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Zaremski JL, Pazik M, Vasilopoulos T, Horodyski M. Workload Risk Factors for Pitching-Related Injuries in High School Baseball Pitchers. Am J Sports Med 2024; 52:1685-1691. [PMID: 38700088 DOI: 10.1177/03635465241246559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
BACKGROUND Pitch counts are only one measure of the true workload of baseball pitchers. Newer research indicates that workload measurement and prevention of injury must include additional factors. Thus, current monitoring systems gauging pitcher workload may be considered inadequate. PURPOSE/HYPOTHESIS The purpose of this study was to develop a novel method to determine workload in baseball pitchers and improve processes for prevention of throwing-related injuries. It was hypothesized that our pitching workload model would better predict throwing-related injuries occurring throughout the baseball season than a standard pitch count model. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS This prospective observational study was conducted at an academic medical center and community baseball fields during the 2019 to 2023 seasons. Pitchers aged 13 to 18 years were monitored for pitching-related injuries and workload (which included pitching velocity; intensity, using preseason and in-season velocity as a marker of effort; and pitch counts). RESULTS A total of 71 pitchers had 313 recorded pitcher outings, 11 pitching-related injuries, and 24,228 pitches thrown. Gameday pitch counts for all pitchers ranged from 19 to 219 (mean, 77.5 ± 41.0). Velocity ranged from 46.8 to 85.7 mph (mean, 71.3 ± 5.8 mph). Intensity ranged from 0.7 to 1.3 (mean, 1.0 ± 0.08). The mean workload was 74.7 ± 40.1 for all pitchers. Risk factors significant for injury included throwing at a higher velocity in game (P = .001), increased intensity (eg, an increase in mean velocity thrown from preseason to in-season; P < .001), and being an older pitcher (P = .014). No differences were found for workload between injured and noninjured pitchers because the analysis was underpowered. CONCLUSION Our workload model indicated that throwing at a higher velocity, throwing at a higher intensity, and older age were risk factors for injury. Thus, this novel workload model should be considered as a means to identify pitchers who may be at greater risk for injury.
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Affiliation(s)
- Jason L Zaremski
- Division of Sports Medicine, PM&R Residency, UF Health Throwing Clinic, Department of Physical Medicine & Rehabilitation, Department of Orthopaedic Surgery & Sports Medicine, University of Florida Health, Gainesville, Florida, USA
| | - Marissa Pazik
- Department of Orthopaedic Surgery and Sports Medicine, Division of Research, University of Florida, Gainesville, Florida, USA
| | - Terrie Vasilopoulos
- Department of Anesthesiology, Department of Orthopaedic Surgery & Sports Medicine, University of Florida, College of Medicine, Gainesville, Florida, USA
| | - MaryBeth Horodyski
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida, USA
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Zaremski JL, Bowers RL, Kriz PK. Pitching Restriction Policies in Adolescent and High-School Baseball Pitchers: Is It Time for an Updated Paradigm? Clin J Sport Med 2024; 34:1-9. [PMID: 37678800 DOI: 10.1097/jsm.0000000000001188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/09/2023] [Indexed: 09/09/2023]
Affiliation(s)
- Jason L Zaremski
- Division of Sports Medicine, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, Florida
| | - Robert L Bowers
- Division of Sports Medicine, Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia
- Department of Physical Medicine and Rehabilitation, Emory University School of Medicine, Atlanta, Georgia; and
| | - Peter K Kriz
- Division of Sports Medicine, Departments of Orthopaedics and Pediatrics, Brown University, Providence, Rhode Island
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Zhang H, Jiang Q, Li A. The impact of resistance-based training programs on throwing performance and throwing-related injuries in baseball players: A systematic review. Heliyon 2023; 9:e22797. [PMID: 38125451 PMCID: PMC10731065 DOI: 10.1016/j.heliyon.2023.e22797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
