Comparison of Peak Shoulder Distraction Forces Between Pain and Pain-Free Youth Baseball Pitchers.

Background: Increased shoulder distraction force during a baseball pitch may make a pitcher susceptible to rotator cuff or glenohumeral labral injuries. A precursor to a pitching injury may be pain experienced in the throwing arm. Purpose: To (1) compare peak shoulder distraction (PSD) forces in youth baseball pitchers with and without upper extremity pain when throwing a fastball and (2) assess if PSD forces across trials differ between pain and pain-free groups. Study Design: Controlled laboratory study. Methods: A total of 38 male baseball pitchers aged 11 to 18 years were separated into a pain-free group (n = 19; mean age, 13.2 ± 1.7 years; mean height, 163.9 ± 13.5 cm; mean weight, 57.4 ± 13.5 kg) and a pain group (n = 19; mean age, 13.3 ± 1.8 years; mean height, 164.9 ± 12.5 cm; mean weight, 56.7 ± 14.0 kg). Pitchers in the pain group indicated that they experienced pain in their upper extremity while throwing a baseball. Pitching mechanical data from 3 fastballs per pitcher were recorded with an electromagnetic tracking system and motion capture software. The mean PSD (mPSD) was calculated as the mean PSD of 3 pitches per pitcher, the trial with the highest recorded PSD was determined as the maximum-effort PSD (PSDmax), and the PSD range (rPSD) was defined as the difference of the PSD force of the trial with the highest PSD and the lowest PSD for each pitcher. The PSD force was normalized to the pitcher's body weight (%BW). Pitch velocity was also recorded. Results: The mPSD force was 114%BW ± 36%BW for the pain group and 89%BW ± 21%BW for the pain-free group. Pitchers in the pain group exhibited a significantly higher PSDmax force (t30.548 = 2.894; P = .007) and mPSD force (t29.231 = 2.709; P = .009) compared with those in the pain-free group. There were no significant between-group differences in the rPSD force or pitch velocity. Conclusion: The normalized PSDmax force was higher in pitchers who experienced pain while throwing fastballs compared with pitchers who were pain-free while throwing. Clinical Relevance: Baseball pitchers who experience pain in their throwing arm are likely to have higher shoulder distraction forces. Improvement in pitching biomechanics and corrective exercises may assist in the mitigation of pain while pitching.

Single-Leg Squat and Reported Pain in Collegiate Softball Pitchers.

Background: Single-leg squat (SLS) performance is related to altered mechanics related to injury during the windmill softball pitch; however, it is unknown if SLS kinematics differ between softball pitchers with and without upper extremity pain. Purpose/Hypothesis: The purpose of this study was to compare knee valgus, trunk rotation, trunk lateral flexion, and trunk flexion during an SLS in collegiate softball pitchers with and without self-reported upper extremity pain. It was hypothesized that those who reported upper extremity pain would show increased compensatory trunk and knee kinematics compared with those without pain. Study Design: Controlled laboratory study. Methods: A total of 75 collegiate softball players (mean age, 20.4 ± 1.7 years; mean height, 173.3 ± 7.7 cm; mean weight, 79.1 ± 11.6 kg) participated and were placed in pain (n = 20) or no-pain (n = 55) groups. Participants performed an SLS once per side. Kinematic data were collected at 100 Hz using an electromagnetic tracking system. A 2 (pain vs no pain) × 2 (descent vs ascent) × 2 (drive leg vs stride leg) mixed-design multivariate analysis of variance with Wilks lambda distribution was used to determine differences in drive-leg and stride-leg lower body mechanics between the descent and ascent phases of the SLS between the pitchers in the current study with and without pain. Results: There was no significant effect in the 3-way interaction between upper extremity pain, side, and phase (Λ = 0.960; F[4, 70] = 0.726; P = .577; η2 = 0.04). However, there were large effects for the phase × side interaction (Λ = 0.850; P = .021; η2 = 0.150). There was a main effect of phase (Λ = 0.283; P < .001; η2 = 0.717). Conclusion: Study findings indicated that SLS mechanics do not differ between collegiate softball pitchers with and without reported upper extremity pain. Drive-leg mechanics showed more stability in the SLS than stride-leg mechanics. Clinical Relevance: Softball pitchers are at risk of upper extremity injury. It is important to identify mechanisms that may lead to pain in order to mitigate the risk of injury.

