scholarly journals Role of Rotational Kinematics in Minimizing Elbow Varus Torques for Professional Versus High School Pitchers

2018 ◽  
Vol 6 (3) ◽  
pp. 232596711876078 ◽  
Author(s):  
Micheal J. Luera ◽  
Brittany Dowling ◽  
Mitchel A. Magrini ◽  
Tyler W.D. Muddle ◽  
Ryan J. Colquhoun ◽  
...  
Keyword(s):  
High School ◽  
External Rotation ◽  
Ligament Injury ◽  
Trunk Rotation ◽  
Elbow Injury ◽  
Risk Of Injury ◽  
Increased Risk ◽  
Rotational Kinematics ◽  
Pelvis Rotation ◽  
Baseball Pitchers

Background: Elbow injury rates among baseball pitchers are rapidly rising. However, this increase has been most dramatic among high school (HS) pitchers. Purpose: To examine pitch velocity and the kinetic and kinematic characteristics of HS versus professional (PRO) pitchers to identify potential differences that may play a role in the increased risk of ulnar collateral ligament injury in youth pitchers. Study Design: Controlled laboratory study. Methods: A total of 37 HS (mean ± SD: age, 16 ± 1 years) and 40 PRO (age, 21 ± 2 years) baseball pitchers completed maximal-effort baseball pitches during a single testing session, from which pitch velocity (PV), absolute and normalized elbow varus torque (EVTA and EVTN, respectively) during arm cocking and at maximum shoulder external rotation (MER), and 8 other elbow and shoulder torques or forces and rotational kinematics of the pelvis and trunk were analyzed, recorded, and compared. Results: PV was greater in PRO than HS athletes; EVTA was greater in PRO than HS athletes during arm cocking and at MER; but EVTN was similar during arm cocking and greater in HS than PRO athletes at MER. In PRO athletes, PV was not related to EVTA during arm cocking or MER ( r = 0.01-0.05). Furthermore, in PRO athletes, EVTA during arm cocking and at MER were inversely related to upper trunk rotation at hand separation and foot contact and to pelvis rotation at elbow extension ( r = –0.30 to –0.33). In contrast, in HS athletes, PV was strongly related to EVTA during arm cocking and MER ( r = 0.76-0.77). Furthermore, in HS athletes, PV and EVTA during arm cocking and at MER were moderately or strongly related to the other elbow and shoulder torques and forces ( r = 0.424-0.991), and EVTA was not related to upper trunk rotation or pelvis rotation throughout the throwing motion ( r = –0.16 to 0.15). Conclusion: The kinetic and rotational kinematic differences observed between PRO and HS pitchers in this study may help explain the greater performance of PRO pitchers while allowing them to minimize EVT during pitching. HS pitchers, however, do not appear to be as capable of utilizing the forces generated by rotation of their trunk and pelvis to aid in pitching, and those who throw the hardest generate the greatest forces at the shoulder and elbow. As a result, they experience higher EVTs relative to their body size, which may place them at an increased risk of injury. Clinical Relevance: HS pitchers throw harder primarily by generating larger forces in the arm and shoulder. Thus, owing to the relative physical immaturity of HS versus PRO pitchers, these factors may place them at an increased risk of injury. Coaches may first wish to focus on improving the rotational kinematics of HS pitchers rather than first focusing on achieving greater pitch velocities.

scholarly journals Relationship between tightness of the hip joint and shoulder/elbow injury in high school baseball pitchers: a prospective study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Noritaka Hamano ◽  
Hitoshi Shitara ◽  
Tsuyoshi Tajika ◽  
Tsuyoshi Ichinose ◽  
Tsuyoshi Sasaki ◽  
...  
Keyword(s):  
High School ◽  
Risk Factor ◽  
Lower Limb ◽  
External Rotation ◽  
Elbow Pain ◽  
Elbow Injury ◽  
Hip Range Of Motion ◽  
Baseball Pitchers ◽  
A Prospective Study ◽  
The Relationship