The aim of this systematic review is to assess the effects of structured resistance training programs on the throwing performance and injury risk of baseball players, irrespective of their age or sex. The literature search was carried out on 18/10/2023, utilizing databases that include PubMed, Scopus, and the Web of Science. Our inclusion criteria encompassed research involving baseball players of all ages and sex who had undergone resistance-based training interventions. For comparison, we considered active control groups, irrespective of their exposure to additional training programs. The outcomes under investigation were related to throwing performance (i.e., throwing velocity and accuracy) and injuries associated with throwing. In our review, we exclusively included studies with a two- or multi-arm design. We evaluated the risk of bias using the PEDro scale. Out of the initial pool of 509 studies, we carefully examined 27 full-text articles and ultimately selected and analyzed 16 studies for inclusion in our review. Out of the 12 studies that compared and presented the inferential statistics for the post-training effects of the experimental versus control groups, it was observed that 8 of these studies demonstrated a significantly more favorable impact of the experimental group on enhancing throwing velocity when compared to the control group. Out of the three studies that compared the experimental and control groups in terms of throwing accuracy, only one study showed a significant improvement in the experimental group compared to the control group after the intervention. In conclusion, this systematic review indicates that resistance-based training interventions appear to be effective in enhancing throwing velocity. However, the evidence regarding the efficacy of these interventions in improving throwing accuracy is less robust. It is worth noting that while some experimental conditions may lead to an increase in injury rates, there is limited data available on this aspect, with only a few studies reporting on this variable.
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Affiliation(s)
- HongBo Zhang
- Geely University of China, 641423, Chengdu, China
| | - Qiang Jiang
- Geely University of China, 641423, Chengdu, China
| | - Ang Li
- Geely University of China, 641423, Chengdu, China
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Erickson BJ, Bowman EN, Camp C, Freehill MT, Smith MV, Serio N, Ishikawa H, Smith K, Chalmers PN. Characteristics Associated With Noncompliance of Current Pitch Smart Guidelines in High School Baseball Pitchers Throughout the United States. Orthop J Sports Med 2023; 11:23259671231199085. [PMID: 37781638 PMCID: PMC10536850 DOI: 10.1177/23259671231199085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/19/2023] [Indexed: 10/03/2023] Open
Abstract
Background Although pitch count and rest guidelines have been promoted for youth and adolescent baseball players for nearly 2 decades, compliance with guidelines remains poorly understood. Purpose/Hypothesis The purpose of this study was to determine the frequency of compliance with Major League Baseball (MLB) Pitch Smart guidelines as well as the association between compliance and range of motion (ROM), strength, velocity, injury, and pitcher utilization. It was hypothesized that pitchers in violation of current recommendations would have increased strength, velocity, and injury. Study Design Case-control study; Level of evidence, 3. Methods This was a prospective, multicenter study of 115 high school pitchers throughout the United States. Pitchers were surveyed about their compliance with current off-season, rest-related guidelines, and history of injury. During the preseason, pitchers underwent standardized physical examinations, and pitch velocity was measured. Pitch counts were collected during the baseball season that followed. Dynamometer strength testing of shoulder forward flexion, and external rotation as well as grip strength was recorded. We compared pitchers who were compliant with recommendations with those who were noncompliant using Student t and Mann-Whitney U tests. Results Based on preseason data, 84% of pitchers had violated current Pitch Smart guidelines. During the season, 14% had at least 1 violation of the Pitch Smart guidelines. Across both the preseason survey and in-season pitch counts, 89% of players had at least 1 violation of the Pitch Smart guidelines. While there were no significant differences in ROM or strength, the noncompliant group had higher maximum pitch velocity than the compliant group (74 ± 8 vs 69 ± 5 mph [119 ± 13 vs 111 ± 8 kph], respectively; P = .009). Players' self-reported velocity differed significantly from the direct measurement, for both peak velocity (80 ± 6 vs 73 ± 8 mph [129 ± 9 vs 117 ± 13 kph], respectively; P < .001) and mean velocity (73 ± 8 vs 53 ± 27 mph [117 ± 13 vs 85 ± 43 kph], respectively; P < .001). Conclusion Most high school pitchers were not fully compliant with current Pitch Smart guidelines, and they tended to overestimate their peak velocity by 7 mph (11 kph). Pitchers who threw with greater velocity were at higher risk for violating Pitch Smart recommendations.
