{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T21:33:24Z","timestamp":1783719204129,"version":"3.55.0"},"reference-count":30,"publisher":"Human Kinetics","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:p><jats:italic><jats:bold>Context<\/jats:bold>:<\/jats:italic> Baseball pitching is a coordinated movement involving the spine. A previous study indicated that increased thoracic kyphosis angle in a standing position was a risk factor for medial elbow injuries in youth baseball players. However, spinal alignments in single-leg standing and their relationships with medial elbow injuries, scapular alignment, or hip joint range of motion are unclear. <jats:italic><jats:bold>Objective<\/jats:bold>:<\/jats:italic> To examine the difference in spinal alignment between standing and single-leg standing positions in youth baseball players and analyze their relationship with elbow injuries, scapular alignment, or hip joint range of motion. <jats:italic><jats:bold>Design<\/jats:bold>:<\/jats:italic> Cross-sectional study. <jats:italic><jats:bold>Setting<\/jats:bold>:<\/jats:italic> University laboratory. <jats:italic><jats:bold>Participants<\/jats:bold>:<\/jats:italic> There were 51 youth baseball players with medial epicondylar fragmentation (medial elbow injury group) and 102 healthy youth baseball players (control group). <jats:italic><jats:bold>Main Outcome Measures<\/jats:bold>:<\/jats:italic> Thoracic kyphosis, lumbar lordosis, and trunk inclination angles during standing and single-leg standing, forward scapular posture, and hip joint range of motion. <jats:italic><jats:bold>Results<\/jats:bold>:<\/jats:italic> In the single-leg standing position, the thoracic kyphosis and backward trunk inclination angles were significantly higher in the medial elbow injury group than in the control group (<jats:italic>P<\/jats:italic>\u2009=\u2009.016 and <jats:italic>P<\/jats:italic>\u2009=\u2009.046, respectively). In the standing position, no significant difference was observed between both groups. The thoracic kyphosis angle in single-leg standing was positively correlated with the bilateral forward scapular posture in the medial elbow injury (<jats:italic>P<\/jats:italic>\u2009=\u2009.008 and <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001 on the throwing and nonthrowing sides, respectively) and control (<jats:italic>P<\/jats:italic>\u2009=\u2009.010 and <jats:italic>P<\/jats:italic>\u2009=\u2009.032 on the throwing and nonthrowing sides, respectively) groups. <jats:italic><jats:bold>Conclusions<\/jats:bold>:<\/jats:italic> High thoracic kyphosis and backward trunk inclination angles are characteristics during single-leg standing in youth baseball players with medial elbow injuries. Spinal alignment measurement in single-leg standing may be useful for identifying youth baseball players who are at risk for sustaining medial elbow injury.<\/jats:p>","DOI":"10.1123\/jsr.2020-0155","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T02:09:15Z","timestamp":1611022155000},"page":"786-793","source":"Crossref","is-referenced-by-count":2,"title":["High Thoracic Kyphosis and Backward Trunk Inclination Angles in the Single-Leg Standing Position Associate With Medial Elbow Injuries in Youth Baseball Players: A Cross-Sectional Study"],"prefix":"10.1123","volume":"30","author":[{"given":"Akira","family":"Saito","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoji","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromichi","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyuki","family":"Shibata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuaki","family":"Kamata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"100","reference":[{"issue":"3","key":"r1","series-title":"Sports Med","doi-asserted-by":"publisher","first-page":"189","DOI":"10.2165\/00007256-200636030-00001","article-title":"The role of core stability in athletic function","volume":"36","author":"Kibler WB","year":"2006","unstructured":"Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med. 