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Tremblay M, Anderson Sirois S, Verville W, Auger M, Abboud J, Descarreaux M. Acute Upper-Body and Lower-Body Neuromuscular Fatigue Effect on Baseball Pitchers' Velocity: A Pilot Study. J Strength Cond Res 2024:00124278-990000000-00453. [PMID: 38838214 DOI: 10.1519/jsc.0000000000004822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
ABSTRACT Tremblay, M, Anderson Sirois, S, Verville, W, Auger, M, Abboud, J, and Descarreaux, M. Acute upper-body and lower-body neuromuscular fatigue effect on baseball pitchers' velocity: A pilot study. J Strength Cond Res XX(X): 000-000, 2024-The purpose of this pilot study was to explore the acute effect of upper-body and lower-body neuromuscular fatigue protocols on baseball pitchers' velocity. Sixteen baseball pitchers were recruited, and a crossover design was used to meet the study purpose. Pitchers were tested twice, 7 days apart, with their upper-body and lower-body explosiveness, pitching velocity, and muscle soreness perception of their throwing arm (forearm flexors, biceps, anterior deltoid, and upper trapezius muscles) assessed before and after an upper-body and lower-body neuromuscular fatigue protocol. Two-way analysis of variances and paired t tests (p < 0.05) were used to identify and compare prescores and postscores. Following both fatigue protocols, results revealed a significant decrease in time for pitching velocity (p = 0.005, ηp2 = 0.462), and increases in muscle soreness perception of the forearm flexors (p = 0.005, ηp2 = 0.470), anterior deltoid (p = 0.045, ηp2 = 0.274), and upper trapezius (p = 0.023, ηp2 = 0.339) muscles. Paired t test results showed a significant decrease in preneuromuscular and postneuromuscular fatigue protocol in the upper-body (p < 0.01) and lower-body (p < 0.01) explosiveness scores. These pilot study results show the impact of different exercise protocols on pitchers' explosiveness, velocity, and muscle soreness perception emphasizing the need for further investigation into the acute effect of exercise targeting the upper or lower-body on pitching performance, specifically at the pitcher's position.
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Affiliation(s)
- Mathieu Tremblay
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; and
- Department of Human Kinetics, Groupe de recherche sur les affections neuromusculosquelettiques, Trois-Rivières, Québec, Canada
| | - Samuel Anderson Sirois
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; and
- Department of Human Kinetics, Groupe de recherche sur les affections neuromusculosquelettiques, Trois-Rivières, Québec, Canada
| | - William Verville
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; and
- Department of Human Kinetics, Groupe de recherche sur les affections neuromusculosquelettiques, Trois-Rivières, Québec, Canada
| | - Mathis Auger
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; and
- Department of Human Kinetics, Groupe de recherche sur les affections neuromusculosquelettiques, Trois-Rivières, Québec, Canada
| | - Jacques Abboud
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; and
- Department of Human Kinetics, Groupe de recherche sur les affections neuromusculosquelettiques, Trois-Rivières, Québec, Canada
| | - Martin Descarreaux
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada; and
- Department of Human Kinetics, Groupe de recherche sur les affections neuromusculosquelettiques, Trois-Rivières, Québec, Canada
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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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Hoenecke H, Fiske JW, Tamayo AE, D'Lima DD. Evolution of the throwing shoulder: why apes don't throw well and how that applies to throwing athletes. J Shoulder Elbow Surg 2024; 33:1404-1417. [PMID: 38316235 DOI: 10.1016/j.jse.2023.12.010] [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] [Received: 09/16/2023] [Revised: 12/04/2023] [Accepted: 12/17/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Humans have unique characteristics making us the only primate that can throw well while most other primates throw predominately underhand with poor speed and accuracy. The purpose of this study is to illuminate the uniquely human characteristics that allow us to throw so well. When treating an injury such as a labral tear or capsule tear, this study hopes the reader can gain a better understanding of the issues that lead to the tear and those that may determine the success of treatment besides the actual repair. METHODS In addition to a review of scientific and medical literature, information was obtained from interviews and experience with primate veterinarians, anthropologists, archeologists, and professional baseball players. These sources were used to study the connection between evolutionary throwing activities and current sports medicine issues. RESULTS Arm acceleration requires a functional kinetic chain, rapid motor sequences, and the ability to absorb elastic energy in the shoulder. Successful treatment of the throwing shoulder requires awareness of the shoulder's position in the kinetic chain and correction of defects in the ability to execute the kinetic chain. Some problems in the shoulder could reflect regression to a more primitive anatomy or dyskinesis. Return of performance requires regaining the elasticity in the tissues of the shoulder to temporarily store kinetic energy. For example, tissue remodeling after rotator cuff repair continues for months to years; however, the newly formed tissue lacks the same elasticity of the native tendon. This suggests why throwing performance typically does not return for 7 or more months after repair even though there may be structural integrity at 3-4 months. CONCLUSION The shoulder has developed uniquely in modern man for the act of throwing. The anatomic deficiencies in primates for throwing provide an illustration of the more subtle changes that a throwing athlete might have that are detrimental to throwing. Nonhuman primates have been unable to demonstrate the kinetic chain sequence for throwing secondary to the lack of neurologic pathways required. Humans are more sophisticated and precise in their movements but lack robusticity in their bone and muscle architecture, seen especially in the human rotator cuff. Successful treatment of a throwing injury requires familiarity with the conditions that cause the injury or affect the rehabilitation process. The return of performance following injury or surgery requires regaining the elasticity in the tissues of the shoulder to temporarily store kinetic energy from the kinetic chain.
