{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:38:15Z","timestamp":1792701495609,"version":"4.5.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Left-handed baseball pitchers exhibit unique throwing biomechanics, yet the risk factors for shoulder and elbow injuries in this population remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To prospectively investigate preseason risk factors for shoulder and elbow injuries in left-handed high school baseball pitchers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A total of 160 left-handed high school baseball pitchers were enrolled. Preseason evaluations included age, height, weight, shoulder muscle strength, and range of motion of the shoulder and elbow. Participants completed a self-recorded questionnaire on shoulder and elbow pain and associated pitching limitations during the subsequent season. Participants were categorized into the noninjured or injured group. The Mann-Whitney\n                      <jats:italic toggle=\"yes\">U<\/jats:italic>\n                      test, chi-square test, logistic regression analysis, and receiver operating characteristic curve analysis were used to identify injury risk factors and cutoff values for shoulder and elbow injuries.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Shoulder and elbow injuries occurred in 27 participants (16.9%). The injured group had significantly greater abduction\u2013external rotation (ABER) in the dominant shoulder (114.8\u00b0\u00b1 11.9\u00b0 vs 107.5\u00b0\u00b1 13.0\u00b0;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .008) and a greater total arc of the dominant shoulder (166.4\u00b0\u00b1 25.1\u00b0 vs 156.0\u00b0\u00b1 23.4\u00b0;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .039). Logistic regression analysis showed that ABER in the dominant shoulder was an independent risk factor for injuries (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.031; OR,\u20091.04). Receiver operating characteristic curve analysis determined that an ABER \u2265109\u00b0 predicted injury (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .017). Pitchers with ABER \u2265109\u00b0 had a 3.3 times higher incidence of injury than those with ABER &lt;109\u00b0 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Increased shoulder ABER was significantly associated with shoulder and elbow injuries among left-handed high school baseball pitchers. Pitchers with ABER \u2265109\u00b0 are at higher risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671251340300","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T07:39:57Z","timestamp":1751528397000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The Association between Excessive Glenohumeral External Rotation and Risk for Shoulder and Elbow Injury in Left-Handed High School Baseball Pitchers: A Prospective Cohort Study"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3547-0718","authenticated-orcid":false,"given":"Hitoshi","family":"Shitara","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma Prefecture, Japan"},{"name":"Investigation performed at Gunma University Hospital, Gunma, 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