Lower body energy generation, absorption, and transfer in youth baseball pitchers.

An efficient baseball pitch will produce a high-velocity ball while minimizing the risk of injury to the pitcher. This study quantified ground reaction forces and lower body power during the entire pitching motion of youth baseball pitchers to investigate how developing athletes generate and transfer energy from lower limbs to the throwing arm. These data provide a foundation for comparing youth pitching strategy and mechanics to optimal throwing mechanics and may aid in developing appropriate training suggestions for this age group. Full-body three-dimensional (3D) motion capture and force platform data were collected on 23 youth pitchers performing fastballs thrown for strikes. Youth pitchers within this study used a "controlled drop" strategy in which the COM was lowered during the stride phase followed by a weak forward drive motion. Ground reaction forces (GRFs) indicate that the drive leg propels the center of mass (COM) toward the home plate while the stride leg braking force contributes to power generation up the kinetic chain. The stride hip generates energy assisting in energy flow up the kinetic chain as well as the creation of a stable base to rotate the trunk about. The lumbosacral joint generates the most energy of any joint studied, facilitating energy flow up the kinetic chain and underscoring the importance of core strength and coordination in proper pitching mechanics.

Energy Flow Analysis to Investigate Youth Pitching Velocity and Efficiency.

PURPOSE: The purposes of this study were 1) to investigate the transfer of energy through the kinetic chain by youth baseball pitchers during the pitching motion and 2) to provide insight into how the total magnitude of energy flow and its linear and rotational components relate to both velocity and joint torque per unit increment of pitch velocity (joint load efficiency). METHODS: Twenty-four youth baseball pitchers participated in this study. Data collection occurred in an indoor research laboratory equipped with a 14-camera infrared motion capture system and an instrumented pitcher's mound with embedded force plates. Energy flow was calculated by integrating power transfer into and out of each segment. The magnitudes of key instances of energy flow were compared to pitch velocity and velocity-normalized joint torques using simple linear regressions. RESULTS: All of the energy flow variables calculated had a significant correlation to pitch velocity. Energy flow into the arm from the trunk had the strongest correlation to velocity of any variable investigated (r = 0.900, P = 0.000). The total magnitude of energy flow into the trunk had a significant correlation to increased horizontal shoulder adduction efficiency and shoulder internal rotation efficiency. The magnitude of energy flow into the trunk by only joint forces had a significant correlation to increased horizontal shoulder adduction efficiency, shoulder internal rotation efficiency, and elbow varus efficiency. CONCLUSIONS: Energy flow analysis is an effective tool providing quantitative assessment of the kinetic chain to gain a deeper understanding of how energy moves through an athlete, and how specific pitching mechanics impact this movement. The results of this study support the importance of generating energy flow throughout the body to produce high velocities and energy flow through the trunk to increase pitch efficiency.

Correlations between internal and external power outputs during weightlifting exercise.

Identifying loads that maximize mechanical power is important because training at such loads may optimize gains in dynamic athletic performance. The purpose of this study was to examine correlations between measures of external mechanical power output and internal mechanical joint power output across different loads during a weightlifting exercise. Ten subjects performed 3 sets of the clean exercise at 65, 75, and 85% of 1 repetition maximum (1RM). Peak external mechanical power output was calculated with 4 commonly used methods, whereas an inverse dynamics approach was used to calculate peak internal mechanical power output for the hip, knee, and ankle joints along with the peak of the sum of all internal joint powers. All peak mechanical power outputs were expressed as relative peak power by either ratio (watts per kilogram) or allometrically scaling to body mass (W·kg). Correlation coefficients were used to compare power output measures. The greatest numbers of significant correlations between internal and external power outputs were observed at 85% of 1RM, at this load hip and knee joint power outputs were correlated to external mechanical power output when calculated with the traditional work-energy method. In addition, the peak sum of all mechanical joint powers was correlated to mechanical power output when calculated with the impulse-momentum method at loads of 75 and 85% of the 1RM. Allometric scaling of power outputs yielded one more significant correlation than did the ratio scaled power outputs. These findings support the use of the work-energy method when making inferences about internal joint powers from external power outputs when loads equal to 85% of 1RM are being lifted. In addition, the impulse-momentum method may be used to make inferences about the sum of all internal joint powers from external power outputs when loads between 75 and 85% of 1RM are being lifted.