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Affiliation(s)
- Heinz Hoenecke
- Division of Sports Medicine, Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA, USA; Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA.
| | | | | | - Darryl D D'Lima
- Division of Sports Medicine, Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA, USA; Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA
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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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Tsurukami H, Itoigawa Y, Uehara H, Hatae F, Kubota A, Mizuno M, Maezawa K, Takazawa Y, Ishijima M. Stiffness Changes in Shoulder Muscles between Pitchers and Position Players after Throwing Overhead Using Shear Wave Elastography and Throwing Motion Analysis. J Clin Med 2024; 13:2056. [PMID: 38610821 PMCID: PMC11012453 DOI: 10.3390/jcm13072056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/16/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
Objectives: The objective is to compare stiffness changes around the shoulder muscles between pitchers and position players after throwing overhead using shear wave elastography (SWE) in relation to throwing motion analysis and muscle strength. Methods: A total of 32 male college baseball players (12 pitchers and 20 position players) were observed throwing 20 times, and SWE was performed to evaluate 13 shoulder muscle items-tendons (supraspinatus, infraspinatus, subscapularis, and teres minor), muscles (supraspinatus, infraspinatus [transverse and oblique part], teres minor, lower trapezius, latissimus dorsi, and pectoralis minor), and capsules (posterior and posteroinferior). Motion analysis was used to assess elbow torque, forearm angle, forearm rotation speed, and maximum external rotation angle of the shoulder. Muscle strength was measured using a dynamometer for abduction, internal/external rotation of the shoulder at an abduction of 0°, internal/external rotation of the shoulder at an abduction of 90°, and internal/external rotation of shoulder at a flexion of 90°. Results: In the pitcher group, SWE values for the teres minor muscle and latissimus dorsi muscle increased significantly after throwing. In the position player group, SWE values for the teres minor muscle significantly increased, and SWE values of the pectoralis minor muscle decreased after throwing. In the pitcher group, positive correlations were found between the teres minor muscle and forearm rotation speed and between the latissimus dorsi muscle and forearm angle. No significant difference was found in muscle strength after throwing in any of the groups. Conclusions: Stiffness changes occurred after throwing and were related to the motion analysis, but the regions in which stiffness occurred varied between pitchers and position players.
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Affiliation(s)
- Hironori Tsurukami
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Urayasu 279-0021, Japan; (H.T.); (F.H.); (K.M.)
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan; (H.U.); (M.I.)
| | - Yoshiaki Itoigawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Urayasu 279-0021, Japan; (H.T.); (F.H.); (K.M.)
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan; (H.U.); (M.I.)
| | - Hirohisa Uehara
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan; (H.U.); (M.I.)
| | - Fumitoshi Hatae
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Urayasu 279-0021, Japan; (H.T.); (F.H.); (K.M.)
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan; (H.U.); (M.I.)
| | - Atsushi Kubota
- Graduate School of Health and Sports Science, Juntendo University, Inzai 270-1695, Japan; (A.K.); (M.M.); (Y.T.)
- Department of Sports Medicine, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan
| | - Motoki Mizuno
- Graduate School of Health and Sports Science, Juntendo University, Inzai 270-1695, Japan; (A.K.); (M.M.); (Y.T.)
| | - Katsuhiko Maezawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Urayasu 279-0021, Japan; (H.T.); (F.H.); (K.M.)
| | - Yuuji Takazawa
- Graduate School of Health and Sports Science, Juntendo University, Inzai 270-1695, Japan; (A.K.); (M.M.); (Y.T.)
- Department of Sports Medicine, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan
| | - Muneaki Ishijima
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Hongo, Tokyo 113-0034, Japan; (H.U.); (M.I.)