AbstractSome studies have reported that upper limb tightness is a risk factor for shoulder/elbow pain in high school baseball pitchers; but there has been insufficient research on the relationship between lower limb tightness and shoulder and elbow pain in pitchers. This study aimed to clarify the correlation among pre-season hip range of motion (ROM) and shoulder and elbow disorders in high school baseball pitchers. We surveyed 125 high school pitchers. Hip ROM was measured in the supine and prone positions. After the season, based on their answers to the self-recorded questionnaire, a “shoulder or elbow injury” was defined as any condition resulting in the pitcher being considered disabled for ≥ 8 days. An independent t-test and logistic regression analysis were used for statistical analysis. Eleven disabled pitchers (9%) were identified during the season. In the injured group, the ROM of the plant side hip with 90° flexed external rotation was smaller than that in the non-injured group. Preseason limited ROM in the plant side hip with 90° flexed external rotation was a risk factor for the occurrence of shoulder/elbow pain in the season.

scholarly journals Professional and Amateur Pitchers’ Perspective on the Ulnar Collateral Ligament Injury Risk

2019 ◽  
Vol 7 (6) ◽  
pp. 232596711985077
Author(s):  
Danica D. Vance ◽  
Frank J. Alexander ◽  
Brian W. Kunkle ◽  
Mark Littlefield ◽  
Christopher S. Ahmad
Keyword(s):  
Injury Risk ◽  
Ulnar Collateral Ligament ◽  
Cross Sectional Study ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Chi Square ◽  
Cross Sectional ◽  
Elbow Injury ◽  
Increased Risk ◽  
Baseball Pitchers

Background: Medial ulnar collateral ligament (UCL) injury is increasingly prevalent in professional baseball pitchers, and significant research has been devoted to understanding the risk factors and prevention strategies associated with it. To date, no study has investigated what the players themselves believe causes and prevents the injury. Purpose: To evaluate the opinions of UCL injuries among pitchers, including professional athletes. Study Design: Cross-sectional study. Methods: A total of 214 baseball pitchers (45 high school/college, 169 Major League Baseball [MLB]/Minor League Baseball) completed a 52-item questionnaire designed to evaluate their opinions on the cause of UCL injuries, injury prevention, and Tommy John surgery. Overall, 51 of the 214 pitchers had previously experienced a UCL injury. The frequency of the selection of each answer option was measured. Additionally, chi-square tests were used to compare (1) responses between professional and nonprofessional pitchers and (2) responses between pitchers with and without a previous UCL injury. Results: Only 45% of pitchers thought that UCL injuries are avoidable in MLB. Additionally, 55% of pitchers with a UCL injury had a history of elbow injuries as an adolescent/child, compared with 18% in the uninjured group ( P < .0001). Also, 72% of all surveyed pitchers agreed that fatigue over the course of a season increases the risk of UCL injuries, and the majority of pitchers agreed that inadequate rest from throwing both during the off-season (61%) and the season (59%) increases the risk of UCL injuries. Moreover, 59% of pitchers believed that a 6-man starting rotation would decrease the incidence of UCL injuries. Professional and nonprofessional pitchers significantly differed ( P = .005) in the type of pitch most prone to causing UCL injuries. Conclusion: Pitchers with a previous childhood elbow injury had a significantly higher incidence of UCL injuries during their adult career, suggesting possible predisposition to UCL injury and warranting further research. Fatigue and inadequate rest were of greatest concern among all pitchers for an increased risk of UCL injuries. Understanding and acknowledging the opinions that players have regarding UCL injuries are important to improve UCL education, prevention, and treatment.

scholarly journals Comparison of Kinematic Sequences During Curveball and Fastball Baseball Pitches

2021 ◽  
Vol 3 ◽  
Author(s):  
Donna Moxley Scarborough ◽  
Pablo E. Colón ◽  
Shannon E. Linderman ◽  
Eric M. Berkson
Keyword(s):  
External Rotation ◽  
Distal Segment ◽  
Median Number ◽  
Elbow Injury ◽  
Total Percentage ◽  
Increased Risk ◽  
Sequence Patterns ◽  
Ball Velocity ◽  
Baseball Pitchers ◽  
Epidemiology Studies