2006;36(3):189\u2013198. PubMed ID: 16526831 doi:10.2165\/00007256-200636030-000011652683110.2165\/00007256-200636030-00001"},{"issue":"10","key":"r2","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"2430","DOI":"10.1177\/0363546513496547","article-title":"Effect of excessive contralateral trunk tilt on pitching biomechanics and performance in high school baseball pitchers","volume":"41","author":"Oyama S","year":"2013","unstructured":"Oyama S, Yu B, Blackburn JT, Padua DA, Li L, Myers JB. Effect of excessive contralateral trunk tilt on pitching biomechanics and performance in high school baseball pitchers. Am J Sports Med. 2013;41(10):2430\u20132438. PubMed ID: 23884305 doi:10.1177\/03635465134965472388430510.1177\/0363546513496547"},{"issue":"10","key":"r3","series-title":"Orthop J Sports Med","doi-asserted-by":"publisher","first-page":"2325967118800240","DOI":"10.1177\/2325967118800240","article-title":"Sagittal plane trunk tilt is associated with upper extremity joint moments and ball velocity in collegiate baseball pitchers","volume":"6","author":"Solomito MJ","year":"2018","unstructured":"Solomito MJ, Garibay EJ, Nissen CW. Sagittal plane trunk tilt is associated with upper extremity joint moments and ball velocity in collegiate baseball pitchers. Orthop J Sports Med. 2018;6(10):2325967118800240. PubMed ID: 30349837 doi:10.1177\/23259671188002403034983710.1177\/2325967118800240"},{"issue":"1","key":"r4","series-title":"JSES Open Access","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.jses.2017.12.007","article-title":"Three-dimensional kinematic analysis of throwing motion focusing on pelvic rotation at stride foot contact","volume":"2","author":"Oi T","year":"2018","unstructured":"Oi T, Takagi Y, Tsuchiyama K, et\u00a0al. Three-dimensional kinematic analysis of throwing motion focusing on pelvic rotation at stride foot contact. JSES Open Access. 2018;2(1):115\u2013119. PubMed ID: 30675578 doi:10.1016\/j.jses.2017.12.00710.1016\/j.jses.2017.12.00730675578"},{"issue":"1","key":"r5","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1177\/0363546516663931","article-title":"Physical risk factors for a medial elbow injury in junior baseball players: a prospective cohort study of 353 players","volume":"45","author":"Sakata J","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. 2017;45(1):135\u2013143. PubMed ID: 27604190 doi:10.1177\/03635465166639312760419010.1177\/0363546516663931"},{"issue":"5","key":"r6","series-title":"J Anat","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1111\/joa.12586","article-title":"Standing sagittal alignment of the whole axial skeleton with reference to the gravity line in humans","volume":"230","author":"Hasegawa K","year":"2017","unstructured":"Hasegawa K, Okamoto M, Hatsushikano S, et\u00a0al. Standing sagittal alignment of the whole axial skeleton with reference to the gravity line in humans. J Anat. 2017;230(5):619\u2013630. PubMed ID: 28127750 doi:10.1111\/joa.1258610.1111\/joa.1258628127750"},{"issue":"2","key":"r7","series-title":"J Shoulder Elbow Surg","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.jse.2018.07.015","article-title":"The influence of lumbopelvic control on shoulder and elbow kinetics in elite baseball pitchers","volume":"28","author":"Laudner KG","year":"2019","unstructured":"Laudner KG, Wong R, Meister K. The influence of lumbopelvic control on shoulder and elbow kinetics in elite baseball pitchers. J Shoulder Elbow Surg. 2019;28(2):330\u2013334. PubMed ID: 30268588 doi:10.1016\/j.jse.2018.07.0153026858810.1016\/j.jse.2018.07.015"},{"issue":"11","key":"r8","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"2734","DOI":"10.1177\/0363546514545861","article-title":"Lumbopelvic control and days missed because of injury in professional baseball pitchers","volume":"42","author":"Chaudhari AM","year":"2014","unstructured":"Chaudhari AM, McKenzie CS, Pan X, Onate JA. Lumbopelvic control and days missed because of injury in professional baseball pitchers. Am J Sports Med. 