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Dowling B, Hodakowski A, Olmanson BA, Cohn MR, Pauley PJ, Verma NN, Nicholson GP, Garrigues GE. Relationship Between Arm Path, Ball Velocity, and Elbow Varus Torque in Professional Baseball Pitchers. Orthop J Sports Med 2023; 11:23259671231202524. [PMID: 38045766 PMCID: PMC10693215 DOI: 10.1177/23259671231202524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/22/2023] [Indexed: 12/05/2023] Open
Abstract
Background Currently, most pitching instructors suggest a shorter arm path-the total distance the arm travels during pitching. Theoretically, this combination allows for better body segment sequencing, a more efficient energy transfer through the kinetic chain, and increased ball velocity, while limiting elbow varus torque. Hypothesis Shorter arm paths would be associated with increased ball velocity and decreased elbow varus torque. Study Design Descriptive laboratory study. Methods A total of 182 professional pitchers threw 8 to 12 fastball pitches while evaluated by 3-dimensional motion capture (480 Hz). The arm path was calculated as the total distance the hand marker traveled during the pitch. The pitch was divided into early, late, and total arm paths. A linear regression model assessed the interpitcher relationship between arm path, elbow varus torque, and ball velocity. A linear mixed-effects model with random intercepts assessed intrapitcher relationships. Results Interpitcher comparison showed that total arm path weakly correlated with greater elbow varus torque (P = .025). Strong correlations were found between ball velocity and early (R2 = 0.788; P < .001), late (R2 = 0.787; P = .024), and total arm paths (R2 = 0.792; P < .001). Strong positive intrapitcher correlations were found between elbow varus torque and early (R2 = 0.962; P < .001) and total arm path (R2 = 0.964; P < .001). For individual pitchers, there was a large variation in the early (30.1 ± 15.7 cm) and late (21.4 ± 12.1 cm) arm path. For every 30-cm (11.8-inch) increase in early arm path (the mean range for an individual pitcher), there was a 1.29-N (β = 0.0429) increase in elbow varus torque and a 0.354 m/s (0.79 mph) (β = 0.0118) increase in ball velocity. Conclusion A shorter arm path correlated with decreased elbow varus torque and decreased ball velocity in intrapitcher comparisons. Determining the individual mechanics that decrease elbow varus torque may help coaches and trainers correct these patterns. Clinical Significance A shorter arm path during the pitch can decrease elbow varus torque, which limits the load on the medial elbow but also has a detrimental effect on ball velocity. An improved understanding of the impact of shortening arm paths on stresses on the throwing arm may help minimize injury risk.
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Affiliation(s)
- Brittany Dowling
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, USA
| | | | | | - Matthew R. Cohn
- Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Patrick J. Pauley
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, USA
| | - Nikhil N. Verma
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, USA
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Gregory P. Nicholson
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, USA
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Grant E. Garrigues
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, USA
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
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Kew ME, Koo A, Manzi JE, Coladonato C, Estrada J, Dines JS, Carr JB. Kinematic Parameters Predictive of Pitch Velocity in Youth to Professional Baseball Pitchers: A Qualitative Systematic Review. Orthop J Sports Med 2023; 11:23259671231196539. [PMID: 38035212 PMCID: PMC10687953 DOI: 10.1177/23259671231196539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/26/2023] [Indexed: 12/02/2023] Open
Abstract
Background Specific kinematic factors have been found to contribute to faster pitch speeds, with poor mechanics leading to injury. Purpose To discuss the kinematic parameters that predict faster ball velocity among baseball pitchers. Study Design Systematic review. Methods Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the authors utilized the Cochrane Database of Systematic Reviews, PubMed (2008-2019), and OVID/MEDLINE (2008-2019) databases. Eligible articles included those that reported on kinematic factors predictive of ball velocity across youth, high school, collegiate, and professional levels of play. The quality of all included studies was evaluated by 2 reviewers using the Appraisal tool for Cross-Sectional Studies (AXIS). The lack of consistent study design or outcome variables precluded meta-analysis. Results A total of 584 studies were identified from the initial search with 12 included in final analysis (930 pitchers in total; 429 [46.1%] youth, 164 [17.6%] high school, 153 [16.5%] collegiate and 184 [19.8%] professional) with mean ball velocity of 71.1 mph (114.4 km/h). The average AXIS score was 16 out of a possible 20. The shoulder played a significant role in the generation of velocity-induced torques. Hip and shoulder separation was associated with a 2.6 ± 0.5 mph (4.1 ± 0.8 km/h) increase in velocity, whereas increased shoulder movement of the nonthrowing arm was negatively correlated with initial ball velocity (r2 = 0.798). Furthermore, hip/shoulder separation, decreased movement of the nonthrowing shoulder, trunk power and timing of maximum trunk rotation, increased contralateral trunk tilt and increased sagittal-plane trunk tilt, and decreased knee flexion at ball release were all associated with higher fastball speeds. Conclusion Multiple upper extremity and trunk kinematic parameters affect ball velocity, with significant contributions from the throwing shoulder and trunk, as well as nondominant arm. Understanding kinematic predictors of faster ball velocity can help guide training regimens.
