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At least 343 records · Page 19Linked to original sources
PubMed2005

Kinetic comparison among the fastball, curveball, change-up, and slider in collegiate baseball pitchers.

BACKGROUND: Controversy exists about whether breaking pitches are more stressful than are fastballs. Previous biomechanical studies compared kinematics but not kinetics. HYPOTHESIS: Elbow and shoulder forces and torques are statistically different among the fastball, curveball, change-up, and slider. STUDY DESIGN: Descriptive laboratory study. METHODS: Twenty-one healthy collegiate pitchers were studied with a high-speed automated digitizing system. All subjects threw fastballs (n = 21), most threw curveballs (n = 20) and change-ups (n = 19), and a few threw sliders (n = 6). Wrist, elbow, and shoulder kinetics were calculated using inverse dynamics. Nine kinetic and 26 kinematic parameters were compared among the different pitch types using repeated-measures analysis of variance. RESULTS: At the shoulder, internal rotation torque, horizontal adduction torque, abduction torque, and proximal force were significantly less in the change-up than in the other 3 pitches. Shoulder horizontal adduction torque was greater in the fastball than in the curveball and slider. Shoulder proximal force was greater in the slider than in the curveball. Elbow proximal force was less in the change-up than in the other 3 pitches. Elbow varus torque was greater in the fastball and curveball than in the change-up. Elbow flexion torque was greater in the curveball than in the change-up. The curveball and change-up demonstrated kinematic differences from the fastball, consistent with previous studies. CONCLUSION: There were significant kinematic differences between the fastball and curveball but few kinetic differences. The change-up had lower joint kinetics, lower angular velocities, and different body positions than the other 3 pitch types had. Results for the slider were inconclusive because of small sample size. CLINICAL RELEVANCE: Because the resultant joint loads were similar between the fastball and curveball, this study did not indicate that either pitch was more stressful or potentially dangerous for a collegiate pitcher. The low kinetics in the change-up implies that it is the safest.

Adult↗
PubMed2006

Risk factors for shoulder and elbow injuries in adolescent baseball pitchers.

BACKGROUND: There is little evidence supporting current safety recommendations for adolescent pitchers. HYPOTHESIS: Pitching practices of adolescent pitchers without history of arm injury will be significantly different from those of adolescent pitchers who required shoulder or elbow surgery. STUDY DESIGN: Case control study; Level of evidence, 3. METHODS: Ninety-five adolescent pitchers who had shoulder or elbow surgery and 45 adolescent pitchers who never had a significant pitching-related injury completed a survey. Responses were compared between the 2 groups using t tests and chi(2) analyses. Multivariable logistic regression models were developed to identify the risk factors. RESULTS: The injured group pitched significantly more months per year, games per year, innings per game, pitches per game, pitches per year, and warm-up pitches before a game. These pitchers were more frequently starting pitchers, pitched in more showcases, pitched with higher velocity, and pitched more often with arm pain and fatigue. They also used anti-inflammatory drugs and ice more frequently to prevent an injury. Although the groups were age matched, the injured group was taller and heavier. There were no significant differences regarding private pitching instruction, coach's chief concern, pitcher's self-rating, exercise programs, stretching practices, relieving frequency, pitch type frequency, or age at which pitch types were first thrown. CONCLUSION: Pitching practices were significantly different between the groups. The factors with the strongest associations with injury were overuse and fatigue. High pitch velocity and participation in showcases were also associated with increased risk for injury. CLINICAL RELEVANCE: New recommendations were made based on these results. Adherence to the recommendations may reduce the incidence of significant injury to adolescent pitchers.

Adolescent↗
PubMedDate not supplied

Biomechanics of baseball pitching. A preliminary report.

Fifteen professional major league pitchers were filmed with high speed cinematography. One hundred forty-seven pitches were analyzed using an electromagnetic digitizer and a microcomputer. Three phases of throwing were studied: cocking, acceleration, and follow-through. The cocking phase is the period of time between the initiation of the windup and the moment at which the shoulder is in maximum external rotation. This phase occurs in approximately 1500 ms, and the shoulder is brought into an extreme position of external rotation. The acceleration phase and the initial stages of the follow-through phase produce extraordinary demands on the shoulder and elbow. The acceleration phase begins with the throwing shoulder in the position of maximum external rotation and terminates with ball release. This phase occurs in approximately 50 ms, and peak angular velocities averaging 6,180 deg/sec for shoulder internal rotation and 4,595 deg/sec for elbow extension were measured. The follow-through phase begins at ball release and continues until the motion of throwing has ceased. This phase occurs in approximately 350 ms.

Acceleration↗
PubMedDate not supplied

Undersurface tear of the ulnar collateral ligament in baseball players. A newly recognized lesion.

