{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T04:51:47Z","timestamp":1770785507647,"version":"3.50.0"},"reference-count":66,"publisher":"National Athletic Trainers' Association","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Baseball pitching load is linked to injury in adolescent baseball athletes; however, it is unclear if pitch counts are a good indicator of total upper extremity load during baseball pitching.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The purpose of this study is to determine (1) the recovery time-course of musculoskeletal variables after a single live pitching bout and (2) the association between pitch counts, rating of perceived exertion (RPE), and arm-specific session RPE on musculoskeletal changes after live game pitching in adolescent baseball athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Competitive baseball games.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants or Other Participants<\/jats:title>\n                    <jats:p>Thirty-six adolescent baseball pitchers (16.1 \u00b1 0.9 years, 178.2 \u00b1 10.4 cm, 71.5 \u00b1 10.2 kg).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Internal and external shoulder range of motion, internal and external shoulder rotation peak force, and infraspinatus cross-sectional area and echo intensity were collected before pitching, immediately after pitching, and on days 1, 3, and 5 after pitching. Pitch count and RPE were collected during the pitching bout, and an arm-specific session RPE score was calculated as the product of pitch count and RPE. Linear mixed models were used to determine the recovery time-course on both arms and to determine the association between the load variables (pitching count, RPE, arm-specific session RPE) and the change in the musculoskeletal variables on the dominant arm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Internal shoulder range of motion was highest on day 3 (mean difference: 3.31,\n                      <jats:italic>t<\/jats:italic>\n                      = 3.12,\n                      <jats:italic>P<\/jats:italic>\n                      = .019), and external shoulder rotation peak force decreased immediately after pitching (\u221211.53,\n                      <jats:italic>t<\/jats:italic>\n                      = 3.51,\n                      <jats:italic>P<\/jats:italic>\n                      = .005) and increased at day 5 (14.8,\n                      <jats:italic>t<\/jats:italic>\n                      = 4.52,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Internal shoulder rotation peak force was lowest immediately after pitching and highest at day 5 (19.14,\n                      <jats:italic>t<\/jats:italic>\n                      = 4.18,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). No significant (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; .057) association was found between load variables and musculoskeletal variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Baseball-specific pitching load metrics did not predict musculoskeletal changes after live game pitching. Future researchers should investigate pitching load variables that better predict musculoskeletal changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-0052.25","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:17Z","timestamp":1752537617000},"page":"863-869","source":"Crossref","is-referenced-by-count":0,"title":["Throwing Load Does Not Affect Musculoskeletal Measures Around Competitive Pitching in Adolescent Baseball Pitchers"],"prefix":"10.4085","volume":"60","author":[{"given":"Brett S.","family":"Pexa","sequence":"first","affiliation":[{"name":"High Point University, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hayden K.","family":"Giuliani-Dewig","sequence":"additional","affiliation":[{"name":"Rockefeller Neuroscience Institute, West Virginia University, Morgantown"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph B.","family":"Myers","sequence":"additional","affiliation":[{"name":"Tampa Bay Rays, St. Petersburg, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony C.","family":"Hackney","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Berkoff","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric D.","family":"Ryan","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"issue":"7","key":"i1938-162X-60-12-863-b01","series-title":"J Athl Train","first-page":"742","article-title":"Epidemiology of injuries in National Collegiate Athletic Association men\u2019s baseball: 2014\u20132015 through 2018\u20132019","volume":"56","author":"Boltz","year":"2021","unstructured":"Boltz AJ,\nPowell JR,\nRobison HJ,\nMorris SN,\nCollins CL,\nChandran A. Epidemiology of injuries in National Collegiate Athletic Association men\u2019s baseball: 2014\u20132015 through 2018\u20132019. J Athl Train. 2021;56(7):742\u2013749. doi:10.4085\/1062-6050-432-20"},{"issue":"10","key":"i1938-162X-60-12-863-b02","series-title":"Am J Sports Med","first-page":"2379","article-title":"Deficits in glenohumeral passive range of motion increase risk of shoulder injury in professional baseball pitchers: a prospective study","volume":"43","author":"Wilk","year":"2015","unstructured":"Wilk KE,\nMacrina LC,\nFleisig GS, et al. Deficits in glenohumeral passive range of motion increase risk of shoulder injury in professional baseball pitchers: a prospective study. Am J Sports Med. 2015;43(10):2379\u20132385. doi:10.1177\/0363546515594380"},{"issue":"9","key":"i1938-162X-60-12-863-b03","series-title":"Am J Sports Med","first-page":"2075","article-title":"Deficits in glenohumeral passive range of motion increase risk of elbow injury in professional baseball pitchers: a prospective study","volume":"42","author":"Wilk","year":"2014","unstructured":"Wilk KE,\nMacrina LC,\nFleisig GS, 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. 