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Yanagisawa O. Alterations in pitching biomechanics and performance with an increasing number of pitches in baseball pitchers: A narrative review. PM R 2024; 16:632-643. [PMID: 37574914 DOI: 10.1002/pmrj.13054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/09/2023] [Accepted: 07/28/2023] [Indexed: 08/15/2023]
Abstract
In baseball pitchers, the association of fatigue with overuse injury and decline in pitching performance has been discussed frequently, but the scientific data concerning their interrelationships have been inconsistently reported. The purpose of this narrative review is to summarize and explore the evidence regarding acute changes in pitching biomechanics and performance from repetitive throwing motions among baseball pitchers. Muscle fatigue from repetitive throwing not only decreases muscle output but also disturbs the kinetic chain of baseball pitching. In addition, repetitive throwing can impair the proprioceptive and kinesthetic functions needed for accurate joint position sense in the shoulder and elbow. Consequently, these changes negatively affect ball velocity and pitching accuracy, two critical aspects of overall pitching performance. Moreover, the cumulative loading caused by fatigue contributes to the high prevalence of overuse injuries, particularly in the elbow and shoulder joints. Thus it is important to comprehensively understand the relationships among changed pitching mechanics, deteriorated performance, and musculoskeletal injury originating from muscle fatigue due to repetitive pitching.
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Affiliation(s)
- Osamu Yanagisawa
- Faculty of Business Information Sciences, Jobu University, Isesaki, Japan
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van Trigt B, van Hogerwou T, Leenen TAJR, Hoozemans MJM, van der Helm FCT, Veeger DHEJ. Magnitude and variability of individual elbow load in repetitive baseball pitching. Sci Rep 2023; 13:17250. [PMID: 37821633 PMCID: PMC10567693 DOI: 10.1038/s41598-023-44333-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023] Open
Abstract
In baseball pitchers the elbow is exposed to high and repetitive loads (i.e. external valgus torque), caused by pitching a high number of balls in a practice session or game. This can result in overuse injuries like the ulnar collateral ligament (UCL) injury. To understand injury mechanisms, the effect of repetitive pitching on the elbow load magnitude and variability was investigated. In addition, we explored whether repetitive pitching affects elbow muscle activation during pitching. Fifteen pitchers threw each 60 to 110 balls. The external valgus torque and electromyography of three elbow muscles were quantified during each pitch. Linear mixed model analyses were performed to investigate the effect of repetitive pitching. On a group level, the linear mixed models showed no significant associations of repetitive pitching with valgus torque magnitude and variability and elbow muscle activity. Significant differences exist between pitchers in their individual trajectories in elbow valgus torque and muscle activity with repetitive pitching. This shows the importance of individuality in relation to repetitive pitching. In order to achieve effective elbow injury prevention in baseball pitching, individual characteristics of changes in elbow load and muscle activity in relation to the development of UCL injuries should be investigated.
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Affiliation(s)
- Bart van Trigt
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands.
| | - Thomas van Hogerwou
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands
| | - Ton A J R Leenen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 9, 1081 BT, Amsterdam, the Netherlands
| | - Marco J M Hoozemans
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 9, 1081 BT, Amsterdam, the Netherlands
| | - Frans C T van der Helm
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands
| | - DirkJan H E J Veeger
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands
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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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Mair H, Kenney NA, Uhl TL, Ullery LR, Hosey RG. Effect of Pitching Restrictions and Mound Distance on Youth Baseball Pitch Counts. Orthop J Sports Med 2022; 10:23259671221110547. [PMID: 35859649 PMCID: PMC9289911 DOI: 10.1177/23259671221110547] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Studies have shown that higher pitch counts are directly related to a greater
incidence of elbow and shoulder pain among youth baseball pitchers. Purpose/Hypothesis: The purpose of this study was to examine the effect of different pitching
restriction rules on the number of pitches thrown in youth baseball leagues.