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Affiliation(s)
- Michelle E. Kew
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Alexander Koo
- Weill Cornell Medical College, New York, New York, USA
| | | | - Carlo Coladonato
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Jennifer Estrada
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Joshua S. Dines
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - James B. Carr
- Sports Medicine Institute, Hospital for Special Surgery Florida, West Palm Beach, Florida, USA
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Barfield JW. Letter to the Editor regarding Manzi et al: "Elbow varus torque and ball velocity associations in high school and professional pitchers with increased sagittal-plane trunk tilt". J Shoulder Elbow Surg 2023; 32:e129. [PMID: 36496137 DOI: 10.1016/j.jse.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/10/2022] [Accepted: 10/20/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Jeff W Barfield
- Physical Education and Exercise Science Department, Lander University, Greenwood, SC, USA
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Manzi JE, Wang Z, Wright-Chisem J, Dowling B, Moran J, Sudah SY, Nicholson A, Dennis E, Dines JS. Response to Barfield regarding: "Elbow varus torque and ball velocity associations in high school and professional pitchers with increased sagittal-plane trunk tilt". J Shoulder Elbow Surg 2023; 32:e130-e131. [PMID: 36496138 DOI: 10.1016/j.jse.2022.10.019] [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: 09/29/2022] [Accepted: 10/13/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Joseph E Manzi
- Department of Orthopaedic Surgery, Lenox Hill, New York, NY, USA
| | - Zhaorui Wang
- Weill Cornell Medical College, New York, NY, USA
| | | | - Brittany Dowling
- Sports Performance Center, Midwest Orthopaedics at Rush, Chicago, IL, USA
| | - Jay Moran
- Yale School of Medicine, Stamford, CO, USA
| | - Suleiman Y Sudah
- Department of Orthopaedic Surgery, Monmouth Medical Center, Monmouth, NJ, USA
| | - Allen Nicholson
- Department of Orthopaedic Surgery, Monmouth Medical Center, Monmouth, NJ, USA
| | - Elizabeth Dennis
- Department of Orthopaedic Surgery, Mount Sinai Medical Center, New York, NY, USA
| | - Joshua S Dines
- Sports Medicine Institute Hospital for Special Surgery, New York, NY, USA
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Fava AW, Giordano KA, Friesen KB, Nguyen A, Oliver GD. Comparison of Trunk and Pelvic Kinematics in Youth Baseball Pitchers With and Without Upper Extremity Pain: A Cross-Sectional Study. Orthop J Sports Med 2023; 11:23259671221145679. [PMID: 36743724 PMCID: PMC9893373 DOI: 10.1177/23259671221145679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/26/2022] [Indexed: 01/27/2023] Open
Abstract
Background Motion of the pelvis and trunk during baseball pitching is associated with increased upper extremity (UE) kinetics. Increased kinetics on the UE may lead to throwing-arm pain in youth pitchers. Limited biomechanical comparisons have been conducted on youth pitchers with and without throwing-arm pain to identify mechanical risk factors associated with pain. Purpose To examine trunk and pelvic kinematics in youth baseball pitchers with and without UE pain. Study Design Cross-sectional study; Level of evidence, 3. Methods A total of 26 male youth baseball pitchers (mean age, 12.7 ± 1.5 years; mean height, 162.2 ± 12.9 cm; mean weight, 52.6 ± 13.1 kg) were recruited to participate. An electromagnetic tracking system was used to obtain kinematic data during the fastball pitch. Data from a health history questionnaire was examined. Participants who answered "yes" to experiencing pain and who selected a region on their UE as the pain location were placed into the UE pain group. Participants who responded "no" to experiencing pain were placed into the pain-free group. We compared between-group differences in trunk rotation, flexion, and lateral flexion; pelvic rotation, anteroposterior tilt, and lateral tilt; and hip-shoulder separation from peak knee height to ball release of the baseball pitch using 1-dimensional statistical parametric mapping with an alpha level set at .05. Results No statistically significant differences were observed between the UE pain and pain-free groups in the 7 trunk and pelvic kinematics analyzed from peak knee height to ball release (P > .05). Conclusion Trunk and pelvic kinematics during the pitching motion did not differ between pain and pain-free groups of youth baseball pitchers.
