A Biomechanical Comparison of the Fastball and Curveball in Adolescent Baseball Pitchers

2009 ◽  
Vol 37 (8) ◽  
pp. 1492-1498 ◽  
Author(s):  
Carl W. Nissen ◽  
Melany Westwell ◽  
Sylvia Õunpuu ◽  
Mausam Patel ◽  
Matthew Solomito ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Kinetic Data ◽  
Mixed Model ◽  
Warm Up ◽  
Risk Of Injury ◽  
Bony Landmarks ◽  
Elbow Injuries ◽  
Baseball Pitchers ◽  
The Difference ◽  
Biomechanical Comparison

Background The incidence of shoulder and elbow injuries in adolescent baseball players is rapidly increasing. One leading theory about this increase is that breaking pitches (such as the curveball) place increased moments on the dominant arm and thereby increase the risk of injury. Hypothesis There is no difference in the moments at the shoulder and elbow between fastball and curveball pitches in adolescent baseball pitchers. Study Design Controlled laboratory study. Methods Thirty-three adolescent baseball pitchers with a minimum of 2 years of pitching experience underwent 3-dimensional motion analysis using reflective markers aligned to bony landmarks. After a warm-up, pitchers threw either a fastball or curveball, randomly assigned, from a portable pitching mound until 3 appropriate trials were collected for each pitch technique. Kinematic and kinetic data for the upper extremities, lower extremities, thorax, and pelvis were collected and computed for both pitch types. Statistical analysis included both the paired sample t test and mixed model regression. Results There were lower moments on the shoulder and elbow when throwing a curveball versus when throwing a fastball. As expected, speed for the 2 pitches differed: fastball, 65.8 ± 4.8 mph; and curveball, 57.7 ± 6.2 mph (P <. 001). Maximal glenohumeral internal rotation moment for the fastball was significantly higher than for the curveball (59.8 ± 16.5 N·m vs 53.9 ± 15.5 N·m; P <. 0001). Similarly, the maximum varus elbow moment for the fastball was significantly higher than for the curveball (59.6 ± 16.3 N·m vs 54.1 ± 16.1 N·m; P <. 001). The wrist flexor moment was greater in the fastball, 8.3 ± 3.6 N·m, than in the curveball, 7.8 ± 3.6 N·m (P <. 001), but the wrist ulnar moment was greater in the curveball, 4.9 ± 2.0 N·m, than in the fastball, 3.2 ± 1.5 N·m (P <. 001). Relatively minor motion differences were noted at the shoulder and elbow throughout the pitching motion, while significant differences were seen in forearm and wrist motion. The forearm remained more supinated at each point in the pitching cycle for the curveball but had less overall range of motion (62° ± 20°) than with the fastball (69° ± 17°) (P <. 001), and the difference in the forearm pronation and supination moment between the pitches was not significant (P =. 104 for pronation and P =. 447 for supination). The wrist remained in greater extension during the fastball from foot contact through ball release but did not have significantly different total sagittal range of motion (53° ± 11°) when compared with the curveball (54° ± 15°) (P =. 91). Conclusion In general, the moments on the shoulder and elbow were less when throwing a curveball than when throwing a fastball. In each comparison, the fastball demonstrated higher moments for each individual pitcher for both joints. Clinical Relevance The findings based on the kinematic and kinetic data in this study suggest that the rising incidence of shoulder and elbow injuries in pitchers may not be caused by the curveball mechanics. Further evaluation of adolescent and adult baseball pitchers is warranted to help determine and subsequently reduce the risk of injury.

scholarly journals Glenohumeral Passive Range Of Motion And The Correlation To Elbow Injuries In Professional Baseball Pitchers

2013 ◽  
Vol 1 (4_suppl) ◽  
pp. 2325967113S0001
Author(s):  
Kevin E. Wilk ◽  
Leonard Macrina ◽  
Glenn S. Fleisig ◽  
Kyle Aune ◽  
Ron Porterfield ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Professional Baseball ◽  
Elbow Injuries ◽  
Baseball Pitchers

scholarly journals Acute Effect of Intermittent and Continuous Static Stretching on Hip Joint Range of Motion in Trained and Untrained Subjects

