청소년기 야구 투수의 상완골 회전력: 소아 야구 견 및 상완골 후염의 발달에 미치는 영향

Humeral Torque in Youth Baseball Pitchers: Implications for the Development of Little League Shoulder and Humeral Retroversion

목적: 청소년기야구투수의견관절의운동학및동력학을통해소아야구견및상완골후염의발달에대한역학적측면을분석하고자하였다. 대상및방법: 모의 게임을통해 14명의청소년기야구투수에서관절운동학과상완골에작용하는총힘및회전력을계산하였다.결과: 상완골에작용하는주된힘은평균378$\pm$81N의장력으로공이손을 떠난 직후에정점을이루었다. 상완골에 작용하는 주된 회전력은 상완골의 장축에 대한 외 회전력으로 투구 동작의 약73$\%$ 시기에 정점을 나타냈으며 정점의 평균 회전력은 35.3$\pm$ 6.7Nm이었다. 이러한회전력은성인의상완골골절을발생시킬수있는회전력의약66$\%$이다. 결론: 상완골회전력은투구하는손의상완골후염의증가를발달시키는방향이었다. 따라서후기거상기동안의큰회전력으로부터발생되는 전단응력은상대적으로약한근위상완성장판에변형을초래할수있다. 또한투구중상완골에발생되어진외회전력은투구동작중성장판에작용하는회전응력이소아야구견을일으키는기전이될수있다는가설을뒷받침해준다.

Purpose: We examined the kinematics and kinetics of the shoulder in youth baseball pitchers in light of the mechanisms of development of little league shoulder and humeral retrotorsion. Materials and Methods: The joint kinematics and the net force and torque acting on the humerus were calculated in fourteen youth pitchers throwing in a simulated game. Results: The major force component acting on the humerus was a tensile force of 378$\pm$81 N that peaked just after ball release. The predominant torque on the humerus was an external rotation torque about the long axis of the humerus. This torque reached a peak value of 35.3$\pm$6.7 Nm about 73$\%$through the pitching motion. This torque is approximately 66$\%$ of the torque required to fracture of the adult humerus. Conclusions: The direction of the humeral torque was consistent with the development of increased humeral retrotorsion in the throwing arm. Shear stress arising from the high torque during the late cocking phase likely leads to deformation the relatively weak proximal humeral epiphysis. The external rotation torque applied to the humerus during the pitch also agrees with the proposed mechanism for development little league shoulder, which has been hypothesized to be due to rotational stresses acting on the epiphysis during the throwing motion.