Preliminary Analysis of Closed Kinetic Chain Upper Extremity Stability Test Differences Between Healthy and Previously Injured/In-Pain Baseball Pitchers.

BACKGROUND: A comprehensive examination of the kinetic chain during an overhead athlete's upper extremity assessment, such as the closed kinetic chain upper extremity stability test (CKCUEST), may help clinicians identify potential upper extremity dysfunction. HYPOTHESIS: Body position observed on dominant and nondominant hand touch during a CKCUEST trial differs between players with previous injury/pain history compared with healthy counterparts. STUDY DESIGN: Descriptive laboratory study. LEVEL OF EVIDENCE: Level 5. METHODS: Seventeen baseball pitchers were recruited to participate (18.03 ± 2.01 years; 185.40 ± 6.57 cm; 83.92 ± 13.87 kg). A medical history questionnaire was used to separate participants into groups, either previous injury/pain or healthy. Kinematic and kinetic data were collected on the participants performing the CKCUEST with an electromagnetic tracking system. Kinematics were analyzed using a pair of 1-way multivariate analyses of variance (MANOVAs). RESULTS: The MANOVA for nondominant hand touch in the CKCUEST revealed a significant difference in lumbopelvic-hip complex (LPHC) kinematics between previously injured/pain group and healthy group (Λ = 0.37; F4,12 = 5.12; P = 0.01). CONCLUSIONS: The previously injured/pain group displayed less pelvic axial rotation and dominant hip abduction during the nondominant touch indicating more LPHC stability during the nondominant touch. In conclusion, differences were observed in LPHC kinematics during the CKCUEST nondominant touch between a healthy and previously injured/pain group perhaps due to the increased awareness provided through rehabilitative programs for the previously injured/pain group. CLINICAL RELEVANCE: Clinicians can use this information to help address kinetic chain movement efficiency within baseball pitchers. This study provides evidence of LPHC kinematic differences during the nondominant touch of baseball pitchers and may enhance the use of the CKCUEST as a return-to-play assessment.

Pelvis and Trunk Energy Flow in Collegiate Softball Pitchers With and Without Upper Extremity Pain.

BACKGROUND: The softball pitch is a full-body motion, where efficient proximal to distal energy flow through the kinetic chain is said to reduce stress at the upper extremity. Although altered trunk kinematic parameters are associated with upper extremity pain in softball pitchers, further research is needed to determine whether differences exist in proximal energy flow between softball pitchers with and without pain. HYPOTHESIS/PURPOSE: To examine pelvis and trunk energy flow during the acceleration phase of the pitch in collegiate softball pitchers with and without upper extremity pain. It was hypothesized that those with upper extremity pain would have less energy flowing into the proximal ends of the pelvis and trunk as well as less energy flowing out of the distal ends of the pelvis and trunk during the acceleration phase when compared with pitchers who did not have upper extremity pain. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 54 female National Collegiate Athletic Association Division I softball pitchers (age, 20.2 ± 2.0 years; height, 173.5 ± 6.9 cm; weight, 78.5 ± 11.5 kg) were assigned to pain (n = 17) and pain-free (n = 38) groups. Participants pitched 3 maximal effort rise-balls for a strike, and the average of the 3 trials was used for analysis. Kinematic data were collected at 100 Hz using an electromagnetic tracking system. A segment power analysis was performed to quantify energy flow for the pelvis and trunk. The Mann-Whitney U test was used to compare pelvis and trunk energy flow during the acceleration phase of the pitch as well as pitch velocity between collegiate softball pitchers with and without upper extremity pain. RESULTS: No significant differences were found between pelvis and trunk energy flow during the acceleration phase or pitch velocity between collegiate softball pitchers with and without upper extremity pain (all P values >.057). CONCLUSION: Previous research determined that kinematic parameters differ between collegiate pitchers with and without upper extremity pain. However, the current study found no difference in pelvis and trunk energy flow or pitch velocity. Although altered kinematics in collegiate pitchers with upper extremity pain may serve as compensation patterns to maintain pitch velocity and proximal energy flow, future research is needed to confirm this postulation. CLINICAL RELEVANCE: The lack of energy flow differences between upper extremity pain groups suggests that pitchers may adapt their biomechanics to maintain trunk and pelvis energy flow patterns. Coaches, athletes, and clinicians should know that movement adaptations can allow for maintained performance levels but may result in the presence of pain that may manifest in other deleterious and injury-susceptible biomechanics.