Seven patients were diagnosed with an undersurface tear of the deep capsular layer of the anterior bundle of the ulnar collateral ligament. Preoperatively, all of the patients had tenderness over the anterior bundle of the ulnar collateral ligament and pain with valgus stressing of the elbow. Six of the seven patients had a normal magnetic resonance imaging scan, with one magnetic resonance imaging scan showing degeneration within the ligament. All of the patients had a negative computed tomography arthrogram for extracapsular contrast extravasation. A consistent finding in five of the seven patients was a leak of contrast around the edge of the humerus or ulna, although the contrast was contained within the joint. At arthroscopic evaluation, all of the patients demonstrated medial elbow instability as valgus stress was applied across the elbow joint in 70 degrees of flexion. All of the patients underwent open medial elbow surgery, where the ulnar collateral ligament was visualized and found to be intact externally. But when the anterior bundle was incised, there was a detachment of the undersurface of the ligament at the ulna or the humerus. Cadaveric dissections were performed to define the anatomy of the insertion sites and to confirm that this lesion was not an anatomic variant. A tear of the deep layer of the ulnar collateral ligament can result in symptomatic instability that is difficult to diagnose with conventional preoperative testing. This lesion of the anterior bundle of the ulnar collateral ligament has not been previously reported, and in our series it was associated with persistent medial elbow pain in throwing athletes.

Adult↗
PubMedDate not supplied

Kinetics of baseball pitching with implications about injury mechanisms.

Elbow and shoulder kinetics for 26 highly skilled, healthy adult pitchers were calculated using high-speed motion analysis. Two critical instants were 1) shortly before the arm reached maximum external rotation, when 67 N-m of shoulder internal rotation torque and 64 N-m of elbow varus torque were generated, and 2) shortly after ball release, when 1090 N of shoulder compressive force was produced. Inability to generate sufficient elbow varus torque may result in medial tension, lateral compression, or posteromedial impingement injury. At the glenohumeral joint, compressive force, joint laxity, and 380 N of anterior force during arm cocking can lead to anterior glenoid labral tear. Rapid internal rotation in combination with these forces can produce a grinding injury factor on the labrum. After ball release, 400 N of posterior force, 1090 N of compressive force, and 97 N-m of horizontal abduction torque are generated at the shoulder; contribution of rotator cuff muscles in generating these loads may result in cuff tensile failure. Horizontal adduction, internal rotation, and superior translation of the abducted humerus may cause subacromial impingement. Tension in the biceps tendon, due to muscle contraction for both elbow flexion torque and shoulder compressive force, may tear the anterosuperior labrum.

Acceleration↗
PubMedDate not supplied

Upper extremity blood flow in collegiate and high school baseball pitchers A preliminary report.

The arterial and venous volume blood flow in the dominant and nondominant upper extremities of five male pitchers, ages 16 to 21, was measured using color flow duplex ultrasound. Blood-flow measurements were obtained at baseline, after warm-up, and after each sequence of 20 pitches until 100 pitches were thrown. Blood flow was additionally determined 1 hour after the last pitch. The velocity of each pitch was recorded with a speed gun. Anthropomorphic measurements of the upper extremity were obtained at baseline and immediately after Pitch 100 using a standard measuring tape. The highest average arterial volume flow in the pitching arm occurred after 40 pitches, reaching a peak of 549 ml/min (56% increase from baseline). Thereafter, the average arterial blood flow steadily declined, reaching an average of 402 ml/min after the 100th pitch (14% increase from baseline). In contrast, the arterial blood flow in the nonpitching arm increased only slightly from baseline, reaching a maximal volume flow of 448 ml/min immediately after the warm-up period (10% increase from baseline). The volume flow then persistently fell to a level 30% below baseline after the 100th pitch. Although this small pilot study does not demonstrate causation between a decline in pitching performance and arterial blood flow, it suggests arterial flow in the dominant extremity falls as the pitch count increases.

Adolescent↗
PubMedDate not supplied

Suprascapular nerve entrapment at the spinoglenoid notch in a professional baseball pitcher.

Suprascapular nerve injuries at the spinoglenoid notch are uncommon. The true incidence of this lesion is unknown; however, it appears to be more common in athletes who participate in sports involving overhead activities. When a patient is being evaluated for posterior shoulder pain and infraspinatus muscle weakness, electrodiagnostic studies are an essential part of the evaluation. Electromyography will identify an injury to the suprascapular nerve as well as assist in localizing the site of injury. In addition, imaging studies are also indicated to help exclude other diagnoses that can mimic a suprascapular nerve injury. The initial management should consist of cessation of the aggravating activity along with an organized shoulder rehabilitation program. If the patient fails to improve with 6 months to 1 year of nonoperative management, surgical exploration of the suprascapular nerve should be considered. Release of the spinoglenoid ligament with resultant suprascapular nerve decompression may result in relief of pain and a return of normal shoulder function.

Adult↗