Proceedings ◽  
2019 ◽  
Vol 25 (1) ◽  
pp. 16 ◽  
Author(s):  
Vasiliki Gaspari ◽  
Kostantina Papia ◽  
Ioli Panidi ◽  
Olyvia Donti ◽  
Gregory C. Bogdanis
Keyword(s):  
Range Of Motion ◽  
Hip Joint ◽  
Mixed Model ◽  
Total Duration ◽  
Acute Effect ◽  
Important Variable ◽  
Dependent Manner ◽  
Static Stretching ◽  
Warm Up ◽  
Joint Range

Aim: It is well documented that static stretching acutely increases range of motion (ROM) in a dose-dependent manner. However, most previous studies have utilized intermittent stretching protocols, and it is not known if intermittent and continuous stretches elicit different changes in joint ROM and, in particular, in flexibility-trained subjects. The aim of this study was to examine changes in hip joint ROM after an intermittent or a continuous static stretching protocol of equal total duration. Material & Method: Twenty-seven female subjects (age, 19.9 ± 3.0 years; height, 167.3 ± 6.1 cm; body mass, 58.2 ± 5.2 kg), 14 artistic and rhythmic gymnasts, and 13 recreationally active participants performed 3 min of intermittent (6 × 30 s with 30 s rest) or continuous stretching (3 min) of the hamstring muscles, with an intensity of 8–9 on a 10-point visual analogue scale. Hip joint ROM was measured for both legs after warm-up and immediately after stretching. The same individuals performed both conditions with alternate legs in a randomized, counterbalanced order. Data were analysed using mixed-model three-way ANOVA. Results: In the untrained participants, only intermittent stretching increased ROM by 13% (from 91.0 ± 7.2° to 102.4 ± 14.5°, p = 0.001), while continuous stretching did not affect ROM (from 92.4 ± 6.9° to 93.1 ± 9.2°, p = 0.99). In the trained participants, both stretching types equally increased ROM by ~6% (continuous, 140.9 ± 20.4° to 148.6 ± 18.8°, p = 0.047; intermittent, 141.8 ± 20.3° to 150.0 ± 18.8°, p = 0.029). Conclusions: The different effect of intermittent vs. continuous stretching on hip ROM between trained and untrained subjects suggests that stretching mode is an important variable when examining the acute effects of static stretching on ROM enhancement.

scholarly journals Preseason Neck Mobility Is Associated With Throwing-Related Shoulder and Elbow Injuries, Pain, and Disability in College Baseball Pitchers

2020 ◽  
Vol 8 (5) ◽  
pp. 232596712092055
Author(s):  
Laurie Lee Devaney ◽  
Craig R. Denegar ◽  
Charles A. Thigpen ◽  
Adam S. Lepley ◽  
Cory Edgar ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Time Loss ◽  
Elbow Injury ◽  
Increased Risk ◽  
Patient Reported ◽  
Elbow Injuries ◽  
College Baseball ◽  
Baseball Pitchers ◽  
Neck Mobility ◽  
Injury Analysis