Optimal Load Magnitude and Placement for Peak Power Production in a Vertical Jump: A Segmental Contribution Analysis.

ABSTRACT: Bordelon, NM, Jones, DH, Sweeney, KM, Davis, DJ, Critchley, ML, Rochelle, LE, George, AC, and Dai, B. Optimal load magnitude and placement for peak power production in a vertical jump: A segmental contribution analysis. J Strength Cond Res 36(4): 911-919, 2022-Weighted jumps are widely used in power training, however, there are discrepancies regarding which loading optimizes peak jump power. The purpose was to quantify the effects of load magnitudes and placements on the force, velocity, and power production in a countermovement vertical jump. Sixteen male and 15 female subjects performed vertical jumps in 7 conditions: no external load, 10 and 20% dumbbell loads, 10 and 20% vest loads, and 10 and 20% barbell loads with load percentages relative to body weight. Arm swing was encouraged for all, but the barbell load conditions. Kinematics were collected to quantify the whole-body (the person and external loads) forces, velocities, and power as well as segments' contributions to the whole-body forces and velocities. Repeated-measure analyses of variance were performed followed by paired comparisons. Jump heights were the greatest for the no external load and 10% dumbbell conditions. The 10 and 20% dumbbell conditions demonstrated the greatest peak whole-body power, while the 2 barbell conditions showed the lowest peak whole-body power. At the time of peak whole-body power, the 2 dumbbell and 2 vest conditions resulted in greater whole-body forces. Whole-body velocities were the greatest for the no external load and 10% dumbbell conditions. Holding the dumbbells in the hands magnified the effects of external loads in producing forces and velocities. The constraint of arm movements in the barbell conditions limited power production. These findings highlight the importance of load placement and arm swing in identifying the optimal configuration for power production in weighted jumps.

Segment power analysis of collegiate softball hitting.

The primary aim of this investigation was to describe the energy flow through the kinetic chain during softball hitting using a segmental power analysis. Twenty-three NCAA Division I collegiate softball athletes (20.4 ± 1.7 yr; 166.7 ± 22.0 cm; 74.9 ± 15.9 kg) performed three maximum effort swings off a stationary tee placed in the middle of the strike zone. Pelvis, trunk, humerus, forearm and hand segment powers were integrated across four phases of the softball swing (load, stride, acceleration, and follow-through). The load and stride phases had low segment energy inflow and outflow values as well as net segment energy flow for all body segments compared to subsequent phases of the swing. The acceleration phase showed large trunk inflow values relative to the pelvis. There was also descriptively larger front compared to back-side upper extremity inflow. Finally, the follow-through phase showed primarily energy outflow for the upper extremity segments likely attributed to slowing down rotation.

Association Between Passive Hip Range of Motion and Pitching Kinematics in High School Baseball Pitchers.

BACKGROUND: Limitations in passive hip range of motion (PROM) may negatively affect pitching mechanics in baseball pitchers. Understanding the relationships between PROM and mechanics can assist in the development of injury prevention protocols. PURPOSE: The purpose of this study was to examine the association of hip rotational PROM with pelvis and trunk rotation during pitching in high school baseball pitchers. Study Design: Cross-sectional. METHODS: Twenty-five healthy high school baseball pitchers volunteered (15.9 ± 1.1 years; 180.4 ± 5.5 cm; 75.4 ± 9.3 kg). Seated passive hip internal rotation (IR) and external rotation (ER) PROM were measured using a digital inclinometer. Total PROM was calculated (IR+ER). Pitching biomechanical data were collected with a 3-dimensional electromagnetic tracking system while pitchers threw fastballs. Simple linear regressions were performed to examine the association between hip IR, ER, and total PROM with pitching kinematics at foot contact including stride length, pelvis rotation, and trunk rotation. RESULTS: Only one significant association in PROM and kinematics was observed. Drive leg hip IR PROM was associated with trunk rotation angle [F(1,24) = 4.936, p = 0.036], with an R2 = 0.177. Drive leg total PROM was not associated trunk rotation angle [F(1,24) = 4.144, p = 0.053] with an R2 = 0.153. CONCLUSIONS: Increased drive leg hip IR PROM was associated with decreased trunk rotation towards home plate. Hip total PROM and ER were not related to pitching mechanics. LEVEL OF EVIDENCE: 2.