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Affiliation(s)
- Brandon J. Erickson
- Rothman Institute, New York, New York, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - Eric N. Bowman
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christopher Camp
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael T. Freehill
- Department of Orthopaedic Surgery, Stanford University, Palo Alto, California, USA
| | - Matthew V. Smith
- Department of Orthopaedic Surgery, Washington University in Saint Louis, Missouri, USA
| | | | - Hiroaki Ishikawa
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Karch Smith
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Peter N. Chalmers
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA
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Bowman EN, Camp CL, Erickson BJ, Freehill MT, Smith MV, Madia E, Matthews M, Simister S, Wheelwright C, Ishikawa H, Chalmers PN. Most high school baseball pitchers are using weighted ball throwing programs to increase ball velocity: crosssectional analysis of US high school pitchers. JSES REVIEWS, REPORTS, AND TECHNIQUES 2023; 3:137-141. [PMID: 37588444 PMCID: PMC10426506 DOI: 10.1016/j.xrrt.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Weighted-ball velocity training programs are popular but may be associated with increased injury risk. The purpose of this study was to determine the current frequency of these programs, as well as their association with range of motion, strength, velocity, injury, and utilization in high school baseball pitchers. Methods This was a multicenter, prospective, community-based study including high schools from the Northeastern, Southeastern, Midwestern, and Western regions of the United States. Preseason pitchers were surveyed about their use of weighted ball velocity programs and history of injury. Preseason pitchers underwent standardized physical examinations and pitch velocity was measured. During a single high school season, pitch counts and injury incidence were prospectively collected. Results In total, 115 pitchers were recruited, of whom 63% had participated in a weighted ball program. There were no differences in range of motion or strength between groups who used weighted balls and those who did not. Pitchers that utilized weighted ball programs demonstrated a higher average fastball velocity (114.26 vs. 106.22 km/h [71 vs. 66 mph]; P < .001) as well as peak fastball velocity (115.87 vs. 109.44 km/h [72 vs. 68 mph]; P = .001) compared to those that did not use weighted ball programs. Pitchers that utilized weighted ball programs were no more likely to be single-sport athletes (44%) than those who were multisport athletes (49%, P = .667). Within the group who had used a weighted ball program 29% (13/45) reported a history of injury and within the group who had not used a weighted ball program 25% (10/40) reported a history of injury (P = .687). As only a single injury occurred in the entire cohort, comparison of injury rates could not be completed. Conclusion In this prospective study, the majority of high school pitchers reported using weighted ball programs to increase velocity, and these programs were associated with increased average and peak velocity compared to pitchers who did not use weighted ball programs. There were no significant differences in injury history between the 2 groups. Further study is necessary to understand the injury risk associated with weighted ball programs.