2014;42(11):2734\u20132740. PubMed ID: 25159541 doi:10.1177\/036354651454586110.1177\/036354651454586125159541"},{"issue":"1","key":"r9","series-title":"Int J Sports Phys Ther","doi-asserted-by":"publisher","first-page":"58","DOI":"10.26603\/ijspt20180058","article-title":"Trunk lean during a single-leg squat is associated with trunk lean during pitching","volume":"13","author":"Plummer HA","year":"2018","unstructured":"Plummer HA, Oliver GD, Powers CM, Michener LA. Trunk lean during a single-leg squat is associated with trunk lean during pitching. Int J Sports Phys Ther. 2018;13(1):58\u201365. PubMed ID: 29484242 doi:10.26603\/ijspt2018005810.26603\/ijspt2018005829484242"},{"issue":"3S","key":"r10","series-title":"PM R","doi-asserted-by":"publisher","first-page":"S69","DOI":"10.1016\/j.pmrj.2015.11.015","article-title":"The kinetic chain revisited: new concepts on throwing mechanics and injury","volume":"8","author":"Chu SK","year":"2016","unstructured":"Chu SK, Jayabalan P, Kibler WB, Press J. The kinetic chain revisited: new concepts on throwing mechanics and injury. PM R. 2016;8(3S):S69\u2013S77. PubMed ID: 26972269 doi:10.1016\/j.pmrj.2015.11.01510.1016\/j.pmrj.2015.11.01526972269"},{"key":"r11","series-title":"Gait Posture","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.gaitpost.2018.10.022","article-title":"Influence of thoracic posture on scapulothoracic and glenohumeral motions during eccentric shoulder external rotation","volume":"67","author":"Suzuki Y","year":"2019","unstructured":"Suzuki Y, Muraki T, Sekiguchi Y, et\u00a0al. Influence of thoracic posture on scapulothoracic and glenohumeral motions during eccentric shoulder external rotation. Gait Posture. 2019;67:207\u2013212. PubMed ID: 30368207 doi:10.1016\/j.gaitpost.2018.10.0223036820710.1016\/j.gaitpost.2018.10.022"},{"issue":"4","key":"r12","series-title":"Hum Mov Sci","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1016\/S0167-9457(02)00117-3","article-title":"Relationship between the movements of the lumbar spine and hip","volume":"21","author":"Lee RY","year":"2002","unstructured":"Lee RY, Wong TK. Relationship between the movements of the lumbar spine and hip. Hum Mov Sci. 2002;21(4):481\u2013494. PubMed ID: 12450680 doi:10.1016\/S0167-9457(02)00117-310.1016\/S0167-9457(02)00117-312450680"},{"issue":"5","key":"r13","series-title":"Orthop J Sports Med","doi-asserted-by":"publisher","first-page":"2325967114532424","DOI":"10.1177\/2325967114532424","article-title":"Relationship between tightness of the hip joint and elbow pain in adolescent baseball players","volume":"2","author":"Saito M","year":"2014","unstructured":"Saito M, Kenmoku T, Kameyama K, et\u00a0al. Relationship between tightness of the hip joint and elbow pain in adolescent baseball players. Orthop J Sports Med. 2014;2(5):2325967114532424. PubMed ID: 26535327 doi:10.1177\/232596711453242410.1177\/232596711453242426535327"},{"issue":"3","key":"r14","series-title":"J Orthop Sports Phys Ther","doi-asserted-by":"publisher","first-page":"187","DOI":"10.2519\/jospt.1998.27.3.187","article-title":"Preventing throwing injuries","volume":"27","author":"Andrews JR","year":"1998","unstructured":"Andrews JR, Fleisig GS. Preventing throwing injuries. J Orthop Sports Phys Ther. 1998;27(3):187\u2013188. PubMed ID: 957497110.2519\/jospt.1998.27.3.1879574971"},{"issue":"9","key":"r15","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"761","DOI":"10.2106\/JBJS.15.01017","article-title":"Preseason assessment of radiographic abnormalities in elbows of little league baseball players","volume":"98","author":"Pennock AT","year":"2016","unstructured":"Pennock AT, Pytiak A, Stearns P, et\u00a0al. Preseason assessment of radiographic abnormalities in elbows of little league baseball players. J Bone Joint Surg Am. 2016;98(9):761\u2013767. PubMed ID: 271476892714768910.2106\/JBJS.15.01017"},{"issue":"5","key":"r16","series-title":"Int J Sports Phys Ther","first-page":"652","article-title":"Pitching mechanics, revisited","volume":"8","author":"Calabrese