We hypothesized that more pitches would be thrown in leagues with inning
restrictions versus leagues with pitch count restrictions as well as in
leagues with a longer mound distance (from pitching mound to home
plate). Study Design: Cohort study; Level of evidence, 2. Methods: Pitch count data were collected for 2 consecutive years over a 10-week season
from 3 different leagues of 9- to 12-year-old baseball players in a single
city. The Eastern league had a pitch count restriction and 46-ft (14.02-m)
mound distance. The Southeastern and South leagues’ pitching restrictions
were based on innings per week. The Southeastern league had a 50-ft
(15.24-m) mound distance, while the South league had a 46-ft mound distance.
Comparisons of total seasonal pitches thrown were made of the 3
highest-volume pitchers on each team. League averages for each value were
then compared utilizing analysis of variance with Bonferroni post hoc
analysis. The number of pitchers in each league who threw >600 pitches
per season was compared using the chi-square test. Results: No significant difference in seasonal pitch counts or innings pitched was
noted between the Eastern and South leagues, which differed only in their
pitching restrictions. The Southeastern league, with a longer mound
distance, was found to have higher seasonal pitch counts per thrower (598 ±
195 pitches) than the South league (463 ± 198 pitches) for the 3
highest-volume throwers for each team (P = .004). The
Southeastern league also had a significantly larger number of pitchers who
threw >600 pitches per season (33 vs 20 for Eastern and 13 for South;
P = .009). Conclusion: There was no significant difference in seasonal pitch counts when the leagues
in this study differed based on pitching restrictions. However, the league
with a greater mound distance (Southeastern) had higher seasonal pitch
counts for the highest-volume throwers. Pitching restrictions based on pitch
counts, as opposed to innings, may be advisable.
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Affiliation(s)
- Hailey Mair
- University of Kentucky Medical Center, Lexington, Kentucky, USA
| | | | - Timothy L Uhl
- University of Kentucky Medical Center, Lexington, Kentucky, USA
| | - L Robert Ullery
- University of Kentucky Medical Center, Lexington, Kentucky, USA
| | - Robert G Hosey
- University of Kentucky Medical Center, Lexington, Kentucky, USA
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Disabled Throwing Shoulder 2021 Update: Part 1-Anatomy and Mechanics. Arthroscopy 2022; 38:1714-1726. [PMID: 35307240 DOI: 10.1016/j.arthro.2022.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/15/2021] [Accepted: 02/03/2022] [Indexed: 02/02/2023]
Abstract
The purpose of this article is to provide updated information for sports health care specialists regarding the Disabled Throwing Shoulder (DTS). A panel of experts, recognized for their experience and expertise in this field, was assembled to address and provide updated information on several topics that have been identified as key areas in creating the DTS spectrum. Each panel member submitted a concise presentation on one of the topics within these areas, each of which were then edited and sent back to the group for their comments and consensus agreement in each area. Part 1 presents the following consensus conclusions and summary findings regarding anatomy and mechanics, including: 1) The current understanding of the DTS identifies internal impingement, resulting from a combination of causative factors, as the final common pathway for the great majority of the labral pathoanatomy; 2) intact labral anatomy is pivotal for glenohumeral stability, but its structure does not control or adapt well to shear or translational loads; 3) the biceps plays an active role in dynamic glenohumeral stability by potentiating "concavity compression" of the glenohumeral joint; 4) the ultimate function of the kinetic chain is to optimize the launch window, the precise biomechanical time, and position for ball release to most effectively allow the ball to be thrown with maximum speed and accuracy, and kinetic chain function is most efficient when stride length is optimized; 5) overhead throwing athletes demonstrate adaptive bony, capsular, and muscular changes in the shoulder with repetitive throwing, and precise measurement of shoulder range of motion in internal rotation, external rotation, and external rotation with forearm pronation is essential to identify harmful and/or progressive deficits. LEVEL OF EVIDENCE: Level V, expert opinion.
