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Injury Prevention Related to Pitching E. David Osinski M.A. Glenn S. Fleisig, Ph.D. Biomechanics of Pitching Adult pitchers (college & pro) ASMI 18 studies published in last ten years All levels (youth thru pro)

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injury prevention related to pitching

Injury Prevention Related to Pitching

E. David Osinski M.A.

Glenn S. Fleisig, Ph.D.

biomechanics of pitching
Biomechanics of Pitching
  • Adult pitchers (college & pro)
    • ASMI 18 studies published in last ten years
    • All levels (youth thru pro)
    • Kinematic (angular displacements and velocities) and kinetic (forces & torques) comparison of baseball pitching among various levels of development. (Fleisig et al, J Biomechanics, 1999)
results force newtons
Results - Force (Newtons)

Significant relationship between kinetic forces at shoulder & elbow joints for variables for pitching mechanics for youth through professional pitchers.

results force weight
Results - Force (%Weight)

Significant relationship between forces at shoulder & elbow joints for pitching mechanics variables when adjusted for physical differences.

high school stride
High School Stride

Foot Contact

Pelvis = 25° open

Upper Torso = 20° closed

Shoulder:

Abduction = 90°

Rotation = 65°

Elbow:

Flexion = 80°

high school arm cocking
High School Arm Cocking

Max. Rotation

Shoulder:

Rotation = 175°

Elbow:

Flexion = 100°

high school arm cocking9
High School Arm Cocking

Shoulder:

Anterior Force=290N

IR Torque = 51 Nm

Elbow:

Varus Torque=48Nm

(Weight = 740 N = 170 lb)

high school arm acceleration
High School Arm Acceleration

Arm Acceleration

Elbow:

Extension = 2200°/s

Shoulder:

Rotation = 6800°/s

high school arm acceleration11
High School Arm Acceleration

Shoulder:

Proximal Force = 750 N

Elbow:

Proximal Force = 630 N

(Weight = 740 N = 170 lb)

physeal injury little leaguer s shoulder
PHYSEAL INJURYLittle Leaguer’s Shoulder
  • First by Dotter described in 1953
  • Described in literature as
    • osteochondrosis of the proximal humeral epiphysis
    • proximal humeral epiphyseolysis
    • stress fracture of proximal humeral epiphyseal plate
    • rotational stress fracture
adolescent pitcher shoulder injury
Adolescent Pitcher Shoulder Injury
  • Typically males, 12 - 15 years of age
  • 14 y/o more prone due to rapid growth and more skilled
  • Average duration of symptoms before treatment is approximately 7 months
  • Associated with quantity and intensity of pitching, age at which pitching started, use of curveball
elbow anatomy mechanics
Elbow - Anatomy/Mechanics
  • Anterior Band of UCL (main valgus stabilizer) attaches to the medial epicondyle apophysis
elbow anatomy mechanics18
Elbow - Anatomy/Mechanics
  • Increased bone plasticity
  • Hyperelasticity permits excessive joint translation
elbow injuries
Elbow Injuries

Skeletally immature athletes are susceptible to unique injuries secondary to:

  • Relatively weak growth plates (physes)
  • Ligamentous laxity
  • Inadequate dynamic strength / stability to resist high biomechanical forces
medial epicondyle apophysitis avulsion
Medial Epicondyle Apophysitis / Avulsion
  • Most common injury seen in the adolescent throwing athlete
  • Caused by acute valgus overload
  • X-rays may appear normal
1996 survey usa baseball news 1996
1996 Survey (USA Baseball News, 1996)
  • Survey forUSA Baseball
  • 28 Orthop. Surgeons & Baseball Coaches
  • number of pitches more important than innings
  • Increase pitch count limits with age

Examples: 8-10: 50 pitches. 17-18: 90 pitches

  • Start using pitches at different ages
    • Fastball (8), Change (10), Curve (14), Slider (16)
1997 98 study med sci sport exerc 2001
1997-98 Study (Med Sci Sport Exerc, 2001)
  • 200 pitchers each Spring (300 total subjects)
  • 8-12 years old pitchers in Birmingham
  • 50% of pitchers had elbow/shoulder pain during study
  • Increased pitches  Increased pain risk
    • 75 pitches/game recommended limit
    • 600 pitches/season recommended limit
1999 study am j sports med 2002
1999 Study (Am J Sports Med, 2002)
  • Funded byUSA Baseball
  • 500 pitchers in Spring
  • 9-14 years old pitchers throughout Alabama
  • Increased pitches  Increased pain risk
    • 75 pitches/game recommended limit (15 batters)
    • 600 pitches/season recommended limit (120 batters)
  • No relation found between mechanics - pain risk
  • Curveballs/Sliders  Increased pain risk
conclusions mechanics
Conclusions - Mechanics
  • Successful youth and adult pitchers use similar kinematics.
  • Relationship between poor mechanics and risk of injury unproven
conclusions pitch quantity
Conclusions - Pitch Quantity
  • Correlation between pitch count and pain in youth pitchers
  • College/Pros use pitch counts to protect pitchers. Youth pitchers should do as well.
conclusions pitch quantity26
Conclusions - Pitch Quantity

USA Baseball Medical Committee Recommendations 2003

Age Workload Limit in Pitches

Game Week Season Year

9-10 50 75 1000 1000

11-12 75 100 1000 3000

13-14 75 125 1000 3000

american baseball foundation thank you
American Baseball Foundation Thank you

ABF BASIC Program at Rickwood Field