GJ","year":"2013","unstructured":"Calabrese GJ. Pitching mechanics, revisited. Int J Sports Phys Ther. 2013;8(5):652\u2013660. PubMed ID: 2417514424175144"},{"issue":"4","key":"r17","series-title":"J Shoulder Elbow Surg","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1016\/j.jse.2009.10.022","article-title":"Risk factors for elbow injuries among young baseball players","volume":"19","author":"Harada M","year":"2010","unstructured":"Harada M, Takahara M, Mura N, Sasaki J, Ito T, Ogino T. Risk factors for elbow injuries among young baseball players. J Shoulder Elbow Surg. 2010;19(4):502\u2013507. PubMed ID: 201898352018983510.1016\/j.jse.2009.10.022"},{"issue":"3","key":"r18","series-title":"J Sports Sci Med","first-page":"588","article-title":"Sagittal spinal morphology in highly trained adolescent tennis players","volume":"12","author":"Muyor JM","year":"2013","unstructured":"Muyor JM, Sanchez-Sanchez E, Sanz-Rivas D, Lopez-Minarro PA. Sagittal spinal morphology in highly trained adolescent tennis players. J Sports Sci Med. 2013;12(3):588\u2013593. PubMed ID: 2414916924149169"},{"issue":"8","key":"r19","series-title":"J Manipulative PhysiolTher","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1016\/j.jmpt.2008.09.001","article-title":"Reliability of spinal range of motion in healthy boys using a skin-surface device","volume":"31","author":"Kellis E","year":"2008","unstructured":"Kellis E, Adamou G, Tzilios G, Emmanouilidou M. Reliability of spinal range of motion in healthy boys using a skin-surface device. J Manipulative PhysiolTher. 2008;31(8):570\u2013576. PubMed ID: 1898423910.1016\/j.jmpt.2008.09.001"},{"issue":"2","key":"r20","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1007\/s00586-003-0618-8","article-title":"A new skin-surface device for measuring the curvature and global and segmental ranges of motion of the spine: reliability of measurements and comparison with data reviewed from the literature","volume":"13","author":"Mannion AF","year":"2004","unstructured":"Mannion AF, Knecht K, Balaban G, Dvorak J, Grob D. A new skin-surface device for measuring the curvature and global and segmental ranges of motion of the spine: reliability of measurements and comparison with data reviewed from the literature. Eur Spine J. 2004;13(2):122\u2013136. PubMed ID: 1466110410.1007\/s00586-003-0618-814661104"},{"issue":"6","key":"r21","series-title":"Sports Med","doi-asserted-by":"publisher","first-page":"421","DOI":"10.2165\/00007256-199621060-00004","article-title":"Biomechanics of overhand throwing with implications for injuries","volume":"21","author":"Fleisig GS","year":"1996","unstructured":"Fleisig GS, Barrentine SW, Escamilla RF, Andrews JR. Biomechanics of overhand throwing with implications for injuries. Sports Med. 1996;21(6):421\u2013437. PubMed ID: 8784962 doi:10.2165\/00007256-199621060-00004878496210.2165\/00007256-199621060-00004"},{"issue":"10","key":"r22","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"2106","DOI":"10.1177\/0363546510370291","article-title":"The relationship between forward scapular posture and posterior shoulder tightness among baseball players","volume":"38","author":"Laudner KG","year":"2010","unstructured":"Laudner KG, Moline MT, Meister K. The relationship between forward scapular posture and posterior shoulder tightness among baseball players. Am J Sports Med. 2010;38(10):2106\u20132112. PubMed ID: 20595550 doi:10.1177\/036354651037029110.1177\/036354651037029120595550"},{"key":"r23","series-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J","year":"1988","unstructured":"Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: L. Erlbaum Associates; 1988."