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Friesen KB, Aguinaldo A, Oliver GD. Athlete body composition influences movement during sporting tasks: an analysis of softball pitchers' joint angular velocities. Sports Biomech 2022:1-14. [PMID: 35410589 DOI: 10.1080/14763141.2022.2060853] [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] [Received: 02/08/2021] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
Abstract
Softball pitchers are often above-average size and frequently injured; therefore, it is necessary to understand how biomechanics can change according to pitcher body composition. The purpose of this study was to examine the relationship between joint peak angular velocities and pitch velocity, as well as examine how pitchers' joint angular velocities differ between high and healthy body-fat percentage (BF%) groups. Forty high-school and college softball pitchers (170.6 ± 6.3 cm, 75.5 ± 16.1 kg, 16 ± 2 years, 34.6 ± 7.4 BF%) completed body composition testing and were placed in one of two groups: 1) high-fat% (≥32%) or 2) healthy-fat% (<32%). Pitchers completed fastball trials. Kinematic data were tracked using an electromagnetic system synced with motion analysis software. Peak and times-series joint angular velocities were tracked over the final 101 frames of the pitch. Pitch velocity was significantly correlated with peak elbow flexion (r = .380, p = .016) and wrist flexion (r = .621, p < .001) angular velocity. A small difference in elbow joint angular velocity was found between body fat percentage groups between ball release and follow-through (SPM(t)1,38 = 3.296, p = .003). Peak joint angular velocities are related to pitch velocity and slight differences in movement patterns exist according to pitcher body fat percentage.
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Affiliation(s)
- Kenzie B Friesen
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Arnel Aguinaldo
- College of Kinesiology, Point Loma Nazarene University, San Diego, CA, USA
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Friesen KB, Saper MG, Oliver GD. Biomechanics Related to Increased Softball Pitcher Shoulder Stress: Implications for Injury Prevention. Am J Sports Med 2022; 50:216-223. [PMID: 34779664 PMCID: PMC8739590 DOI: 10.1177/03635465211055141] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Softball pitchers exhibit high throwing shoulder distraction force, which is a theorized mechanism of throwing shoulder overuse injury. Windmill pitching involves a variety of highly individualistic pitching styles, and certain kinematics preceding ball release likely influence the amount of shoulder stress that a pitcher accrues. PURPOSE To examine the association of trunk and throwing arm kinematics, kinetics, and timing variables with peak throwing shoulder distraction force in high school softball pitchers. STUDY DESIGN Descriptive laboratory study. METHODS A total of 37 high school pitchers (mean ± SD; height, 1.71 ± 0.06 m; weight, 75.53 ± 16.12 kg; age, 16 ± 2 years) threw 10 fastball pitches at regulation distance (43 ft [13.1 m]) and with maximum effort. Kinematic data were collected at 240 Hz using an electromagnetic motion capture system synced with motion analysis software. The 3 fastest pitches were averaged and analyzed. Kinematic, kinetic, and timing variables were entered into a stepwise linear regression analysis. RESULTS Four variables were included in the significant model (F4,39 = 147.51; P < .001) and explained peak shoulder distraction force (R2 = 0.944; adjusted R2 = 0.938; SE = 0.036): increased peak elbow distraction force (t = 19.90; P < .001) and extension moment (t = 3.63; P = .001), as well as decreased elbow flexion velocity (t = -2.37; P = .023) and trunk flexion at foot contact of the pitch (t = -3.00; P = .005). CONCLUSION Elbow kinetics and angular velocity, as well as trunk positioning at foot contact, are associated with peak throwing shoulder distraction force in high school softball pitchers. CLINICAL RELEVANCE Variables associated with peak throwing shoulder distraction force provide information regarding injury mechanism and coachable cues that might reduce shoulder injury risk among pitchers.