Performance of a sequential proximal-to-distal transfer of segmental angular velocity (or Kinematic Sequence) is reported to reduce stress on musculoskeletal structures and thus the probability of injury while also maximizing ball velocity. However, there is limited investigation regarding the Kinematic Sequence of the five body segments (Pelvis, Trunk, Arm, Forearm, and Hand) among baseball pitchers. Some biomechanical and epidemiology studies have reported an association of the curveball with increased risk for elbow injury among youth pitchers. Kinematic Sequences with altered distal upper extremity (forearm and hand) sequences have been associated with greater elbow valgus and shoulder external rotation torques compared to other Kinematic Sequences. Identifying Kinematic Sequence patterns during curveball pitches may lead to improved understanding of injury susceptibility. This study investigated the Kinematic Sequence patterns (and their variability) during curveball pitching and compared them to the sequences identified during fastball pitches. Using 3D motion analyses, 14 baseball pitchers (four high school, eight college, and two professional) performed 5–6 curveball pitches and 12 pitchers also threw fastball pitches in a simulated bullpen session. Eleven different curveball Kinematic Sequences were identified and 8 fastball Kinematic Sequences. There was no significant variability in the number of Kinematic Sequences performed between the two pitch types, (Z = −0.431, p = 0.67). The median number of KSs performed by each group was 2.5. The most frequently used Kinematic Sequences for both pitch types were due to alteration in the sequence of the distal segments. The total percentage of Kinematic Sequences with altered distal segment sequencing for the curveball pitches was 49% and 43% for fastball pitches. Identifying the frequency of Kinematic Sequences with altered timing of hand and forearm peak velocities across pitch types may lead to a better understanding of the stresses that individual pitchers incur.

scholarly journals Biomechanical Differences Between Japanese and American Professional Baseball Pitchers

2019 ◽  
Vol 7 (2) ◽  
pp. 232596711982562 ◽  
Author(s):  
Takanori Oi ◽  
Shinichi Yoshiya ◽  
Jon Slowik ◽  
Alek Diffendaffer ◽  
Yohei Takagi ◽  
...  
Keyword(s):  
Knee Flexion ◽  
The United States ◽  
Abduction Angle ◽  
Professional Baseball ◽  
Shoulder Abduction ◽  
Elbow Injury ◽  
Risk Of Injury ◽  
Ball Release ◽  
Increased Risk ◽  
Baseball Pitchers

Background: Although baseball injuries are common in both Japan and the United States, the majority of pitching injuries in Japanese players occur at the shoulder, whereas most pitching injuries in American players occur at the elbow. A biomechanical comparison between Japanese and American pitchers may help to identify the different injury mechanisms. Hypothesis: Japanese pitchers produce greater shoulder kinetics whereas American pitchers generate greater elbow kinetics. Also, kinematic differences will be found between the 2 groups, including longer stride and greater lead knee flexion for Japanese pitchers. Study Design: Descriptive laboratory study. Methods: Biomechanical data for 19 Japanese professional baseball pitchers and an age-matched group of 19 American professional baseball pitchers were collected by use of a 3-dimensional, automated, high-speed optical motion capture system. Anthropometric, kinetic, and kinematic data for both groups were compared by use of t tests ( P < .05). Results: American pitchers were taller and heavier and generated greater ball velocity (38.1 ± 1.6 vs 34.7 ± 1.1 m/s; P < .001) than their Japanese counterparts. Most elbow and shoulder kinetic parameters, including elbow varus torque (99 ± 17 vs 86 ± 17 N·m; P = .018), were greater for American pitchers. However, when normalized by bodyweight and height, shoulder horizontal adduction torque was greater for Japanese pitchers (6.8% ± 1.0% vs 5.8% ± 1.1%; P = .005). Japanese pitchers had longer stride (86% ± 5% vs 82% ± 6% of height; P = .023), greater shoulder abduction at ball release (101° ± 8° vs 94° ± 9°; P = .014), and greater knee flexion after ball release (39° ± 18° vs 28° ± 14°; P = .039). Japanese pitchers also demonstrated greater shoulder internal rotation velocity, elbow flexion, and elbow extension velocity. Conclusion: Greater elbow varus torque may predispose American pitchers to greater risk of elbow injury. Japanese pitchers may have increased risk of shoulder injury due to greater normalized horizontal adduction torque and greater abduction angle. Japanese pitchers may be able to reduce their shoulder torque and risk of injury by shortening their stride, reducing their lead knee flexion, and decreasing their throwing arm abduction. Clinical Relevance: Understanding anthropometric, kinetic, and kinematic differences between pitchers from the 2 countries may be of value to clinicians and coaches working to maximize performance of the pitchers while minimizing the risk of injury.