Background: Shoulder and elbow injuries in baseball pitchers, which can lead to significant pain and disability, have been on the rise at all levels of play for 3 decades. Despite anatomic and neurophysiological relationships, neck mobility has not been explored as a contributor to shoulder and elbow injuries in baseball pitchers. Hypothesis: Impaired neck mobility will increase the risk of shoulder and elbow injuries in college baseball pitchers. Study Design: Cohort study; Level of evidence, 2. Methods: Posture, neck mobility, and shoulder passive range of motion were measured in healthy college baseball pitchers during the 2018 preseason. Time loss (days lost because of shoulder or elbow injuries) and patient-reported disability via Functional Arm Scale for Throwers (FAST) scores were used to dichotomize pitchers into injured and uninjured groups. Receiver operating characteristic curves were generated, and accuracy values and risk ratios (RRs) were calculated to assess the diagnostic utility of the physical measures. Time-to-injury analysis was conducted to assess the timing of injuries. Results: A total of 49 pitchers (mean age, 19.92 ± 1.48 years; mean height, 187.04 ± 6.02 cm; mean weight, 89.14 ± 12.08 kg) completed the study. There were 10 pitchers (20.4%) who sustained a time-loss injury >7 days because of a shoulder or elbow injury. A Cervical Flexion-Rotation Test (CFRT) finding on the dominant side of ≤39° resulted in over 9 times the increased risk of time-loss injuries (RR, 9.38 [95% CI, 1.28-68.49]). Time-to-injury analysis demonstrated differences between the 2 groups (χ2 = 7.667; P = .01). Pitchers with a >39.25° finding on the CFRT played a mean 109.4 of 112 days (95% CI, 105-114) before the injury, while pitchers with ≤39.25° only played 83.6 of 112 days (95% CI, 68-99). A CFRT finding of ≤38° (RR, 3.91 [95% CI, 1.23-12.39]), cervical flexion range of motion of ≤64° (RR, 10.56 [95% CI, 1.50-74.34]), and weight of >86.9 kg (RR, 10.42 [95% CI, 1.14-213.70]) were also associated with an increased risk of patient-reported pain and disability on the FAST pitcher module. Conclusion: College baseball pitchers with less neck mobility during the preseason had an increased risk of time loss and shoulder and elbow disability during the season. The predictive value of these measures as part of a risk screening profile should be further explored.

scholarly journals Comparing the Tibial Tuberosity–Trochlear Groove Distance Between CT and MRI in Skeletally Immature Patients With and Without Patellar Instability

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097366
Author(s):  
Zhen-Zhen Dai ◽  
Lin Sha ◽  
Zi-Ming Zhang ◽  
Zhen-Peng Liang ◽  
Hao Li ◽  
...  
Keyword(s):  
Patellar Instability ◽  
Intraclass Correlation ◽  
Mean Difference ◽  
Tibial Tubercle ◽  
Control Group ◽  
Trochlear Groove ◽  
Skeletally Immature ◽  
Bony Landmarks ◽  
The Difference ◽  
Ct And Mri

Background: The tibial tubercle–trochlear groove (TT-TG) distance was originally described for computed tomography (CT), but it has been measured on magnetic resonance imaging (MRI) in patients with patellar instability (PI). Whether the TT-TG measured on CT versus MRI can be considered equivalent in skeletally immature children remains unclear. Purpose: To investigate in skeletally immature patients (1) the effects of CT versus MRI imaging modality and cartilage versus bony landmarks on consistency of TT-TG measurement, (2) the difference between CT and MRI measurements of the TT-TG, and (3) the difference in TT-TG between patients with and without PI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We retrospectively identified 24 skeletally immature patients with PI and 24 patients with other knee disorders or injury but without PI. The bony and cartilaginous TT-TG distances on CT and MRI were measured by 2 researchers, and related clinical data were collected. The interrater, interperiod (bony vs cartilaginous), and intermethod (CT vs MRI) reliabilities of TT-TG measurement were assessed with intraclass correlation coefficients. Results: The 48 study patients (19 boys, 29 girls) had a mean age of 11.3 years (range, 7-14 years). TT-TG measurements had excellent interrater reliability and good or excellent interperiod reliability but fair or poor intermethod reliability. TT-TG distance was greater on CT versus MRI (mean difference, 4.07 mm; 95% CI, 2.6-5.5 mm), and cartilaginous distance was greater than bony distance (mean difference, 2.3 mm; 95% CI, 0.79-3.8 mm). The TT-TG measured on CT was found to increase with the femoral width. Patients in the PI group had increased TT-TG distance compared with those in the control group, regardless of landmarks or modality used ( P > .05 for all). Conclusion: For skeletally immature patients, the TT-TG distance could be evaluated on MRI, regardless of whether cartilage or bony landmarks were used. Its value could not be interchanged with CT according to our results; however, further research on this topic is needed.