},{"issue":"1","key":"r24","series-title":"Biometrics","doi-asserted-by":"publisher","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis JR","year":"1977","unstructured":"Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159\u2013174. PubMed ID: 843571 doi:10.2307\/252931010.2307\/2529310843571"},{"issue":"15","key":"r25","series-title":"Sports Med","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.2165\/00007256-200232150-00004","article-title":"Little league elbow: valgus overload injury in the paediatric athlete","volume":"32","author":"Klingele KE","year":"2002","unstructured":"Klingele KE, Kocher MS. Little league elbow: valgus overload injury in the paediatric athlete. Sports Med. 2002;32(15):1005\u20131015. PubMed ID: 12457420 doi:10.2165\/00007256-200232150-000041245742010.2165\/00007256-200232150-00004"},{"issue":"2","key":"r26","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1177\/0363546509347542","article-title":"Glenohumeral, scapular, and thoracic angles at maximum shoulder external rotation in throwing","volume":"38","author":"Miyashita K","year":"2010","unstructured":"Miyashita K, Kobayashi H, Koshida S, Urabe Y. Glenohumeral, scapular, and thoracic angles at maximum shoulder external rotation in throwing. Am J Sports Med. 2010;38(2):363\u2013368. PubMed ID: 19822769 doi:10.1177\/036354650934754210.1177\/036354650934754219822769"},{"issue":"6","key":"r27","series-title":"Spine Deform","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1016\/j.jspd.2019.03.007","article-title":"Spinopelvic compensatory mechanisms for reduced hip motion (ROM) in the setting of hip osteoarthritis","volume":"7","author":"Buckland AJ","year":"2019","unstructured":"Buckland AJ, Steinmetz L, Zhou P, et\u00a0al. Spinopelvic compensatory mechanisms for reduced hip motion (ROM) in the setting of hip osteoarthritis. Spine Deform. 2019;7(6):923\u2013928. PubMed ID: 31732003doi:10.1016\/j.jspd.2019.03.0073173200310.1016\/j.jspd.2019.03.007"},{"issue":"11","key":"r28","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1824","DOI":"10.1007\/s00586-010-1476-9","article-title":"Sagittal plane deformity: an overview of interpretation and management","volume":"19","author":"Roussouly P","year":"2010","unstructured":"Roussouly P, Nnadi C. Sagittal plane deformity: an overview of interpretation and management. Eur Spine J. 2010;19(11):1824\u20131836. PubMed ID: 20567858 doi:10.1007\/s00586-010-1476-92056785810.1007\/s00586-010-1476-9"},{"issue":"6","key":"r29","series-title":"J Phys Ther Sci","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1589\/jpts.29.1057","article-title":"Lower trunk muscle activity-induced alignment and cop position during single-leg standing","volume":"29","author":"Nakao T","year":"2017","unstructured":"Nakao T, Masuda K, Kanai S, Tsujita J, Hirakawa K, Okada S. Lower trunk muscle activity-induced alignment and cop position during single-leg standing. J Phys Ther Sci. 2017;29(6):1057\u20131061. PubMed ID: 28626324 doi:10.1589\/jpts.29.105710.1589\/jpts.29.105728626324"},{"issue":"2","key":"r30","series-title":"J Orthop Sports Phys Ther","doi-asserted-by":"publisher","first-page":"56","DOI":"10.2519\/jospt.1987.9.2.56","article-title":"The mechanics of pitching","volume":"9","author":"Braatz JH","year":"1987","unstructured":"Braatz JH, Gogia PP. The mechanics of pitching. J Orthop Sports Phys Ther. 1987;9(2):56\u201369. PubMed ID: 18797014 doi:10.2519\/jospt.1987.9.2.5610.2519\/jospt.1987.9.2.5618797014"}],"container-title":["Journal of Sport Rehabilitation"],"original-title":[],"link":[{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/jsr\/30\/5\/article-p786.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.humankinetics.com\/downloadpdf\/journals\/jsr\/30\/5\/article-p786.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.humankinetics.com\/downloadpdf\/journals\/jsr\/30\/5\/article-p786.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T23:27:48Z","timestamp":1756337268000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/jsr\/30\/5\/article-p786.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,1]]},"references-count":30,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.1123\/jsr.2020-0155","relation":{},"ISSN":["1056-6716","1543-3072"],"issn-type":[{"value":"1056-6716","type":"print"},{"value":"1543-3072","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,1]]}}}