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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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Hong Y, Bao D, Manor B, Zhou Y, Zhou J. Effects of endurance exercise on physiologic complexity of the hemodynamics in prefrontal cortex. NEUROPHOTONICS 2024; 11:015009. [PMID: 38515930 PMCID: PMC10956706 DOI: 10.1117/1.nph.11.1.015009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/23/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024]
Abstract
Significance Prefrontal cortex (PFC) hemodynamics are regulated by numerous underlying neurophysiological components over multiple temporal scales. The pattern of output signals, such as functional near-infrared spectroscopy fluctuations (i.e., fNIRS), is thus complex. We demonstrate first-of-its-kind evidence that this fNIRS complexity is a marker that captures the influence of endurance capacity and the effects of hydrogen gas (H 2 ) on PFC regulation. Aim We aim to explore the effects of different physical loads of exercise as well as the intaking of hydrogen gas on the fNIRS complexity of the PFC. Approach Twenty-four healthy young men completed endurance cycling exercise from 0 (i.e., baseline) to 100% of their physical loads after intaking 20 min of either H 2 or placebo gas (i.e., control) on each of two separate visits. The fNIRS measuring the PFC hemodynamics and heart rate (HR) was continuously recorded throughout the exercise. The fNIRS complexity was quantified using multiscale entropy. Results The fNIRS complexity was significantly greater in the conditions from 25% to 100% of the physical load (p < 0.0005 ) compared with the baseline and after intaking H 2 before exercise; this increase of fNIRS complexity was significantly greater compared with the control (p = 0.001 ∼ 0.01 ). At the baseline, participants with a greater fNIRS complexity had a lower HR (β = - 0.35 ∼ - 0.33 , p = 0.008 ∼ 0.02 ). Those with a greater increase of complexity had a lower increase of the HR (β = - 0.30 ∼ - 0.28 , p = 0.001 ∼ 0.002 ) during exercise. Conclusions These observations suggest that fNIRS complexity would be a marker that captures the adaptive capacity of PFC to endurance exercise and to the effects of interventions on PFC hemodynamics.
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Affiliation(s)
- Yinglu Hong
- Beijing Sport University, School of Sport Medicine and Physical Therapy, Beijing, China
| | - Dapeng Bao
- Beijing Sport University, China Institute of Sport and Health Science, Beijing, China
| | - Brad Manor
- Hebrew Senior Life Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, Massachusetts, United States
| | - Yuncong Zhou
- Beijing Sport University, School of Education, Beijing, China
| | - Junhong Zhou
- Hebrew Senior Life Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, Massachusetts, United States
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Nara M, Samukawa M, Oba K, Ishida T, Takahashi Y, Kasahara S, Tohyama H. Repetitive pitching decreases the elbow valgus stability provided by the flexor-pronator mass: the effects of repetitive pitching on elbow valgus stability. J Shoulder Elbow Surg 2023; 32:1819-1824. [PMID: 37172887 DOI: 10.1016/j.jse.2023.03.026] [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] [Received: 12/03/2022] [Revised: 03/10/2023] [Accepted: 03/22/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Baseball pitching induces a large elbow valgus load, stressing the ulnar collateral ligament (UCL). Flexor-pronator mass (FPM) contraction contributes to valgus stability; however, repetitive baseball pitching may weaken the FPM contractile function. The present study investigated the effects of repetitive baseball pitching on the medial valgus stability measured using ultrasonography. We hypothesized that repetitive pitching would decrease elbow valgus stability. METHODS This was a controlled laboratory study. Fifteen young male baseball players at the collegiate level (age: 23.0 ± 1.4 years) were enrolled. The medial elbow joint space was measured using ultrasonography (B-mode, 12-MHz linear array transducer) in the following three conditions: at rest (unloaded), under 3 kg valgus load (loaded), and under valgus load with maximal grip contraction to activate FPM (loaded-contracted). All measurements were performed before and after the pitching tasks, which comprised five sets of 20 pitches. Two-way repeated-measures analysis of variance was applied to determine changes in the medial elbow joint space. The post hoc test with Bonferroni adjustment was applied to assess the changes within the time and condition. RESULTS The medial elbow joint space was significantly greater under the loaded than the unloaded and loaded-contracted conditions both before and after pitching (P < .001). In the loaded-contracted condition, the medial elbow joint space significantly increased after repetitive baseball pitching (P < .001). CONCLUSIONS The results of the present study indicated that repetitive baseball pitching reduced the elbow valgus stability. This reduction could be attributed to the decreased FPM contractile function. Insufficient contraction may increase the tensile load on the UCL with pitching. FPM contraction plays a role in narrowing the medial elbow joint space; however, repetitive baseball pitching reduced the elbow valgus stability. It has been suggested that sufficient rest and recovery of the FPM function are required to reduce the UCL injury risk.
