546516663931","volume":"45","author":"J Sakata","year":"2017","unstructured":"Sakata, J., Nakamura, E., Suzukawa, M., Akaike, A. & Shimizu, K. Physical risk factors for a medial elbow injury in junior baseball players: A prospective cohort study of 353 players. Am. J. Sports Med. 45, 135\u2013143. https:\/\/doi.org\/10.1177\/0363546516663931 (2017).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR19","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.jse.2019.07.004","volume":"29","author":"T Sekiguchi","year":"2020","unstructured":"Sekiguchi, T. et al. Restriction in the hip internal rotation of the stride leg is associated with elbow and shoulder pain in elite young baseball players. J. Shoulder Elbow Surg. 29, 139\u2013145. https:\/\/doi.org\/10.1016\/j.jse.2019.07.004 (2020).","journal-title":"J. Shoulder Elbow Surg."},{"key":"85079_CR20","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1620\/tjem.243.173","volume":"243","author":"T Sekiguchi","year":"2017","unstructured":"Sekiguchi, T. et al. Coexistence of trunk or lower extremity pain with elbow and\/or shoulder pain among young overhead athletes: A cross-sectional study. Tohoku J. Exp. Med. 243, 173\u2013178. https:\/\/doi.org\/10.1620\/tjem.243.173 (2017).","journal-title":"Tohoku J. Exp. Med."},{"key":"85079_CR21","doi-asserted-by":"publisher","first-page":"1927","DOI":"10.1007\/s00167-016-4364-y","volume":"26","author":"T Sekiguchi","year":"2018","unstructured":"Sekiguchi, T. et al. Youth baseball players with elbow and shoulder pain have both low back and knee pain: A cross-sectional study. Knee Surg. Sports Traumatol. Arthrosc. 26, 1927\u20131935. https:\/\/doi.org\/10.1007\/s00167-016-4364-y (2018).","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"85079_CR22","doi-asserted-by":"publisher","DOI":"10.1080\/14763141.2019.1696881","author":"AL Aguinaldo","year":"2020","unstructured":"Aguinaldo, A. L. & Escamilla, R. F. Induced power analysis of sequential body motion and elbow valgus load during baseball pitching. Sports Biomech. https:\/\/doi.org\/10.1080\/14763141.2019.1696881 (2020).","journal-title":"Sports Biomech."},{"key":"85079_CR23","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1249\/mss.0000000000001813","volume":"51","author":"J Howenstein","year":"2019","unstructured":"Howenstein, J., Kipp, K. & Sabick, M. B. Energy flow analysis to investigate youth pitching velocity and efficiency. Med. Sci. Sports Exerc. 51, 523\u2013531. https:\/\/doi.org\/10.1249\/mss.0000000000001813 (2019).","journal-title":"Med. Sci. Sports Exerc."},{"key":"85079_CR24","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1177\/0363546516687289","volume":"45","author":"SM Kung","year":"2017","unstructured":"Kung, S. M. et al. Changes in lower extremity kinematics and temporal parameters of adolescent baseball pitchers during an extended pitching bout. Am. J. Sports Med. 45, 1179\u20131186. https:\/\/doi.org\/10.1177\/0363546516687289 (2017).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR25","doi-asserted-by":"publisher","DOI":"10.1080\/14763141.2019.1679243","author":"JR Gdovin","year":"2019","unstructured":"Gdovin, J. R. et al. Impact of shoe and cleat type on youth baseball pitching biomechanics. Sports Biomech. https:\/\/doi.org\/10.1080\/14763141.2019.1679243 (2019).","journal-title":"Sports Biomech."},{"key":"85079_CR26","first-page":"62","volume":"1","author":"G Cook","year":"2006","unstructured":"Cook, G., Burton, L. & Hoogenboom, B. Pre-participation screening: The use of fundamental movements as an assessment of function\u2014part 1. N. Am. J. Sports Phys. Ther. 1, 62\u201372 (2006).","journal-title":"N. Am. J. Sports Phys. Ther."},{"key":"85079_CR27","first-page":"132","volume":"1","author":"G Cook","year":"2006","unstructured":"Cook, G., Burton, L. & Hoogenboom, B. Pre-participation screening: The use of fundamental movements as an assessment of function\u2014part 2. N. Am. J. Sports Phys. Ther. 1, 132\u2013139 (2006).","journal-title":"N. Am. J. Sports Phys. Ther."},{"key":"85079_CR28","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1080\/02640414.2018.1514711","volume":"37","author":"YP Liang","year":"2019","unstructured":"Liang, Y. P. et al. Collegiate baseball players with more optimal functional movement patterns demonstrate better athletic performance in speed and agility. J. Sports Sci. 37, 544\u2013552. https:\/\/doi.org\/10.1080\/02640414.2018.1514711 (2019).","journal-title":"J. Sports Sci."