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Background The Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC) provides questions for the overhead athlete that can aid with determining if someone is throwing with or without pain. However, this scale was initially created for the adult baseball athlete and has not been validated for younger male demographics. Hypothesis/Purpose To (1) determine if the scores on the KJOC are different between those throwing with and without pain in male youth and high school-aged baseball athletes, and (2) establish a prediction score for whether a young baseball athlete is throwing with symptoms. Methods The KJOC questionnaire was used to compare scores in male baseball players between the ages of 10 through 18. This questionnaire consists of 10 questions that each contain a 10-point visual analogue scale (VAS). When all questions are added together the highest possible score is 100 points, with a higher score equating to a better outcome of throwing without symptoms. Retrospective data from 28 subjects with throwing arm pain were compared to 28 prospective subjects actively participating in baseball with no pain. A Mann Whitney-U test was used to compare the mean scores, and regression analysis was used to establish a threshold score between those throwing with and without pain. Results Significant differences were found between the groups (U = 698.5, p < .001) with capability to discriminate those throwing with pain versus those throwing without pain (Area Under Curve (AUC) .891). Results indicate this discriminating threshold score to be at 68.6 points, which signifies anyone scoring above this threshold would be throwing with no pain and a score below this number indicating throwing with pain. Conclusion The KJOC can differentiate between younger baseball athletes throwing with and without pain. The predictive threshold score can be used in a clinical setting to aid with determining if a youth or high school-aged athlete is suffering from pain while participating in overhead throwing, and to guide rehabilitation management. Level of Evidence Level III [ABSTRACT FROM AUTHOR]

Objective: To assess the risk of spondylolysis by sport in nonelite adolescent athletes with low back pain (LBP). Design: Retrospective case series. Setting: Hospital-based sports medicine clinic. Patients: The medical charts of 1025 adolescent athletes with LBP (age 15 +/- 1.8 years) were examined; 308 (30%) were diagnosed with a spondylolysis. Assessment of Risk: Risk of spondylolysis was assessed in 11 sports for males and 14 sports for females. Main Outcome Measure: Relative risk of diagnosis of spondylolysis injury. Results: The risk of spondylolysis differed by sex with baseball (54%), soccer (48%), and hockey (44%) having the highest prevalence in males and gymnastics (34%), marching band (31%), and softball (30%) for female athletes. Baseball was the only sport to demonstrate a significant increased risk of spondylolysis. Conclusions: The sports with the greatest risk of spondylolysis in adolescent athletes in this study were not consistent with published literature. Clinicians should be cautious generalizing high-risk sports to their practice, as geographic region and level of the athlete may significantly influence the incidence of spondylolysis in the population they are treating. [ABSTRACT FROM AUTHOR]

The article presents research which examined poor lumbopelvic control as a risk factor for baseball pitchers with injuries. Topics covered include the association of lumbopelvic control with players' loading, kinematics and pitching performance. Also provided are the number of days missed by injured player for the entire season as quantified by the team's medical staff.

Background: High levels of humeral torsion allow baseball pitchers to achieve maximum external rotation in the late cockingphase of pitching with lower twisting and shear forces on the long head of the biceps tendon and rotator cuff tendons.Hypothesis: Humeral torsion is inversely related to the incidence and severity of shoulder injuries and other upper extremityinjuries in professional baseball pitchers.Study Design: Case-control study; Level of evidence, 3.Methods: A total of 25 professional pitchers from a single Major League Baseball organization were prospectively recruited intothis study. Computed tomography (CT) was performed on dominant and nondominant humeri, and image data were processedwith a 3-dimensional volume-rendering postprocessing program. The software program was then modified to model a simplifiedthrowing motion and to measure potential internal impingement distances in a small subset of players. Players were followed for 2years after CT, and the number of days missed from pitching activities was recorded as a measure of injury severity andincidence.Results: The mean dominant humeral torsion was 38.5° ± 8.9°; the mean nondominant humeral torsion was 27.6° ± 8.0°. Thedifference between dominant and nondominant torsions was significant (P<.0001). Among the 11 pitchers (44%) injured duringfollow-up, 5 players had shoulder injuries, 7 had elbow injuries, and 2 had finger injuries. Dominant humeral torsion was a statisticallysignificant predictor of severe injuries (≥30 days; P = .048) but not of milder injuries. Among injured players, higher numbersof days missed because of injury were strongly correlated with lower degrees of dominant humeral torsion (r = 20.78; P = .005)and smaller differences between dominant and nondominant humeral torsions (r = 20.59; P = .055). There was no significantassociation between the incidence of shoulder injury and minimum glenoid-tuberosity distance in the dominant or nondominantshoulder or degree of dominant glenoid version.Conclusion: A strong relationship was found between lower degrees of dominant humeral torsion and more severe upperextremity injuries as well as a trend relating lower side-to-side differences in torsion with more severe dominant upper extremityinjuries. In addition, there was a higher incidence of severe injuries in players with lower degrees of dominant torsion. If futurestudies confirm these results, humeral torsion measurements could play a role in risk assessment in pitchers. [ABSTRACT FROM AUTHOR]

The article focuses on batter concussion risk as a function of helmet hit-by-pitch (H-HBP) pitch velocity, number of days missed post H-HBP, time duration batter spent on the ground post H-HBP and first responder assessment time duration. It estimates H-HBP impact locations on the helmet based on the extant National Operating Committee on Standards for Athletic Equipment helmet test standards. Pairing an on-field clinical concussion test with quantitative parameters should be considered.

Mild traumatic brain injury (MTBI) is frequently encountered in pediatrics and challenges healthcare practitioners to provide safe, consistent, cost-effective care. Clinical management of children who sustain MTBI poses dilemmas for healthcare practitioners. This article will provide an overview of pediatric MTBI including definition, issues impacting diagnosis and management, risk factors for intracranial injury, indications for diagnostic imaging, disposition, and return to sports/activity. Knowledge and understanding of MTBI in children aid healthcare practitioners to make informed competent recommendations for care. Clinicians must have a thorough understanding and working knowledge of pediatric MTBI to aid clinical decisions and optimize patient outcomes.