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Affiliation(s)
- Kenzie B. Friesen
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada,Kenzie B. Friesen, PhD, College of Kinesiology, University of Saskatchewan, 87 Campus Dr, Saskatoon, SK S7N 5B2, Canada () (Twitter: @kfreeze17)
| | - Michael G. Saper
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington, USA
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Sterner JA, Reaves SK, Aguinaldo AL, Hazelwood SJ, Klisch SM. Inverse dynamics analysis of youth pitching arm kinetics using body composition imaging. Sports Biomech 2020; 21:993-1007. [DOI: 10.1080/14763141.2020.1715470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Jay A. Sterner
- Mechanical Engineering, College of Engineering, Cal Poly State University, San Luis Obispo, CA, USA
| | - Scott K. Reaves
- Food Science & Nutrition, College of Agriculture, Food, and Environmental Sciences, Cal Poly State University, San Luis Obispo, CA, USA
| | - Arnel L. Aguinaldo
- Kinesiology, College of Kinesiology, Point Loma Nazarene University, San Diego, CA, USA
| | - Scott J. Hazelwood
- Mechanical Engineering, College of Engineering, Cal Poly State University, San Luis Obispo, CA, USA
- Biomedical Engineering, College of Engineering, Cal Poly State University, San Luis Obispo, CA, USA
| | - Stephen M. Klisch
- Mechanical Engineering, College of Engineering, Cal Poly State University, San Luis Obispo, CA, USA
- Biomedical Engineering, College of Engineering, Cal Poly State University, San Luis Obispo, CA, USA
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Aguinaldo A, Escamilla R. Segmental Power Analysis of Sequential Body Motion and Elbow Valgus Loading During Baseball Pitching: Comparison Between Professional and High School Baseball Players. Orthop J Sports Med 2019; 7:2325967119827924. [PMID: 30828584 PMCID: PMC6390228 DOI: 10.1177/2325967119827924] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Pitching-related elbow injuries remain prevalent across all levels of
baseball. Elbow valgus torque has been identified as a modifiable risk
factor of injuries to the ulnar collateral ligament in skeletally mature
pitchers. Purpose: To examine how segmental energy flow (power) influences elbow valgus torque
and ball speed in professional versus high school baseball pitchers. Study Design: Descriptive laboratory study. Methods: A total of 16 professional pitchers (mean age, 21.9 ± 3.6 years) and 15 high
school pitchers (mean age, 15.5 ± 1.1 years) participated in marker-based
motion analysis of baseball pitching. Ball speed, maximum elbow valgus
torque (MEV), temporal parameters, and mechanical power of the trunk, upper
arm, and forearm were collected and compared using parametric statistical
methods. Results: Professional pitchers threw with a higher ball speed (36.3 ± 2.9 m/s)
compared with high school pitchers (30.4 ± 3.5 m/s) (P =
.001), and MEV was greater in professional pitchers (71.3 ± 20.0 N·m) than
in high school pitchers (50.7 ± 14.6 N·m) (P = .003). No
significant difference in normalized MEV was found between groups
(P = .497). Trunk rotation time, trunk power, and upper
arm power combined to predict MEV (r = 0.823,
P < .001), while trunk rotation time and trunk power
were the only predictors of ball speed (r = 0.731,
P < .001). There were significant differences
between the professional and high school groups in the timing of maximum
pelvis rotation velocity (42.9 ± 9.7% of the pitching cycle [%PC] vs 27.9 ±
23.4 %PC, respectively; P < .025), maximum trunk
rotation (33 ± 16 %PC vs 2 ± 23 %PC, respectively; P =
.001), and maximum shoulder internal rotation velocity (102.4 ± 8.9 %PC vs
93.0 ± 11.7 %PC, respectively; P = .017). Conclusion: The power of trunk motion plays a critical role in the development of elbow
valgus torque and ball speed. Professional and high school pitchers do not
differ in elbow torque relative to their respective size but appear to adopt
different patterns of segmental motion. Clinical Relevance: Because trunk rotation supplies the power associated with MEV and ball speed,
training methods aimed at core stabilization and flexibility may benefit
professional and high school pitchers in reducing the injury risk and
improving pitching performance.
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Affiliation(s)
| | - Rafael Escamilla
- California State University-Sacramento, Sacramento, California, USA
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