},{"key":"85079_CR29","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.jesf.2018.06.004","volume":"16","author":"CL Lee","year":"2018","unstructured":"Lee, C. L. et al. Functional movement screen comparison between the preparative period and competitive period in high school baseball players. J. Exerc. Sci. Fit 16, 68\u201372. https:\/\/doi.org\/10.1016\/j.jesf.2018.06.004 (2018).","journal-title":"J. Exerc. Sci. Fit"},{"key":"85079_CR30","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520910138","author":"MJ Deal","year":"2020","unstructured":"Deal, M. J. et al. Regional interdependence and the role of the lower body in elbow injury in baseball players: A systematic review. Am. J. Sports Med. https:\/\/doi.org\/10.1177\/0363546520910138 (2020).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR31","doi-asserted-by":"publisher","first-page":"2874","DOI":"10.1016\/j.jbiomech.2008.06.014","volume":"41","author":"M Hirashima","year":"2008","unstructured":"Hirashima, M., Yamane, K., Nakamura, Y. & Ohtsuki, T. Kinetic chain of overarm throwing in terms of joint rotations revealed by induced acceleration analysis. J. Biomech. 41, 2874\u20132883. https:\/\/doi.org\/10.1016\/j.jbiomech.2008.06.014 (2008).","journal-title":"J. Biomech."},{"key":"85079_CR32","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.jsams.2010.08.001","volume":"14","author":"MC Hoch","year":"2011","unstructured":"Hoch, M. C., Staton, G. S. & McKeon, P. O. Dorsiflexion range of motion significantly influences dynamic balance. J. Sci. Med. Sport 14, 90\u201392. https:\/\/doi.org\/10.1016\/j.jsams.2010.08.001 (2011).","journal-title":"J. Sci. Med. Sport"},{"key":"85079_CR33","first-page":"121","volume":"8","author":"CR Basnett","year":"2013","unstructured":"Basnett, C. R. et al. Ankle dorsiflexion range of motion influences dynamic balance in individuals with chronic ankle instability. Int. J. Sports Phys. Ther. 8, 121\u2013128 (2013).","journal-title":"Int. J. Sports Phys. Ther."},{"key":"85079_CR34","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1177\/0363546510363402","volume":"38","author":"AW Anz","year":"2010","unstructured":"Anz, A. W. et al. Correlation of torque and elbow injury in professional baseball pitchers. Am. J. Sports Med. 38, 1368\u20131374. https:\/\/doi.org\/10.1177\/0363546510363402 (2010).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR35","doi-asserted-by":"publisher","first-page":"2075","DOI":"10.1177\/0363546514538391","volume":"42","author":"KE Wilk","year":"2014","unstructured":"Wilk, K. E. et al. Deficits in glenohumeral passive range of motion increase risk of elbow injury in professional baseball pitchers: A prospective study. Am. J. Sports Med. 42, 2075\u20132081. https:\/\/doi.org\/10.1177\/0363546514538391 (2014).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR36","doi-asserted-by":"publisher","first-page":"1629","DOI":"10.1016\/j.arthro.2017.03.025","volume":"33","author":"CL Camp","year":"2017","unstructured":"Camp, C. L. et al. Decreased shoulder external rotation and flexion are greater predictors of injury than internal rotation deficits: Analysis of 132 pitcher-seasons in professional baseball. Arthroscopy 33, 1629\u20131636. https:\/\/doi.org\/10.1016\/j.arthro.2017.03.025 (2017).","journal-title":"Arthroscopy"},{"key":"85079_CR37","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1016\/j.jse.2008.04.002","volume":"17","author":"SL Werner","year":"2008","unstructured":"Werner, S. L., Suri, M., Guido, J. A. Jr., Meister, K. & Jones, D. G. Relationships between ball velocity and throwing mechanics in collegiate baseball pitchers. J. Shoulder Elbow Surg. 17, 905\u2013908. https:\/\/doi.org\/10.1016\/j.jse.2008.04.002 (2008).","journal-title":"J. Shoulder Elbow Surg."},{"key":"85079_CR38","doi-asserted-by":"publisher","first-page":"2043","DOI":"10.1177\/0363546509336721","volume":"37","author":"AL Aguinaldo","year":"2009","unstructured":"Aguinaldo, A. L. & Chambers, H. Correlation of throwing mechanics with elbow valgus load in adult baseball pitchers. Am. J. Sports Med. 37, 2043\u20132048. https:\/\/doi.org\/10.1177\/0363546509336721 (2009).