Weightlifting performance is related to kinematic and kinetic patterns of the hip and knee joints.

The purpose of this study was to investigate the correlations between biomechanical outcome measures and weightlifting performance. Joint kinematics and kinetics of the hip, knee, and ankle were calculated while 10 subjects performed a clean at 85% of 1 repetition maximum (1RM). Kinematic and kinetic time-series patterns were extracted with principal components analysis. Discrete scores for each time-series pattern were calculated and used to determine how each pattern was related to body mass-normalized 1RM. Two hip kinematic and 2 knee kinetic patterns were significantly correlated with relative 1RM. The kinematic patterns captured hip and trunk motions during the first pull and hip joint motion during the movement transition between the first and second pulls. The first kinetic pattern captured a peak in the knee extension moment during the second pull. The second kinetic pattern captured a spatiotemporal shift in the timing and amplitude of the peak knee extension moment. The kinematic results suggest that greater lift mass was associated with steady trunk position during the first pull and less hip extension motion during the second-knee bend transition. Further, the kinetic results suggest that greater lift mass was associated with a smaller knee extensor moments during the first pull, but greater knee extension moments during the second pull, and an earlier temporal transition between knee flexion-extension moments at the beginning of the second pull. Collectively, these results highlight the importance of controlled trunk and hip motions during the first pull and rapid employment of the knee extensor muscles during the second pull in relation to weightlifting performance.

Glenohumeral muscle activation during provocative tests designed to diagnose superior labrum anterior-posterior lesions.

BACKGROUND: Despite considerable medical advances, arthroscopy remains the only definitive means of superior labrum anterior-posterior (SLAP) lesion diagnosis. Natural shoulder anatomic variants limit the reliability of radiographic findings and clinical evaluations are not consistent. Accurate clinical diagnostic techniques would be advantageous because of the invasiveness, patient risk, and financial cost associated with arthroscopy. PURPOSE: The purpose of this study was to examine the behavior of the joint-stabilizing muscles in provocative tests for SLAP lesions. Electromyography was used to characterize the muscle behavior, with particular interest in the long head of the biceps brachii (LHBB), as activation of the long head and subsequent tension in the biceps tendon should, based on related research, elicit labral symptoms in SLAP lesion patients. STUDY DESIGN: Controlled laboratory study. METHODS: Volunteers (N = 21) without a history of shoulder injury were recruited. The tests analyzed were active compression, Speed's, pronated load, biceps load I, biceps load II, resisted supination external rotation, and Yergason's. Tests were performed with a dynamometer to improve reproducibility. Muscle activity was recorded for the long and short heads of the biceps brachii, anterior deltoid, pectoralis major, latissimus dorsi, infraspinatus, and supraspinatus. Muscle behavior for each test was characterized by peak activation and proportion of muscle activity. RESULTS: Speed's, active compression palm-up, bicep I, and bicep II produced higher long head activations. Resisted supination external rotation, bicep I, bicep II, and Yergason's produced a higher LHBB proportion. CONCLUSION: Biceps load I and biceps load II elicited promising long head behavior (high activation and selectivity). Speed's and active compression palm up elicited higher activation of the LHBB, and resisted supination and Yergason's elicited selective LHBB activity. These top performing tests utilize a unique range of test variables that may prove valuable for optimal SLAP test design and performance. CLINICAL RELEVANCE: This study examines several provocative tests that are frequently used in the clinical setting as a means of evaluating a potential SLAP lesion.

Lower extremity biomechanics during weightlifting exercise vary across joint and load.