scholarly journals Four-year trend in shoulder and elbow injuries in competitive level high school baseball pitchers: A repeated cross-sectional survey

2021 ◽  
Author(s):  
Tsuyoshi Sasaki ◽  
Hitoshi Shitara ◽  
Tsuyoshi Tajika ◽  
Takuro Kuboi ◽  
Tsuyoshi Ichinose ◽  
...  
Keyword(s):  
High School ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Elbow Injuries ◽  
Baseball Pitchers

scholarly journals The impact of a ‘milking the COW’ campaign in a regional hospital in Singapore

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Surinder Kaur M. S. Pada ◽  
Poh Lishi ◽  
Kim Sim Ng ◽  
Sarathamani Rethenam ◽  
Lilibeth Silagan Alenton ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Pathogenic Bacteria ◽  
Mixed Model ◽  
Mixed Model Analysis ◽  
Colony Forming Units ◽  
Skin Flora ◽  
Before And After ◽  
The Difference ◽  
And Control ◽  
The Impact

Abstract Background Computerisation of various processes in hospitals and reliance on electronic devices raises the concern of contamination of these devices from the patient environment. We undertook this study to determine if an attached hand hygiene device that unlocks the screen of a computer on wheels (COW) on usage can be effective in decreasing the microbiological burden on computer keyboards. Methods An electronic hand sanitizer was integrated onto the COW. A prospective cohort study with a crossover design involving 2 control and 2 intervention wards was used. The study end point was the number of colony forming units found on the keyboards. Bacteria were classified into 4 main groups; pathogenic, skin flora, from the environment or those thought to be commensals in healthy individuals. We then used a mixed effects model for the statistical analysis to determine if there were any differences before and after the intervention. Results Thirty-nine keyboards were swabbed at baseline, day 7 and 14, with 234 keyboards cultured, colony forming units (CFUs) counted and organisms isolated. By mixed model analysis, the difference of mean bacteria count between intervention and control for week 1 was 32.74 (− 32.74, CI − 94.29 to 28.75, p = 0.29), for week 2 by 155.86 (− 155.86, CI − 227.45 to − 83.53, p < 0.0001), and after the 2-week period by 157.04 (− 157.04, CI − 231.53 to − 82.67, p < 0.0001). In the sub-analysis, there were significant differences of pathogenic bacteria counts for the Intervention as compared to the Control in contrast with commensal counts. Conclusion A hand hygiene device attached to a COW may be effective in decreasing the microbiological burden on computer keyboards.

scholarly journals Combined Ipsilateral Humeral Shaft and Galeazzi Fractures Creating a Floating Elbow Variant

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Patrick Lee ◽  
Allison Z. Piatek ◽  
Michael J. DeRogatis ◽  
Paul S. Issack
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Open Reduction ◽  
Humeral Fracture ◽  
Humeral Shaft ◽  
Proximal Ulna ◽  
Elbow Injury ◽  
Anatomic Reduction ◽  
Elbow Injuries ◽  
Floating Elbow

“Floating elbow” injuries of the arm traditionally represent a combination of humeral shaft and forearm fractures which require anatomic rigid open reduction and internal fixation of all fractures to allow for early range of motion exercises of the elbow. There are published variants of the floating elbow injury which include ipsilateral diaphyseal humeral fracture, proximal ulna fracture with proximal radioulnar joint disruption, and ipsilateral diaphyseal humeral fracture with elbow dislocation and both bones forearm fracture. We present the case of a 21-year-old woman whose left arm became caught between the side of a waterslide and adjacent rocks at a park. She sustained a torsional and axial loading injury to her left upper extremity resulting in ipsilateral humeral shaft and Galeazzi fractures. The combination of ipsilateral humeral shaft and Galeazzi fractures resulted in a rare floating elbow variant. Prompt open reduction and internal fixation of both fractures and early range of motion of the elbow and wrist resulted in an excellent clinical and radiographic result. Floating elbow injuries and their variants should be promptly recognized as early anatomic reduction, and rigid internal fixation can allow for good elbow function with minimization of stiffness.