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR39","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1080\/00913847.2017.1300505","volume":"45","author":"T Matsuura","year":"2017","unstructured":"Matsuura, T., Iwame, T., Suzue, N., Arisawa, K. & Sairyo, K. Risk factors for shoulder and elbow pain in youth baseball players. Phys. Sports Med. 45, 140\u2013144. https:\/\/doi.org\/10.1080\/00913847.2017.1300505 (2017).","journal-title":"Phys. Sports Med."},{"key":"85079_CR40","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1177\/03635465020300040201","volume":"30","author":"S Lyman","year":"2002","unstructured":"Lyman, S., Fleisig, G. S., Andrews, J. R. & Osinski, E. D. Effect of pitch type, pitch count, and pitching mechanics on risk of elbow and shoulder pain in youth baseball pitchers. Am. J. Sports Med. 30, 463\u2013468. https:\/\/doi.org\/10.1177\/03635465020300040201 (2002).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR41","first-page":"962","volume":"55","author":"T Yukutake","year":"2015","unstructured":"Yukutake, T., Nagai, K., Yamada, M. & Aoyama, T. Risk factors for elbow pain in Little League baseball players: A cross-sectional study focusing on developmental factors. J. Sports Med. Phys. Fitness 55, 962\u2013968 (2015).","journal-title":"J. Sports Med. Phys. Fitness"},{"key":"85079_CR42","doi-asserted-by":"publisher","first-page":"232596711773773","DOI":"10.1177\/2325967117737731","volume":"5","author":"EM Greenberg","year":"2017","unstructured":"Greenberg, E. M. et al. Physical and functional differences in youth baseball players with and without throwing-related pain. Orthop. J. Sports Med. 5, 2325967117737731. https:\/\/doi.org\/10.1177\/2325967117737731 (2017).","journal-title":"Orthop. J. Sports Med."},{"key":"85079_CR43","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1177\/0363546510384224","volume":"39","author":"GS Fleisig","year":"2011","unstructured":"Fleisig, G. S. et al. Risk of serious injury for young baseball pitchers: A 10-year prospective study. Am. J. Sports Med. 39, 253\u2013257. https:\/\/doi.org\/10.1177\/0363546510384224 (2011).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR44","doi-asserted-by":"publisher","first-page":"45304","DOI":"10.1038\/srep45304","volume":"7","author":"H Shitara","year":"2017","unstructured":"Shitara, H. et al. Shoulder stretching intervention reduces the incidence of shoulder and elbow injuries in high school baseball players: A time-to-event analysis. Sci. Rep. 7, 45304. https:\/\/doi.org\/10.1038\/srep45304 (2017).","journal-title":"Sci. Rep."},{"key":"85079_CR45","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1177\/0363546505281805","volume":"34","author":"N Steinberg","year":"2006","unstructured":"Steinberg, N. et al. Range of joint movement in female dancers and nondancers aged 8 to 16 years: Anatomical and clinical implications. Am. J. Sports Med. 34, 814\u2013823. https:\/\/doi.org\/10.1177\/0363546505281805 (2006).","journal-title":"Am. J. Sports Med."},{"key":"85079_CR46","first-page":"486","volume":"42","author":"MJ Rauh","year":"2007","unstructured":"Rauh, M. J., Macera, C. A., Ji, M. & Wiksten, D. L. Subsequent injury patterns in girls\u2019 high school sports. J. Athl. Train. 42, 486\u2013494 (2007).","journal-title":"J. Athl. Train."},{"key":"85079_CR47","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1177\/0363546505284188","volume":"34","author":"SJ Olsen 2nd","year":"2006","unstructured":"Olsen, S. J. 2nd., Fleisig, G. S., Dun, S., Loftice, J. & Andrews, J. R. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am. J. Sports Med. 34, 905\u2013912. https:\/\/doi.org\/10.1177\/0363546505284188 (2006).","journal-title":"Am. J. Sports Med."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-85079-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-85079-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-85079-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T04:49:50Z","timestamp":1670042990000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-85079-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,9]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["85079"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-85079-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,9]]},"assertion":[{"value":"13 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"5500"}}