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Affiliation(s)
| | - Mina Samukawa
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Kensuke Oba
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Tomoya Ishida
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | | | - Satoshi Kasahara
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Harukazu Tohyama
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
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Manzi JE, Dowling B, Wang Z, Quan T, Nolan J, Moran J, Morse KW, Nicholson A, Dines JS. Kinetic and kinematic comparisons in high school pitchers with low and high pitch location consistency. J Shoulder Elbow Surg 2022; 31:2620-2628. [PMID: 35931332 DOI: 10.1016/j.jse.2022.06.011] [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] [Received: 03/27/2022] [Revised: 05/29/2022] [Accepted: 06/19/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Although ball velocity has often been associated with increased kinetics at the upper extremity and risk of injury in youth and adolescent pitchers, it is unclear if the performance metric pitch location consistency has any positive or negative associations with pitching kinetics. METHODS High school pitchers (n = 59) pitched 8-12 fastballs using 3D motion capture (480 Hz). Pitchers were divided into high-consistency (HiCon) and low-consistency (LoCon) groups based on the absolute center deviation of each pitcher's pitch to the center of the pitcher's mean pitch location. Ninety-five percent confidence ellipses with major and minor radii were constructed, and kinematics and kinetics were compared between groups. RESULTS Compared with LoCon pitchers, HiCon pitchers had decreased lead hip flexion at elbow extension (40° ± 12° vs. 52° ± 13°, respectively, P = .008), and at foot contact, decreased back hip extension (-1° ± 10° vs. -10° ± 13°, respectively, P = .038) and increased back hip internal rotation (9° ± 15° vs. -2° ± 15°, respectively, P = .043). LoCon pitchers achieved maximum lead hip flexion earlier in the pitch (61.3% ± 23.2% vs. 75.8% ± 15.1%, respectively, P = .039). A multiregression model predicted 0.49 of variance in pitch location consistency using kinematic inputs. DISCUSSSION AND CONCLUSION Pitchers who differ in pitch location consistency outcomes do not appear to demonstrate physiologically unsafe kinematics. High school pitchers who strive for improved pitch consistency can consider adjusting parameters of hip kinematics during early portions of the pitch.
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Affiliation(s)
- Joseph E Manzi
- Department of Orthopaedic Surgery, Lenox Hill, New York, NY, USA.
| | - Brittany Dowling
- Sports Performance Center, Midwest Orthopaedics at Rush, Oak Brook, IL, USA
| | - Zhaorui Wang
- Department of Orthopaedic Surgery, Lenox Hill, New York, NY, USA
| | - Theodore Quan
- Department of Orthopedic Surgery, George Washington Hospital, Washington, DC, USA
| | | | - Jay Moran
- Yale University School of Medicine, New Haven, CT, USA
| | - Kyle W Morse
- Sports Medicine Institute Hospital for Special Surgery, New York, NY, USA
| | - Allen Nicholson
- Department of Orthopaedic Surgery, Monmouth Medical Center, Monmouth, NJ, USA
| | - Joshua S Dines
- Sports Medicine Institute Hospital for Special Surgery, New York, NY, USA.
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Dobos TJ, Bench RWG, McKinnon CD, Brady A, Boddy KJ, Holmes MWR, Sonne MWL. Validation of pitchAI TM markerless motion capture using marker-based 3D motion capture. Sports Biomech 2022:1-21. [PMID: 36409062 DOI: 10.1080/14763141.2022.2137425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 10/12/2022] [Indexed: 11/23/2022]
Abstract
This study sought to compare and validate baseball pitching mechanics, including joint angles and spatiotemporal parameters, from a single camera markerless motion capture solution with a 3D optical marker-based system. Ten healthy pitchers threw 2-3 maximum effort fastballs while concurrently using marker-based optical capture and pitchAITM (markerless) motion capture. Time-series measures were compared using R-squared (r2), and root mean square error (RMSE). Discrete kinematic measures at foot plant, maximal shoulder external rotation, and ball release, plus four spatiotemporal parameters were evaluated using descriptive statistics, Bland-Altman analyses, Pearson's correlation coefficients, p-values, r2, and RMSE. For time-series angles, r2 ranged from 0.69 (glove arm shoulder external rotation) to 0.98 (trunk and pelvis rotation), and RMSE ranged from 4.37° (trunk lateral tilt) to 20.78° (glove arm shoulder external rotation). Bias for individual joint angle and spatiotemporal parameters ranged from -11.31 (glove arm shoulder horizontal abduction; MER) to 12.01 (ball visible). RMSE was 3.62 m/s for arm speed, 5.75% height for stride length and 21.75 ms for the ball visible metric. pitchAITM can be recommended as a markerless alternative to marker-based motion capture for quantifying pitching kinematics. A database of pitchAITM ranges should be established for comparison between systems.