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Affiliation(s)
- Eric N. Bowman
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | - Matthew V. Smith
- Department of Orthopaedic Surgery, Washington University in Saint Louis, MO, USA
| | - Eric Madia
- Athletes Warehouse, Pleasantville, NY, USA
| | - Mike Matthews
- Registered Physical Therapists, Salt Lake City, UT, USA
| | - Sam Simister
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
| | - Cade Wheelwright
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
| | - Hiroaki Ishikawa
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
| | - Peter N. Chalmers
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
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Fiegen AP, Nezlek SP, Loushin SR, Christoffer D, Verhoeven M, Kaufman KR, Camp CL. Changes in Elbow Stress and Ball Velocity During Reduced Effort Pitching: A Marker-Based Motion Capture Analysis. Am J Sports Med 2023; 51:779-785. [PMID: 36625428 DOI: 10.1177/03635465221144020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Baseball pitchers often participate in throwing programs that involve throwing at reduced effort levels to gradually increase the amount of stress experienced across the elbow. It is currently unknown how reduced effort pitching compares with maximum effort with respect to elbow stress and ball velocity. PURPOSE/HYPOTHESIS The purpose was to determine the correlation between elbow stress and ball velocity with reduced effort pitching. We hypothesized that decreased perceived effort would disproportionately correlate with elbow stress and ball velocity. STUDY DESIGN Descriptive laboratory study. METHODS Ten healthy male high school baseball pitchers threw 5 pitches from a regulation pitching mound at 3 effort levels: maximum effort, 75% effort, and 50% effort. Elbow stress, specifically elbow varus torque, was calculated for all pitches using a validated marker-based 3-dimensional motion capture system. Ball velocity was measured using a Doppler radar gun. Intrathrower variability was calculated for each effort level. RESULTS Elbow stress and ball velocity decreased with reduced effort throws (P < .001 and P = .003, respectively). However, the reductions in elbow stress and ball velocity were not proportional. At 75% effort throws, elbow stress measured 81% (intraclass correlation coefficient [ICC], 0.95), and ball velocity measured 90% (ICC, 0.80) of maximum, respectively. At 50% effort throws, elbow stress measured 75% (ICC, 0.93), and ball velocity measured 85% (ICC, 0.87) of maximum. Intrathrower reliability was excellent for elbow stress and ball velocity, with all ICCs ≥0.80. CONCLUSION Pitching at a reduced effort level resulted in decreased elbow stress and ball velocity. However, for every 25% reduction in perceived effort, elbow stress decreased by a mean 13%, and ball velocity decreased 7.5%. When baseball pitchers attempt to throw at a reduced effort of maximum, throwing metrics do not decrease proportionately. CLINICAL RELEVANCE While pitching at a reduced effort of maximum decreases elbow stress and ball velocity, the decrease is not proportional, subjecting the elbow to more stress than intended. This has significant clinical importance to pitchers, coaches, and medical professionals in the setting of injury prevention and return to sports.
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Affiliation(s)
- Anthony P Fiegen
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Stuart P Nezlek
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Stacy R Loushin
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Dan Christoffer
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Kenton R Kaufman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Christopher L Camp
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Colomar J, Corbi F, Baiget E. Improving Tennis Serve Velocity: Review of Training Methods and Recommendations. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lubowitz JH, Brand JC, Rossi MJ. Understanding the Disabled Throwing Shoulder Requires Updated Review of Anatomy, Mechanics, Pathomechanics, and Treatment. Arthroscopy 2022; 38:1379-1380. [PMID: 35501000 DOI: 10.1016/j.arthro.2022.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 02/27/2022] [Indexed: 02/02/2023]
Abstract
Understanding both shoulder health and shoulder pathology in throwers is relevant to overhead athletes, and also relevant to nonoverhead athletes and even nonathletes. The thrower's shoulder is a clinically relevant topic of medical research scholarship today. Some of the greatest advances in sports medicine result from our ability to visualize normal and pathologic anatomy of joints, including the shoulder, using a small camera and a fiberoptic light source, through small portals, and without disruptive surgical dissection, or, in a word, "arthroscopy." Updates on the thrower's shoulder, including anatomy, mechanics, pathomechanics, and treatment, are essential for clinicians and researchers treating or investigating the shoulder.
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Effects of 4 Weeks of Variability of Practice Training in Padel Double Right Wall: A Randomized Controlled Trial. Motor Control 2022; 26:278-290. [PMID: 35276662 DOI: 10.1123/mc.2021-0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/11/2022] [Accepted: 01/31/2022] [Indexed: 11/18/2022]
Abstract
This study aimed to analyze the effect of a variable practice training in the double wall right forehand by using wrist weights. Thirty-four experienced padel players participated in this study. Players were randomly distributed in two groups (control group [CG] and training group [TG]). The TG performed 1 month of variable training, induced by weighted wrist bands, twice a week, with the same number of sessions and volume of training as the CG. TG obtained significant difference in posttest measurements (effect size = 0.437) in terms of the number of successful shots compared to CG (effect size = 0.027). These findings showed a significant effect of the TG with respect to the CG. Results reinforce the role of variability in the exploration and reinforcement of motor learning.
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