2014;42(9):2075\u20132081. doi:10.1177\/0363546514538391"},{"issue":"11","key":"i1938-162X-60-12-863-b04","series-title":"Med Sci Sports Exerc","first-page":"1803","article-title":"Longitudinal study of elbow and shoulder pain in youth baseball pitchers","volume":"33","author":"Lyman","year":"2001","unstructured":"Lyman S,\nFleisig GS,\nWaterbor JW, et al. 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Am J Sports Med. 2002;30(4):463\u2013468. doi:10.1177\/03635465020300040201"},{"issue":"2","key":"i1938-162X-60-12-863-b06","series-title":"Am J Sports Med","first-page":"253","article-title":"Risk of serious injury for young baseball pitchers: a 10-year prospective study","volume":"39","author":"Fleisig","year":"2011","unstructured":"Fleisig GS,\nAndrews JR,\nCutter GR, et al. Risk of serious injury for young baseball pitchers: a 10-year prospective study. Am J Sports Med. 2011;39(2):253\u2013257. doi:10.1177\/0363546510384224"},{"issue":"5","key":"i1938-162X-60-12-863-b07","series-title":"J Athl Train","first-page":"510","article-title":"Rate of upper extremity injury in high school baseball pitchers who played catcher as a secondary position","volume":"53","author":"Hibberd","year":"2018","unstructured":"Hibberd EE,\nOyama S,\nMyers JB. Rate of upper extremity injury in high school baseball pitchers who played catcher as a secondary position. J Athl Train. 2018;53(5):510\u2013513. doi:10.4085\/1062-6050-322-16"},{"issue":"4","key":"i1938-162X-60-12-863-b08","series-title":"Int J Sports Phys Ther","first-page":"476","article-title":"Baseball players with ulnar collateral ligament tears demonstrate decreased rotator cuff strength compared to healthy controls","volume":"10","author":"Garrison","year":"2015","unstructured":"Garrison JC,\nJohnston C,\nConway JE. Baseball players with ulnar collateral ligament tears demonstrate decreased rotator cuff strength compared to healthy controls. Int J Sports Phys Ther. 2015;10(4):476\u2013481."},{"key":"i1938-162X-60-12-863-b09","article-title":"Guidelines for youth and adolescent pitchers. Major League Baseball","year":"2024","unstructured":"Guidelines for youth and adolescent pitchers. Major League Baseball. Updated January 2024. Accessed October 4, 2025. https:\/\/www.mlb.com\/pitch-smart\/pitching-guidelines"},{"issue":"12","key":"i1938-162X-60-12-863-b10","series-title":"J Shoulder Elbow Surg","first-page":"1925","article-title":"Sleeper stretch accelerates recovery of glenohumeral internal rotation after pitching","volume":"25","author":"Reuther","year":"2016","unstructured":"Reuther KE,\nLarsen R,\nKuhn PD,\nKelly JD IV,\nThomas SJ. Sleeper stretch accelerates recovery of glenohumeral internal rotation after pitching. J Shoulder Elbow Surg. 2016;25(12):1925\u20131929. doi:10.1016\/j.jse.2016.07.075"},{"issue":"3","key":"i1938-162X-60-12-863-b11","series-title":"J Sport Rehabil","first-page":"236","article-title":"Infraspinatus cross-sectional area and shoulder range of motion change following live-game baseball pitching","volume":"28","author":"Pexa","year":"2019","unstructured":"Pexa BS,\nRyan ED,\nHibberd EE,\nTeel E,\nRucinski TJ,\nMyers JB. 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J Exerc Rehabil. 2018;14(3):430\u2013435. doi:10.12965\/jer.1836196.098"},{"issue":"11","key":"i1938-162X-60-12-863-b30","series-title":"J Strength Cond Res","first-page":"3016","article-title":"Effects of three recovery protocols on range of motion, heart rate, rating of perceived exertion, and blood lactate in baseball pitchers during a simulated game","volume":"29","author":"Warren","year":"2015","unstructured":"Warren CD,\nSzymanski DJ,\nLanders MR. Effects of three recovery protocols on range of motion, heart rate, rating of perceived exertion, and blood lactate in baseball pitchers during a simulated game. J Strength Cond Res. 2015;29(11):3016\u20133025. doi:10.1519\/JSC.0000000000000487"},{"key":"i1938-162X-60-12-863-b31","article-title":"Long-term athlete development plan. USA Baseball","author":"Myers","year":"2018","unstructured":"Myers JB,\nDeFreese JD,\nDiStefano L, et al. Long-term athlete development plan. USA Baseball. Published 2018. 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Deficits in glenohumeral passive range of motion increase risk of elbow injury in professional baseball pitchers: a prospective study. Am J Sports Med. 2014;42(9):2075\u20132081. doi:10.1177\/0363546514538391"},{"issue":"11","key":"i1938-162X-60-12-863-b04","series-title":"Med Sci Sports Exerc","first-page":"1803","article-title":"Longitudinal study of elbow and shoulder pain in youth baseball pitchers","volume":"33","author":"Lyman","year":"2001","unstructured":"Lyman S,\nFleisig GS,\nWaterbor JW, et al. Longitudinal study of elbow and shoulder pain in youth baseball pitchers. 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Risk of serious injury for young baseball pitchers: a 10-year prospective study. Am J Sports Med. 2011;39(2):253\u2013257. doi:10.1177\/0363546510384224"},{"issue":"5","key":"i1938-162X-60-12-863-b07","series-title":"J Athl Train","first-page":"510","article-title":"Rate of upper extremity injury in high school baseball pitchers who played catcher as a secondary position","volume":"53","author":"Hibberd","year":"2018","unstructured":"Hibberd EE,\nOyama S,\nMyers JB. Rate of upper extremity injury in high school baseball pitchers who played catcher as a secondary position. 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