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Affiliation(s)
- Tyler J Dobos
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Ryan W G Bench
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | | | | | | | | | - Michael W L Sonne
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
- Chicago Cubs, Wrigley Field, Chicago, IL, USA
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Hong Y, Dong G, Li Q, Wang V, Liu M, Jiang G, Bao D, Zhou J. Effects of pre-exercise H2 inhalation on physical fatigue and related prefrontal cortex activation during and after high-intensity exercise. Front Physiol 2022; 13:988028. [PMID: 36117685 PMCID: PMC9478471 DOI: 10.3389/fphys.2022.988028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: In this study, we examined the effects of pre-exercise H2 gas inhalation on physical fatigue (PF) and prefrontal cortex (PFC) activation during and after high-intensity cycling exercise. Methods: Twenty-four young men completed four study visits. On the first two visits, the maximum workload (Wmax) of cycling exercise of each participant was determined. On each of the other two visits, participants inhaled 20 min of either H2 gas or placebo gas after a baseline test of maximal voluntary isometric contraction (MVIC) of thigh. Then participants performed cycling exercise under their maximum workload. Ratings of perceived exertion (RPE), heart rate (HR) and the PFC activation by using functional near-infrared spectroscopy (fNIRS) was measured throughout cycling exercise. The MVIC was measured again after the cycling. Results: It was observed that compared to control, after inhaling H2 gas, participants had significantly lower RPE at each workload phase (p < 0.032) and lower HR at 50% Wmax, 75% Wmax, and 100% Wmax during cycling exercise (p < 0.037); the PFC activation was also significantly increased at 75 and 100% Wmax (p < 0.011). Moreover, the H2-induced changes in PF were significantly associated with that in PFC activation, that is, those who had higher PFC activation had lower RPE at 75% Wmax (p = 0.010) and lower HR at 100% Wmax (p = 0.016), respectively. Conclusion: This study demonstrated that pre-exercise inhalation of H2 gas can alleviate PF, potentially by maintaining high PFC activation during high-intensity exercise in healthy young adults.
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Affiliation(s)
- Yinglu Hong
- School of Sport Medicine and Physical Therapy, Beijing Sport University, Beijing, China
| | - Gengxin Dong
- School of Sport Medicine and Physical Therapy, Beijing Sport University, Beijing, China
| | - Qian Li
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Vienna Wang
- California State University, Long Beach, CA, United States
| | - Meng Liu
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Guole Jiang
- Sports Coaching College, Beijing Sport University, Beijing, China
- National University of Defense Technology, Changsha, Hunan, China
| | - Dapeng Bao
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
- *Correspondence: Dapeng Bao,
| | - Junhong Zhou
- Hebrew Senior Life Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States
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12
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Hamer TJ, Rosen AB, Wilkins SJ, Nicholson KF, Bullock GS, Knarr BA. A Comparison of Pitching Biomechanics and Sport Specialization in High School Pitchers. Int J Sports Phys Ther 2022; 17:870-878. [PMID: 35949379 PMCID: PMC9340844 DOI: 10.26603/001c.37259] [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: 12/14/2021] [Accepted: 05/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background The prevalence of sport specialization in high school athletes continues to rise, particularly among baseball players. Previous research has focused on the incidence of injury among specialized and non-specialized athletes but has yet to examine the level of sport specialization and pitching biomechanics. Hypotheses/Purpose The purpose of this study was to investigate differences in pitching volume and biomechanics between low-, moderate-, and high-level specialized baseball pitchers. It was hypothesized that high-level specialized pitchers would have the most pitching volume within the current and previous years while low-level specialized pitchers would exhibit the least amount. The second hypothesis states that kinematics and kinetics commonly associated with performance and injury risk would differ between low-, moderate-, and high-level specialized pitchers. Study Design Case-Control Study. Methods Thirty-six high school baseball pitchers completed a custom sport specialization questionnaire before participating in a three-dimensional pitching motion analysis. Sport specialization was based off current guidelines and categorized as low-, moderate-, and high-level specialized based upon self-reported outcomes. Pitchers then threw ≈10 fastballs from a mound engineered to professional specifications. Data averaged across fastballs was used for biomechanics variables. Key pitching biomechanical and pitching volume variables were compared between low-, moderate-, and high-level specialized pitchers. Results High-level specialized pitchers were older (p = 0.003), had larger body mass (p = 0.05) and BMI (p = 0.045), and threw faster (p = 0.01) compared to low-level specialized pitchers. Pitching volume and pitching biomechanics were similar across groups. Conclusions Pitching biomechanics were similar across groups, although high-level specialized pitchers threw with significantly higher throwing velocity compared to low-level pitchers. The low amount of pitching volume throughout the season may be responsible for the lack of additional observed differences. Further research should examine the relationship between pitching biomechanics, upper extremity strength and flexibility, and sport specialization. Level of Evidence Level III.