scholarly journals The Relationship between the Glenohumeral Joint Internal Rotation Deficit and the Trunk Compensation Movement in Baseball Pitchers

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 243
Author(s):  
Shih-Chung Cheng ◽  
Ting-Yu Wan ◽  
Chun-Hao Chang
Keyword(s):  
High School ◽  
Internal Rotation ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Senior High School ◽  
Control Group ◽  
Trunk Rotation ◽  
Baseball Pitchers ◽  
The Relationship ◽  
Dominant Side

Background and objectives: Glenohumeral joint internal rotation deficit (GIRD) is commonly observed in the dominant arm of baseball pitchers and is limited by horizontal adduction motions. We inferred that when pitchers’ generation of internal shoulder rotation and horizontal adduction activity is limited, they may generate compensation movements in other body parts. This study aims to investigate whether pitchers with GIRD generates trunk compensation during pitching where pitching targets were on the lower corner of their non-dominant side. Design: Case-control study. Setting: Elite senior high school baseball. Participants: Twenty-five senior high school baseball pitchers participated in this study. Twelve pitchers with GIRD were assigned to the experiment group, and the remaining 13 participants to the control group. Main outcome measures: Glenohumeral internal/external rotation of both arms and internal/external rotation of the bilateral hip joints were measured. The kinematic values of the trunk when pitching to a target were measured using high-speed infrared cameras. Results: Pitchers with GIRD exhibited significantly greater upper trunk rotation toward the non-dominant side when a baseball was released from their hand (27.39 ± 6.62 degrees), compared with non-GIRD pitchers (20.42 ± 5.97 degrees) (p < 0.05). The total rotation of the pivot leg of pitchers with GIRD (67.54 ± 7.84 degrees) was significantly smaller than that of pitchers without GIRD (74.00 ± 7.07 degrees) (p < 0.05). Conclusions: GIRD in the dominant arm affected upper trunk rotation during pitching and was associated with the hip range of motion. Future studies could conduct a longitudinal study regarding the relationship between GIRD and other joint injuries of the lower limbs.

scholarly journals Daily Players’ Satisfaction with Pitching Performance Could Predict Shoulder and Elbow Injuries in High-school Baseball Pitchers: A Prospective Time-to-event Study

2021 ◽  
Author(s):  
Hitoshi Shitara ◽  
Tsuyoshi Tajika ◽  
Takuro Kuboi ◽  
Tsuyoshi Ichinose ◽  
Tsuyoshi Sasaki ◽  
...  
Keyword(s):  
High School ◽  
Event Study ◽  
Operating Characteristics ◽  
Time To Event ◽  
Elbow Injury ◽  
Shoulder Range Of Motion ◽  
Elbow Injuries ◽  
Characteristics Analysis ◽  
Baseball Pitchers ◽  
The Relationship

Abstract The relationship between baseball pitchers’ satisfaction with their own performance and the incidence of shoulder and elbow injuries is unclear. We analyzed the relationship between daily satisfaction scores before injury and incidence of shoulder/elbow injury in high-school baseball pitchers in this prospective, time-to-event study. We collected baseline data on baseball experience, height, weight, elbow and shoulder range of motion, and shoulder muscle strength. The 108 enrolled participants aged 15-17 years were divided into satisfied (88) and unsatisfied (22) groups based on the Receiver operating characteristics analysis results that revealed the cutoff value to be 4 points. The incidence of injury was 10.2% and 50.0% in the satisfied and unsatisfied groups, respectively. We observed that high-school baseball pitchers with a low satisfaction significantly increased the risk of shoulder and elbow injuries: these players had a 7.3-times greater risk of injuries and a 1.9-times earlier occurrence of injuries than pitchers who are satisfied with their performance. High-school baseball pitchers who had low satisfaction with their pitching performance had higher risk of shoulder and elbow injuries and lower time to injury than satisfied pitchers. Daily evaluation of players’ self-satisfaction could predict shoulder and elbow injuries in high-school baseball pitchers.

What Can a Jump Tell Us About Elbow Injuries in Professional Baseball Pitchers?