Comparison of Pelvis and Trunk Kinematics Between Youth and Collegiate Windmill Softball Pitchers.

BACKGROUND: The windmill softball pitch is a dynamic sporting movement that places softball pitchers at high risk of injury. Unlike baseball, there is limited research into the mechanical differences between softball pitchers of varying skill levels. PURPOSE/HYPOTHESIS: The purpose of this study was to compare pelvis and trunk kinematics between youth and collegiate softball pitchers. It was hypothesized that there would be significant differences in pelvis and trunk kinematics between these 2 groups. STUDY DESIGN: Descriptive laboratory study. METHODS: The pelvic and trunk kinematics of 90 softball pitchers were collected during full-effort pitching using a 3-dimensional motion capture system. Participants were grouped based on their age at the time of data collection (35 youth [mean age, 11 ± 1 years]; 55 collegiate [mean age, 20 ± 2 years]). We compared between-group differences in pelvic posterior tilt, lateral tilt, axial rotation, and axial rotation velocity as well as trunk extension, lateral flexion, axial rotation, and axial rotation velocity during the pitching phase between start of pitch and ball release (BR) using 1-dimensional statistical parametric mapping. Statistical significance was determined using Holmes-Sidák stepdown correction-adjusted P values (P '). RESULTS: Compared with youth pitchers, collegiate pitchers exhibited a more posteriorly tilted pelvis from the moment of start of pitch until 94% of the way between start of pitch and BR (P ' = .002) and a more laterally flexed trunk toward the glove side from the moment of start of pitch until 71% of the way between start of pitch and BR (P ' = .010). CONCLUSION: Collegiate pitchers displayed a more posteriorly tilted pelvis and more laterally flexed trunk toward the glove side during the windmill pitching motion when compared with youth pitchers. CLINICAL RELEVANCE: These findings add to the growing body of softball research and help elucidate mechanical differences between youth and collegiate softball pitchers.

The influence of a simulated game on muscular strength in female high-school and collegiate softball pitchers.

Softball pitchers often pitch several games within a day and over consecutive days during a competitive season. High volumes of pitches thrown can decrease muscular strength, resulting in less proximal force generation and upper extremity compensation to maintain performance. Therefore, the purpose of this study was to assess upper and lower extremity muscular strength after pitching in a simulated game. Fourteen softball pitchers (17.9 ± 2.3 years, 166.4 ± 8.7 cm, 72.2 ± 12.6 kg) completed baseline isokinetic strength assessment for knee, hip, trunk and pitching elbow flexion and extension as well as trunk rotation. Seven days later, participants pitched a simulated game consisting of 105 fastballs prior to repeating all strength assessments. Changes in muscular strength were assessed using paired samples t-tests, with significance set a priori as p ≤ 0.05. Normalised (%BW) stride leg knee extension peak torque was significantly higher (p = 0.020) post-simulated game (75.1 ± 24.6%BW) as compared to baseline (64.0 ± 19.5%BW) and trunk flexion peak torque was significantly higher (p = 0.009) post-simulated game (84.8 ± 47.0%BW) as compared to baseline (63.5 ± 47.1%BW). This study showed an increase in knee extension and trunk flexion strength after an acute bout of pitching. The findings give insight into muscular changes following pitching which can assist in appropriate softball training and recovery.

Kinematic Differences Exist Between the Fastball, Changeup, Curveball, and Dropball Pitch Types in Collegiate Softball Pitchers.