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Affiliation(s)
- Tyler J Hamer
- Department of Biomechanics, University of Nebraska Omaha
| | - Adam B Rosen
- School of Health and Kinesiology, University of Nebraska Omaha
| | | | | | | | - Brian A Knarr
- Department of Biomechanics, University of Nebraska Omaha
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13
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Manzi JE, Dowling B, Wang Z, Luzzi A, Thacher R, Rauck RC, Dines JS. Pitching Mechanics and the Relationship to Accuracy in Professional Baseball Pitchers. Am J Sports Med 2022; 50:814-822. [PMID: 35006015 DOI: 10.1177/03635465211067824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Biomechanical predictors of pitching accuracy are underevaluated in baseball research. It is unclear how pitchers with higher accuracy differ in terms of kinematics and upper extremity kinetics. PURPOSE To differentiate high- and low-accuracy professional pitchers by full-body kinematic and upper extremity kinetic parameters. STUDY DESIGN Descriptive laboratory study. METHODS In total, 121 professional baseball pitchers threw 8 to 12 fastballs while assessed with motion-capture technology (480 Hz). Pitchers were divided into high-accuracy (n = 33), moderate-accuracy (n = 52), and low-accuracy (n = 36) groups based on the absolute center deviation of each pitcher's average pitch to the center of the pitching chart by greater or less than 0.5 SD from the mean, respectively. The 95% confidence ellipses with comparisons of major and minor radii and pitching probability density grids were constructed. Analysis of variance was used to compare kinematic and kinetic values between groups. RESULTS The absolute center deviation (14.5% ± 6.7% vs 33.5% ± 3.7% grid width; P < .001) was significantly lower in the high-accuracy compared with the low-accuracy group, with no significant difference in ball velocity (38.0 ± 1.7 vs 38.5 ± 2.0 m/s; P = .222). Lead knee flexion at ball release (30.6°± 17.8° vs 40.1°± 16.3°; P = .023) was significantly less for the high-accuracy pitchers. Peak normalized shoulder internal rotation torque (5.5% ± 1.0% vs 4.9% ± 0.7% body weight [BW] × body height [BH]; P = .008), normalized elbow varus torque (5.4% ± 1.0% vs 4.8% ± 0.7% BW × BH; P = .008), and normalized elbow medial force (42.9% ± 7.3% vs 38.6% ± 6.2% BW; P = .024) were significantly greater for the low-accuracy group compared with the high-accuracy group. CONCLUSION Professional pitchers with increased accuracy experienced decreased throwing arm kinetics. These pitchers had increased lead knee extension at later stages of the pitch, potentially providing more stable engagement with the ground and transference of kinetic energy to the upper extremities. Professional pitchers can consider increasing lead knee extension at the final stages of the pitch to improve the accuracy of their throws and mitigate elbow varus torque. CLINICAL RELEVANCE Increased elbow varus torque, shoulder internal rotation torque, and elbow medial force in less accurate pitchers may contribute to increased injury risk in this group.
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Affiliation(s)
| | - Brittany Dowling
- Sports Performance Center, Midwest Orthopaedics at Rush, Oak Brook, Illinois, USA
| | - Zhaorui Wang
- Weill Cornell Medical College, New York, NY, USA
| | - Andrew Luzzi
- Columbia University Irving Medical Center Orthopedic Surgery, New York, New York, USA
| | - Ryan Thacher
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Ryan C Rauck
- 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
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14
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Ma YW, Chen JL, Hsu CC, Lai YH. Design and Analysis of a Pitch Fatigue Detection System for Adaptive Baseball Learning. Front Psychol 2021; 12:741805. [PMID: 34966320 PMCID: PMC8711585 DOI: 10.3389/fpsyg.2021.741805] [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: 07/23/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022] Open
Abstract
Owing to the rapid development of information and communication technologies, such as the Internet of Things, artificial intelligence, and computer vision, in recent years, the concept of smart sports has been proposed. A pitch fatigue detection method that includes acquisition, analysis, quantification, aggregation, learning, and public layers for adaptive baseball learning is proposed herein. The learning determines the fatigue index of the pitcher based on the angle of the pitcher's elbow and back as the number of pitches increases. The coach uses this auxiliary information to avoid baseball injuries during baseball learning. Results show a test accuracy rate of 89.1%, indicating that the proposed method effectively provides reference information for adaptive baseball learning.
