棒球投手的肘傷

Injuries to the Throwing Elbow

10.29617/JPT.198711.0004

王子娟(Tzyy-Jiuan Wang)

Pitching elbow ； Pathomechanism ； Sports injury

物理治療學會雜誌

12卷（1987 / 11 / 29）

19 - 25

繁體中文

棒球投手的肘傷可由分析投球動作來探討病理機轉；投球動作的加速期與隨勢期易有肘傷，乃是因爲在加速期前期，肘關節內側有外翻應力産生，這種過度外翻應力會造成肘關節內側拉扯力、外側壓迫力及後側嵌入效應；在加速期後期及隨勢期的前臂旋前動作也會造成肘關節外側的壓迫及旋前肌在外側肱骨上髁産生拉力；而隨勢期中，肘關節伸直或過度伸直力量會對喙突及前關節囊産生拉力、對鷹嘴突産生衛撞力。這些力量過度使用或使用不當均分別對相關軟組織、骨組織或尺神經造成傷害。有關肘傷的治療，多半是外科手術方法的研究文獻；由於預防才是最佳治療之道，所以注重平時體能、訓練適當的肌力與關節活動度並執行正確的投球方式才是最重要的。

Pathomechanism of pitching elbow injuries could be analysed by studying of throwing mechanism. It is essential to understand the basic aspects of the pitching movement in order to recognize the different areas of stress concentration about the elbow. Elbow injuries generally occur during acceleration and follow- through phases. During the early acceleration, the elbow is placed in a position of extreme valgus stress. The extreme valgus stress can distract medial elbow structures, compress lateral elbow, and cause a wedging effect of the olecranon into olecranon fossa. Forearm pronation during late acceleration and follow-through can produce lateral compressive force on radiohumeral articulation. At the same time, the vigorous contraction of pronator teres may distract lateral epicondyle. During follow-through the hyperextension of elbow not only makes olecranon impinge posteriorly into olecranon fossa but also stresses the anterior capsule and coronoid process. All these forces can cause injuries of soft tissue around elbow, bone structures or ulnar nerve. Most of the articles relating to treatment of elbow injuries concerned about surgical intervention. Since prevention is the bes' treatment, it is important to do good conditioning exercises, to increase or maintain adequate muscle strength as well as good flexibility, and to perform proper throwing mechanism.