Lower Extremity Balance as an Indicator of Upper Extremity Injury in Baseball Players: A Systematic Review

Lower Extremity Balance as an Indicator of Upper Extremity Injury in Baseball Players: A Systematic Review Mower L, Ortman I, Murphy S. University of Montana Purpose: This review will seek to determine if a lack of lower limb balance can be a predisposing factor for elbow injuries in baseball players. Methods: We searched the database Pubmed on October 6th, 2021 using a combination of keywords baseball, UCL tears , UCL injur* , Tommy John , UCL sprain , elbow injur* , balance, lower extremity , kinetic chain , biomechanics, kinematics and throwing mechanics . The resulting articles were manually screened for relevance and inclusion/exclusion criteria. Articles were excluded if there were no special tests required, used female participants, or did not assess baseball specifically. Articles were included if the star excursion balance test or lower quarter y-balance test were assessed, participants consisting of baseball players, and elbow injuries. Studies identified by the search strategy were screened according to the inclusion criteria, and two reviewers assessed the data. Data extracted included the comparison of the average reach percentage of the lead leg and average reach percentage of the stance leg. Of the 133 articles identified through the initial database search, 4 studies were included in this review. Two articles assessed the Y-balance test while the other two articles assessed the star excursion balance test. Our observation for this systemic review assessed the overall balance findings from both subgroups. We then assessed the relationship between overall balance and elbow pathologies. This correlation was observed because elbow injuries and Tommy John surgeries are on a steady rise. Data is separated between the lead leg and stance leg in which the percentage of balance between injured and uninjured athletes can be visualized. The studies utilizing the Lower Quarter Y-Balance Test concluded athletes with lower balance percentages had a higher occurrence of elbow injuries. Studies utilizing the star excursion balance test concluded that athletes with higher percentages of balance capabilities were more likely to succumb to elbow pain. Originality: This systematic review demonstrated further understanding of the role of the kinetic chain is needed to find a definitive correlation among baseball players with a decreased level of dynamic balance and the presence of elbow injuries. While findings were contradictory to one another, clinicians can now assume proper throwing techniques, and balance programs should be employed in baseball strengthening programs for athletes to maximize their throwing velocity and decrease the risk of injury. Significance: This research provides a concise summary of the previous research completed that can be more easily used by clinicians. However, further research needs to be done in how we collect the lower extremity balance and its correlation to baseball throwing mechanics