scholarly journals Limiting the Pitch Count in Youth Baseball Pitchers Decreases Elbow Pain

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712198910
Author(s):  
Tetsuya Matsuura ◽  
Yuki Takata ◽  
Toshiyuki Iwame ◽  
Jyoji Iwase ◽  
Kenji Yokoyama ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Stress Test ◽  
Daily Maximum ◽  
Test Results ◽  
Level Of Evidence ◽  
Valgus Stress ◽  
Radiographic Images ◽  
Elbow Pain ◽  
Youth Baseball ◽  
Baseball Pitchers

Background: Reducing the number of pitches thrown is regarded as the most effective way to prevent throwing injuries in youth baseball pitchers. However, few studies have compared the effectiveness of limiting the pitch count versus the limiting the number of innings pitched in terms of elbow injuries. Hypothesis: We hypothesized that, compared with inning limits, pitch count limits would lead to greater decreases in elbow pain, range of motion deficits, positive moving valgus stress test results, and the risk of capitellar osteochondritis dissecans (OCD). Study Design: Cohort study; Level of evidence, 3. Methods: This study retrospectively reviewed baseball pitchers aged 8 to 12 years in 2017 and 2018. Inning and pitch count limits in games were set to a daily maximum of 7 innings in 2017 and 70 pitches in 2018. Elbow pain, range of motion, and moving valgus stress test results were evaluated. The presence of capitellar OCD was assessed on ultrasonographic and radiographic images. Results: A total of 352 pitchers in 2017 and 367 pitchers in 2018 participated. The mean pitch count per game was lower in the pitch count limit (CL) group (52.5 ± 16.0) than in the inning limit (IL) group (98.2 ± 19.5) ( P < .001). Compared with the IL group, the CL group had significantly lower rates of elbow pain (40.9% vs 31.9%, respectively; P = .01) and reduced flexion (19.0% vs 10.6%, respectively; P = .001). Multivariate analysis revealed a significant association between elbow pain and age in both the IL and the CL groups ( P < .0001 and P = .02, respectively) and between OCD and elbow pain in the CL group ( P = .04). Conclusion: A pitch count limit of ≤70 pitches per day for baseball pitchers ≤12 years could be more protective against elbow pain and reduced flexion than a limit of ≤7 innings per day, but it may not be effective for reducing the risk of capitellar OCD.

scholarly journals An analysis of pre-season risk factors for low back injury in high-school baseball pitchers: a prospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kurumi Nakase ◽  
Hitoshi Shitara ◽  
Tsuyoshi Tajika ◽  
Takuro Kuboi ◽  
Tsuyoshi Ichinose ◽  
...  
Keyword(s):  
High School ◽  
Shoulder Function ◽  
Whole Body ◽  
Back Injury ◽  
Low Back ◽  
Shoulder Range Of Motion ◽  
Low Back Injury ◽  
Significant Independent Risk Factor ◽  
Elbow Injuries ◽  
Baseball Pitchers

AbstractPitching motion requires whole-body coordination; therefore, poor control of the lower extremities, pelvis and trunk may cause shoulder and elbow injuries. However, few studies have described the relationship between the shoulder joint function and low back injury in high-school baseball pitchers. A total of 128 healthy high school pitchers underwent pre-season medical checkups, where their shoulder range of motion and shoulder strength were measured. The participants completed a self-recorded daily questionnaire regarding the presence of low back pain. Pitchers were divided into injured and non-injured groups. Low back injury was observed in 13 participants (13.4%). In the injured group, horizontal adduction on the dominant shoulder was significantly less than in the non-injured group. A logistic regression analysis showed that horizontal adduction on the dominant side was a significant independent risk factor for low back injury during the season. It is important to recognize that restriction of the shoulder function not only causes shoulder and elbow injuries but can also risk low back injury.

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