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Affiliation(s)
- Anthony W. Fava
- Sports Medicine and Movement Laboratory, School of Kinesiology,
Auburn University, Auburn, Alabama, USA
| | - Kevin A. Giordano
- Department of Physical Therapy, School of Pharmacy and Health
Professions, Creighton University, Omaha, Nebraska, USA
| | - Kenzie B. Friesen
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta,
Canada
| | - Adam Nguyen
- Sports Medicine and Movement Laboratory, School of Kinesiology,
Auburn University, Auburn, Alabama, USA
| | - Gretchen D. Oliver
- Sports Medicine and Movement Laboratory, School of Kinesiology,
Auburn University, Auburn, Alabama, USA.,Gretchen D. Oliver, PhD, Sports Medicine and Movement
Laboratory, School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL
36849, USA ()
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Everhart KM, Friesen KB, Bordelon NM, Fava AW, Plummer HA, Shannon DM, Oliver GD. Single-Leg Squat and Reported Pain in Collegiate Softball Pitchers. Orthop J Sports Med 2023; 11:23259671221144757. [PMID: 36655020 PMCID: PMC9841856 DOI: 10.1177/23259671221144757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 09/26/2022] [Indexed: 01/15/2023] Open
Abstract
Background Single-leg squat (SLS) performance is related to altered mechanics related to injury during the windmill softball pitch; however, it is unknown if SLS kinematics differ between softball pitchers with and without upper extremity pain. Purpose/Hypothesis The purpose of this study was to compare knee valgus, trunk rotation, trunk lateral flexion, and trunk flexion during an SLS in collegiate softball pitchers with and without self-reported upper extremity pain. It was hypothesized that those who reported upper extremity pain would show increased compensatory trunk and knee kinematics compared with those without pain. Study Design Controlled laboratory study. Methods A total of 75 collegiate softball players (mean age, 20.4 ± 1.7 years; mean height, 173.3 ± 7.7 cm; mean weight, 79.1 ± 11.6 kg) participated and were placed in pain (n = 20) or no-pain (n = 55) groups. Participants performed an SLS once per side. Kinematic data were collected at 100 Hz using an electromagnetic tracking system. A 2 (pain vs no pain) × 2 (descent vs ascent) × 2 (drive leg vs stride leg) mixed-design multivariate analysis of variance with Wilks lambda distribution was used to determine differences in drive-leg and stride-leg lower body mechanics between the descent and ascent phases of the SLS between the pitchers in the current study with and without pain. Results There was no significant effect in the 3-way interaction between upper extremity pain, side, and phase (Λ = 0.960; F[4, 70] = 0.726; P = .577; η2 = 0.04). However, there were large effects for the phase × side interaction (Λ = 0.850; P = .021; η2 = 0.150). There was a main effect of phase (Λ = 0.283; P < .001; η2 = 0.717). Conclusion Study findings indicated that SLS mechanics do not differ between collegiate softball pitchers with and without reported upper extremity pain. Drive-leg mechanics showed more stability in the SLS than stride-leg mechanics. Clinical Relevance Softball pitchers are at risk of upper extremity injury. It is important to identify mechanisms that may lead to pain in order to mitigate the risk of injury.
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Affiliation(s)
- Katherine M. Everhart
- Sports Medicine & Movement Laboratory, School of Kinesiology, Auburn University, Auburn, Alabama, USA
| | - Kenzie B. Friesen
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Nicole M. Bordelon
- Sports Medicine & Movement Laboratory, School of Kinesiology, Auburn University, Auburn, Alabama, USA
| | - Anthony W. Fava
- Sports Medicine & Movement Laboratory, School of Kinesiology, Auburn University, Auburn, Alabama, USA
| | | | - David M. Shannon
- Educational Research and Evaluation, Auburn University, Auburn, Alabama, USA
| | - Gretchen D. Oliver
- Sports Medicine & Movement Laboratory, School of Kinesiology, Auburn University, Auburn, Alabama, USA
- Gretchen D. Oliver, PhD, Sports Medicine & Movement Laboratory, School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL 36849, USA ()
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