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Affiliation(s)
- Yi-Wei Ma
- Department of Electrical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Jiann-Liang Chen
- Department of Electrical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Chia-Chi Hsu
- Department of Electrical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Ying-Hsun Lai
- Department of Computer Science and Information Engineering, National Taitung University, Taitung, Taiwan
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15
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Manzi JE, Dowling B, Wang Z, Arzani A, Chen FR, Nicholson A, Dines JS. Kinematic and kinetic findings in high vs. low consistency professional baseball pitchers. J Orthop 2021; 27:28-33. [PMID: 34475727 DOI: 10.1016/j.jor.2021.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/15/2021] [Indexed: 12/15/2022] Open
Abstract
While the performance metric ball velocity has often been associated with increased kinetics at the upper extremity and risk of injury in baseball pitchers, it is unclear if the performance metric pitch location consistency has any positive/negative associations with pitching kinetics. Professional pitchers subdivided into high(Hcon) and low(Lcon) consistency groups were instructed to throw 8-12 fastballs while assessed with motion-capture technology(480 Hz). To further assess pitching consistency, 95% confidence ellipses with comparisons of major and minor radii were conducted with an external comparison to a cohort of high school pitchers. Lastly, kinematic and kinetic values were compared between Hcon and Lcon professional pitchers. Professional baseball pitchers(n = 338) had consistency in pitch location comparable to high school pitchers(n = 59) (22.0 ± 6.7 vs. 23.2 ± 7.5% grid width respectively, p-value = 0.21). Hcon professional pitchers(n = 91) compared to Lcon pitchers(n = 98) had a smaller major radius(15.2 ± 3.0 vs. 26.3 ± 5.9 respectively, p-value<0.001) and a smaller minor radius(9.4 ± 1.9 vs. 16.1 ± 4.4 respectively, p-value<0.001) in the 95% confidence ellipses. Hcon pitchers compared to Lcon pitchers had increased arm slot(59.7 ± 13.5 vs. 54.7 ± 12.4° respectfully, p-value = 0.009), trunk tilt(-33.4 ± 9.1 vs. -37.2 ± 8.9° respectfully, p-value = 0.004), and trunk lateral flexion(-27.1 ± 9.3 vs. -31.8 ± 9.0° respectfully, p-value<0.001) at ball release. These pitchers also had lower shoulder(112.4 ± 15.9 vs. 118.3 ± 15.1% BW respectfully, p-value = 0.001) and elbow distraction forces(110.5 ± 17 vs. 117.0 ± 15.2% BW respectfully, p-value = 0.006) during arm deceleration. Professional pitchers who approach a sidearm style of pitching, typically involving less contralateral trunk tilt, may achieve higher consistency in their throws while also experiencing diminished peak distractive forces at the elbow and shoulder.
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Affiliation(s)
| | - Brittany Dowling
- Sports Performance Center, Midwest Orthopaedics at Rush, Oak Brook, IL, USA
| | - Zhaorui Wang
- Weill Cornell Medical College, New York, NY, USA
| | | | - Frank R Chen
- Department of Anesthesiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Allen Nicholson
- Sports Medicine Institute Hospital for Special Surgery, New York, NY, USA
| | - Joshua S Dines
- Sports Medicine Institute Hospital for Special Surgery, New York, NY, USA
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16
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Fury MS, Oh LS, Linderman SE, Wright-Chisem J, Fury JN, Scarborough DM, Berkson EM. Return to Performance After Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers: A Case-Control Assessment of Advanced Analytics, Velocity, Spin Rates, and Pitch Movement. Orthop J Sports Med 2021; 9:23259671211035753. [PMID: 35111865 PMCID: PMC8801672 DOI: 10.1177/23259671211035753] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/25/2021] [Indexed: 11/24/2022] Open
Abstract
Background: There are limited data on the performance or pitching metrics of Major League Baseball (MLB) pitchers who returned to play after ulnar collateral ligament reconstruction (UCLR). Purpose: To describe MLB pitcher performance after return from primary UCLR, compare the velocity and pitch characteristics against the preoperative season, and determine if performance analytics can predict successful return to pitching after UCLR. Study Design: Case-control study; Level of evidence, 3. Methods: This study included 63 pitchers who underwent primary UCLR between 2015 and 2019. Publicly available advanced analytics and pitch metrics from the first 2 postoperative seasons were compared with the preoperative (index) season as well as with an uninjured control group. Results: Overall, 57% of the pitchers successfully returned to the MLB level. Although they threw significantly fewer pitches (P = .012) and innings (P = .022) in postoperative year 1 as compared with the index season, there were no significant differences in pitch velocity, release extension, perceived velocity, or performance as measured by advanced analytics. Also, as compared with the index season, returners demonstrated increased postoperative spin rates on curveballs (P = .001) and sliders (P = .010), and curveball horizontal movement was significantly increased (P = .007); however, horizontal movement was significantly decreased for 4-seam fastballs (P = .026), changeups (P = .005), and sinkers (P = .019). The vertical movement on 4-seam fastballs was greater (P < .001) in postoperative year 1, and the vertical movement on curveballs (P = .031) and sinkers (P = .010) was greater in postoperative year 2 when compared with the index season. Pitchers who failed to return to the MLB level had a lower preoperative strikeout percentage (P = .047), fewer strikeouts per 9 innings pitched (P = .046), fewer wins above replacement ([WAR]; P = .026), and lower player value (P = .030) than the pitchers who returned. Conclusion: Pitchers returning to the MLB level after UCLR demonstrated changes in pitch movement profiles and spin rates postoperatively, but there were no differences in velocity or many advanced analytics upon return. Pitchers with lower strikeout metrics, fewer WAR, and less player value before surgery may have an elevated risk of failing to return to the MLB level.