2020 ◽  
Vol 48 (5) ◽  
pp. 1220-1225
Author(s):  
John Mayberry ◽  
Scott Mullen ◽  
Scott Murayama
Keyword(s):  
Test Performance ◽  
Injury Risk ◽  
Reaction Force ◽  
Professional Baseball ◽  
Shoulder Injury ◽  
Injury Rates ◽  
Elbow Injury ◽  
Increased Risk ◽  
Elbow Injuries ◽  
Baseball Pitchers

Background: The incidence rate of elbow injuries has been rising in recent years among professional baseball pitchers. Determining valid screening procedures that allow practitioners to identify pitchers at an increased risk of such injuries is therefore of critical importance. Purpose: To validate the use of countermovement jump (CMJ) tests as a diagnostic tool for pitcher conditioning. Study Design: Case-control study; Level of evidence, 3. Methods: More than 500 pitchers at a single professional baseball organization performed preseason CMJ assessments on a force plate before the 2013 to 2018 seasons. Three measurements were extracted from ground-reaction force data during the test: eccentric rate of force development (ERFD), average vertical concentric force (AVCF), and concentric vertical impulse (CVI). Athletic trainers at the organization collected detailed information on elbow and shoulder injury rates as well as workload (pitch count) throughout the rest of the season. Poisson regression models were fit to investigate the dependency of injury rates on CMJ test performance. Results: ERFD, CVI, and AVCF were all significant predictors of elbow injury risk after accounting for pitcher age, weight, and workload. The analysis identified 3 specific indicators of heightened risk based on the results of a CMJ scan: low ERFD, a combination of low AVCF and high CVI, and a combination of high AVCF and low CVI. In contrast, shoulder injury risk was roughly independent of all 3 CMJ test measurements. Conclusion: This study supports the hypothesis of the entire kinetic chain’s involvement in pitching by establishing a link between CMJ test performance and elbow injury risk in professional baseball pitchers. CMJ assessment may be a powerful addition to injury risk alert and prevention protocols. Pitchers in high-risk groups can be prescribed specific exercise plans to improve movement imbalances.

Association Between Pitching Volume And Shoulder And Elbow Injury In High School Baseball Pitchers

2008 ◽  
Vol 40 (Supplement) ◽  
pp. S233
Author(s):  
Johna K. Register-Mihalik ◽  
Stephen W. Marshall ◽  
Frederick O. Mueller
Keyword(s):  
High School ◽  
Elbow Injury ◽  
Baseball Pitchers

Weak Hip Strength Increases Dynamic Knee Valgus in Single-Leg Tasks of Collegiate Female Athletes

2021 ◽  
pp. 1-4
Author(s):  
Kyndell R. Crowell ◽  
Ryan D. Nokes ◽  
Nicole L. Cosby
Keyword(s):  
Female Athletes ◽  
External Rotation ◽  
Common Factor ◽  
Knee Valgus ◽  
Bottom Line ◽  
Level Of Evidence ◽  
Hip Strength ◽  
Risk Of Injury ◽  
Increased Risk ◽  
Collegiate Female Athletes

Clinical Scenario: Dynamic knee valgus (DKV) is a mechanical alteration in the knee that leads to increased risk of injury. Weakness of hip musculature in hip abduction (HABD), extension (HEXT), and external rotation (HER) may contribute to increased DKV in single-leg landing tasks. Focused Clinical Question: Is decreased hip strength associated with an increase in DKV during a single-leg landing task in collegiate female athletes? Summary of Key Findings: Three studies were included: One randomized control trial (RCT), one cohort study, and one case-control. All three studies found that decreases in HABD and HER strength contributed to increased DKV during single-leg landing tasks. One study also found that the hip extensors contribute to controlling hip adduction, a common factor in many mechanisms of injuries. These three studies recommended strengthening HABD, HEXT, and HER to decrease DKV and reduce the risk of injury at the knee. Clinical Bottom Line: Weak HABD, HEXT, and HER contribute to increased DKV in college female athletes, but strengthening HABD, HEXT, and HER can lead to decreases in DKV and, overall, reduce the risk of injury at the knee. Strength of Recommendation: These articles were graded with a level of evidence of III or higher, giving a grade of B strength of recommendation that weak HABD, HEXT, and HER are associated with increased DKV in collegiate female athletes.

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