This study aimed to reveal changes over time in the knowledge of pitch count recommendations and compliance with them by comparing with previous studies, and to reveal coaches' prior knowledge on baseball elbow and their actual coaching practices.
The results of this study showed that 52.3% of the coaches in youth baseball teams of Kyoto Prefecture had knowledge on pitch count recommendations, an increase from 39.8% conducted in our laboratory 10 years ago.25 However, the compliance rate with the recommendations in this study was 22.1%, which was not significantly different from 28.3% in a previous study.25 Since 2010, Kyoto Prefecture has been conducting annual baseball elbow examinations for elementary school students, in an effort to detect and prevent baseball elbow in its early stages. As a result of these ongoing efforts, it is assumed that the coaches are aware of the dangers of baseball elbow and knowledge rate of the recommendations, which is one of the baseball elbow prevention projects, has increased. However, despite the prevalence of knowledge on pitch count recommendations in Kyoto Prefecture over the past 10 years, the compliance rate has not increased. The results of a study conducted in Gunma Prefecture between 2017–20189 showed that knowledge rate of the recommendations was close to 100% and their compliance rate was 15.5%. As shown above, many of the coaches do not follow the recommendations, even though they have the knowledge, and it is necessary to consider measures to increase compliance.
The coaches with knowledge had significantly longer coaching experience than the coaches without knowledge. Additionally, coaches who had attended seminars and workshops were significantly older and had longer coaching experience. The analysis of the relationship between the coaches' knowledge and their participation in seminars and workshops showed that the coaches who had participated in seminars and workshops were more knowledgeable about pitch count recommendations. The results of the analysis of the relationship between the coaches' knowledge and their participation in seminars and workshops showed that many of them had more knowledge about baseball elbow because they participated in seminars and workshops. These results suggest that there is a need for efforts to encourage participation in prevention projects, especially among coaches who have been coaching for a short time. Additionally, based on the results of compliance rates with pitch count recommendations, it is possible that efforts to improve compliance rates could be achieved not only by presenting pitch count recommendations but also by including a broad range of knowledge about baseball elbow. It is said that there is a need for education aimed at highlighting the benefits of compliance, injury risks, long-term effects, etc., in injury prevention initiatives,18 and a more critical way of informing coaches with a sense of urgency would also be necessary to increase participation in seminars and workshops by coaches with shorter coaching experience. For example, it would be effective to survey the opinions of parents who have actually experienced baseball elbow and share their actual experiences.
Coaches who did not comply with the recommendations were significantly older and tended to have longer coaching experience. Koester reported that coaches who do not have correct knowledge on sports technique often teach based on their own personal experience.11 Additionally, it is said that even trained coaches often learn the technical aspects of their assignments by observing and listening to other coaches; therefore, both styles of coaching knowledge acquisition tend to spread misinformation and inappropriate theories, which can lead to injury incidence.11A prior study reported that coaches often relied on their limited knowledge, thereby adopting commonly used prevention strategies.22 In the results of this study, coaches who had knowledge also had longer coaching experience; therefore, it is possible that coaches with older age and longer coaching experience did not comply because of their experience and knowledge.
Of the 172 participants, 119 coaches were parents of players, which is 70% of the total number of participants. Coaches who were parents of players were significantly younger and had shorter coaching experience. Significantly fewer coaches who were parents of players attended seminars and workshops than those who were not. In a previous study, it was stated that most coaches in little leagues are parents of players,11 and the results of this study were similar. The results of this study suggest that coaches who are parents of players might be involved with the team as coaches only during the period the players are members of the team. As a result, their coaching experience is expected to be short, and they could not attend seminars and workshops during their period with the team. This suggests the need to consider the frequency of seminars and workshops. It is assumed that regular and frequent implementation of seminars would provide more opportunities for coaches with short periods of enrollment to attend seminars and workshops. It is suggested that cost and time might be barriers to participation in seminars and workshops.2,20,22 However, preventive projects conducted in Kyoto Prefecture are fee-based,12 and lower costs for preventive projects could be a solution to encourage participation. Most parents today have dual income families,16 and have significant time constraints to attend seminars and workshops on weekends and holidays. Although the reasons for the lack of experience of coaches in participating in seminars and workshops were not identified in this study, it is believed that the cost, as well as the content should be reviewed when encouraging participation in prevention projects in the future.
These results suggest the need to encourage coaches, especially those with short coaching experience and those who are parents of players, to participate in opportunities to gain knowledge about baseball elbow. Based on this, it is important that all coaches, regardless of their coaching experience, acquire knowledge about baseball elbow and put it into practice.
This study has several limitations. The accuracy of the knowledge and the source of the information, contents of the seminars and workshops, are unknown. The results are specific to Kyoto Prefecture and cannot be generalized as a reality of Japanese coaching. In addition, it is not a complete data set and is likely to contain non-response bias. In the future, it is necessary to conduct surveys in regions besides Kyoto Prefecture and to conduct research that includes the relationship with the actual occurrence of baseball elbow in players. It would also be desirable to provide feedback to the teams to promote prevention projects.