BACKGROUND: A majority of softball literature focuses on the mechanics associated with pain and injury within a single pitch type per study; however, the generalizability of these findings is unknown since a kinematic comparison has yet to be performed between pitch types. Understanding kinematic differences between pitch types can be used to identify risk factors for injury, improve safety guidelines, and improve performance by linking specific mechanics with desired pitch outcomes. HYPOTHESIS/PURPOSE: The purpose of this study was to compare kinematics between the fastball, changeup, curveball, and dropball pitch types in collegiate softball pitchers. It was hypothesized that there would be significant kinematic differences between pitch types. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 28 female collegiate softball pitchers pitched 3 trials of each pitch type to a catcher at regulation distance. Pitch speed, stride length, trunk extension, trunk rotation, trunk lateral flexion, elbow flexion, and center of mass for each trial were calculated using an electromagnetic motion capture system and were averaged for analysis. A 1-way analysis of variance (ANOVA) was used to investigate pitch speed differences between the 4 pitch types. A 4 (pitch type) × 5 (event) within-athlete multivariate ANOVA was also used to determine kinematic differences. RESULTS: The results revealed a significant difference in pitch speed between pitch types; a pitch type main effect for trunk extension, trunk rotation, trunk lateral flexion, and center of mass; and an event main effect for all variables except stride length. The results also revealed a pitch type by event interaction for trunk flexion, trunk lateral flexion, and center of mass. Specifically, the dropball type had less trunk extension than the fastball at all pitching events. Similarly, the curveball type had a more posteriorly shifted center of mass than the dropball at the last 3 pitching events of foot contact, ball release and follow-through. CONCLUSION: Significant kinematic differences exist between pitch types, but these differences may be necessary to execute desired pitch outcomes. CLINICAL RELEVANCE: This is the first study to analyze kinematic differences between pitch types in softball pitchers. Understanding the effects of different pitch types on kinematic parameters may enhance injury prevention and performance strategies for softball pitchers.

Lower Extremity Pain and Pitching Kinematics and Kinetics in Collegiate Softball Pitchers.

The primary aims of the study were (1) to examine kinematics and kinetics of those pitching with and without lower extremity pain in collegiate softball pitchers, and (2) to determine if there was an association between the lower extremity pain and lower extremity kinematics, trunk kinematics, and shoulder kinetics in collegiate softball pitchers. Thirty-seven NCAA Division I female collegiate softball pitchers (19.8±1.3 yrs,173.7±7.7 cm, 79.0±12.4 kg) participated. Participants were divided into two groups, those who were currently experiencing lower extremity pain and those who were not. Participants threw three rise ball pitches. Kinematic data were collected at 100 Hz using an electromagnetic tracking system. Mann-Whitney U tests revealed no significant kinematic or kinetic differences between pitchers with and without lower extremity pain. Additionally, there were no significant correlations between pain and recorded kinematic and kinetic variables. Considering there were no biomechanical differences observed between pitchers, coaches and athletic trainers should take caution with athlete assessment since athletes may not display altered biomechanics. Further examination into the duration and degree of pain is needed in an attempt to fully understand the implication of pain and pitching mechanics.

Longitudinal assessments of balance and jump-landing performance before and after anterior cruciate ligament injuries in collegiate athletes.

The purpose was to quantify the effect of an anterior cruciate ligament (ACL) injury on balance and jump-landing performance and bilateral asymmetries. Among 500 collegiate athletes who performed a reaching test and a double-leg counter-movement jump-landing test at baseline, 8 male and 6 female athletes suffered ACL injuries. In the follow-up, they performed the reaching test 3 and 6 months after ACL reconstruction (ACLR) and the jump-landing test 6 months after ACLR. Less reaching distances for the injured leg and increased reaching distance asymmetries were observed 3 and 6 months after ACLR compared to baseline. Less peak jumping and landing forces for the injured leg and increased jumping and landing force asymmetries were found 6 months after ACLR compared to baseline. The decreased performance of the injured leg and increased asymmetries may contribute to the high ACL re-injury rates. Baseline assessments would be useful for establishing an individual's pre-injury performance.

Educational Intervention Changes College Students' Attitudes toward Prescription Opioid Drug Use.

Background: More than 47,000 people in the United States died from opioid drug overdoses in 2017. Among college students, opioid drugs are the second most abused drug. Objective: This study aimed to examine if an educational intervention impacted college students' attitudes towards prescription opioid drugs (POD). Methods: Two hundred forty-two participants (72 males, 21 ± 3 years) from an American university participated. After collecting demographic data (questionnaire 1; Q1), investigators recited a narrative in which the protagonist was injured and prescribed POD. Next, participants rated their agreement on 10 Likert prompts and two visual analog scales (VAS) before (Q2) and after (Q3) an educational intervention, then noted (Q4) which topics were most or least influential in any changed responses. Results: 7/10 Likert prompts (all p < 0.002) and both VAS (both p < 0.001) changed between Q2 and Q3. Educational intervention topics related to risk were most influential and topics related to alternative therapies were least influential. Conclusion/Importance: Educational interventions may be beneficial for college students. Any interventions that are employed should focus on risks associated with POD use.