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Affiliation(s)
- Matthew S. Fury
- Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Luke S. Oh
- Sports Medicine Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shannon E. Linderman
- Sports Medicine Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Jacob N. Fury
- Delgado Community College, New Orleans, Louisiana, USA
| | - Donna M. Scarborough
- Sports Medicine Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Eric M. Berkson
- Sports Medicine Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
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17
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Kim BG, Lim SK, Kong S. The Relationship between Scapular Upward Rotation and Shoulder Internal and External Rotation Isokinetic Strength in Professional Baseball Pitchers. Healthcare (Basel) 2021; 9:healthcare9060759. [PMID: 34207473 PMCID: PMC8233980 DOI: 10.3390/healthcare9060759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
This study aims to assess the relationship between scapular upward rotation (SUR) across varying humeral-elevation angles (HEAs) and shoulder isokinetic strength and ratio in professional baseball pitchers. The subjects were professional baseball pitchers (n = 16) without a history of shoulder injury in the last six months. The subject’s SUR angles were measured with the humerus elevated at HEAs of 0° (at rest), 60°, 90°, and 120° to the scapular plane. Shoulder isokinetic strength was evaluated for shoulder internal rotation (IR) and external rotation (ER) strength (PT%BW and TW%BW), and the ER/IR strength ratios were determined at 60, 120 and 180°/s using an isokinetic dynamometer. The SUR angle at an HEA of 0° was positively correlated with IR strength at 120°/s (r = 0.535) and 180°/s (r = 0.522). The SUR angle at an HEA of 60° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.505) and 120°/s (r = −0.500). The SUR angle at an HEA of 90° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.574; r = −0.554) and 120°/s (r = −0.521; r = −0.589) as well as with ER strength at 180°/s (r = −0.591, r = −0.556). The SUR angle at an HEA of 120° was negatively correlated with ER strength at 60°/s (r = −0.558), 120°/s (r = −0.504; r = −0.524), and 180°/s (r = −0.543) and the ER/IR strength ratio at 60°/s (r = −0.517). In this study, we found that the ratio of isokinetic strength between ER and IR became closer to the normal range on increasing the SUR angle. In particular, an HEA of 90°, which resembles the pitching motion, showed a clear relationship between SUR, shoulder ER, and the ratio of ER/IR isokinetic strength in professional baseball pitchers.
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Affiliation(s)
| | - Seung Kil Lim
- Department of Exercise Prescription, Dongshin University, Naju 58245, Korea;
| | - Sunga Kong
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul 06351, Korea
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul 06351, Korea
- Correspondence: ; Tel.: +82-02-2148-9498; Fax: +82-02-3410-6639
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18
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Mayo BC, Miller A, Patetta MJ, Schwarzman GR, Chen JW, Haden M, Secretov E, Hutchinson MR. Preventing Tommy John Surgery: The Identification of Trends in Pitch Selection, Velocity, and Spin Rate Before Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers. Orthop J Sports Med 2021; 9:23259671211012364. [PMID: 34189147 PMCID: PMC8209837 DOI: 10.1177/23259671211012364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/05/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Ulnar collateral ligament (UCL) reconstruction is a common surgery among Major League Baseball (MLB) pitchers that results in a significant number of missed games. Little has been reported regarding game-by-game trends that can identify those on the verge of becoming injured. Purpose: To determine if there is a patterned change in MLB pitchers’ pitch selection, velocity, or spin rate in games leading up to Tommy John surgery that may predict subsequent UCL surgery. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of MLB pitchers who underwent primary UCL reconstruction between 2009 and 2019 was performed. Pitch characteristics were evaluated on a game-by-game basis for the 15 games leading up to surgery. A Mann-Kendall trend test was used to identify trends in pitch selection, velocity, and spin rate for multiple pitch types. A Kendall τb correlation coefficient was identified, with values closer to 1 or –1 signifying a stronger monotonic trend. Results: A total of 223 MLB pitchers underwent UCL reconstruction in the time period. In the 15 games leading up to surgery, decreases in pitch velocity for 4-seam fastballs (τb = –0.657; P < .001), 2-seam fastballs (τb = –0.429; P = .029), and sliders (τb = –0.524; P = .008) were significantly associated with game number closer to injury. There was a significant positive association in the spin rate for cutters (τb = 0.410; P = .038) and a significant negative association in spin rate for 4-seam fastballs over the course of these 15 games (τb = –0.581; P = .003). In addition, there was a significant positive association in the percentage of curveballs thrown (τb = 0.486; P = .013). Conclusion: The study results suggest that there is a patterned change in certain pitch statistics in MLB pitchers in the games leading up to Tommy John surgery. Although the absolute change from game to game may be small, it may be possible for these trends to be monitored before a player becomes injured, thus reducing the significant burden Tommy John surgery places on these athletes.
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Affiliation(s)
| | - Adam Miller
- University of Illinois at Chicago, Chicago, Illinois, USA
| | | | | | - Jeffrey W Chen
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Marshall Haden
- University of Illinois at Chicago, Chicago, Illinois, USA
| | - Erwin Secretov
- University of Illinois at Chicago, Chicago, Illinois, USA
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