The purpose of this study was to determine the effect of load on lower extremity biomechanics during the pull phase of the clean. Kinematic and kinetic data of the 3 joints of the lower extremity were collected while participants performed multiple sets of cleans at 3 percentages: 65, 75, and 85% of 1 repetition maximum (1RM). General linear models with repeated measures were used to assess the influence of load on angular velocities, net torques, powers, and rates of torque development at the ankle, knee, and hip joint. The results suggest that the biomechanical demands required from the lower extremities change with the lifted load and to an extent depend on the respective joint. Most notably, the hip and knee extended significantly faster than the ankle independent of load, whereas the hip and ankle generally produced significantly higher torques than the knee did. Torque, rate of torque development (RTD), and power were maximimal at 85% of 1RM for the ankle joint and at 75% of 1RM for the knee joint. Torque and RTD at the hip were maximal at loads >75% of 1RM. This study provides important novel information about the mechanical demands of a weightlifting exercise and should be heeded in the design of resistance training programs.

Anterior shoulder forces in professional and Little League pitchers.

BACKGROUND: The developing musculoskeletal system of a youth pitcher is substantially different from that of the adult professional pitcher, predisposing the younger players to a different set of injuries. METHODS: High-speed videography of 39 professional and 13 youth pitchers were obtained. High-speed motion analysis was performed to calculate average anterior forces and arm positions at maximal force generation. RESULTS: Professional players generated an average of 33.8+/-14.4 N/kg maximal anterior force, corresponding to 151.9+/-17.0 degrees of external rotation. Youth pitchers generated 16.2+/-3.8 N/kg of anterior forces, corresponding to 118.0+/-23.4 degrees of external rotation. The degree of coronal abduction and horizontal abduction between the 2 groups were not significantly different-92.4+/-9.0 degrees in professionals versus 91.7+/-7.9 degrees in the youth and 11.1+/-11.1 degrees of horizontal abduction in professionals versus 7.8+/-14.1 degrees in the younger throwers. Professional pitchers exerted higher internal rotation torque at 19.4+/-4.1 Nm/kg versus 5.6+/-1.0 Nm/kg in youth, and compressive forces were found to be 121.7+/-21.7 N/kg in professional pitchers compared with 47.5+/-7.6 N/kg in the youth pitchers. CONCLUSIONS: Youth pitchers experience significant anterior shoulder forces and internal rotation torques, although these are lower than professional pitchers. CLINICAL RELEVANCE: Overhead throwing as a youth can lead to shoulder injuries and can predispose the shoulder to more significant injuries as an adult pitcher.

Influence of towing force magnitude on the kinematics of supramaximal sprinting.

The purpose of this study was to determine the influence of towing force magnitude on the kinematics of supramaximal sprinting. Ten high school and college-age track and field athletes (6 men, 4 women) ran 60-m maximal sprints under 5 different conditions: Nontowed, Tow A (2.0% body weight [BW]), Tow B (2.8% BW), Tow C (3.8% BW), and Tow D (4.7% BW). Three-dimensional kinematics of a 4-segment model of the right side of the body were collected starting at the 35-m point of the trial using high-speed (250 Hz) optical cameras. Significant differences (p < 0.05) were observed in stride length and horizontal velocity of the center of mass during Tow C and Tow D. For Tow D, a significant increase (p = 0.046) in the distance from the center of mass to the foot at touchdown was also observed. Contact time decreased significantly in all towing conditions (p < 0.01), whereas stride rate increased only slightly (<2.0%) under towed conditions. There were no significant changes in joint or segment angles at touchdown, with the exception of a significant decrease (p = 0.044) in the flexion/extension angle at the hip during the Tow D condition. We conclude that towing force magnitude does influence the kinematics of supramaximal running and that potentially negative training effects may arise from towing individuals with a force in excess of 3.8% BW. Therefore, we suggest that coaches and practitioners adjust towing force magnitude for each individual and avoid using towing forces in excess of 3.8% of the athlete's BW.

A biomechanical analysis of youth pitching mechanics.

BACKGROUND: It is estimated that nearly 6% of youth baseball participants seek medical attention for injuries sustained during play. Most injuries are overuse injuries, and 26% are to the shoulder or upper arm. By quantifying youth pitching biomechanics, knowledge can be gained concerning the manner in which these injuries are sustained during play. METHODS: Sixteen healthy right hand-dominant baseball pitchers participated in this study. After digitization of 21 bony landmarks, kinematic calculations were conducted using the 3-dimensional coordinates from each video frame. Data were time normalized, forcing major temporal components of the movement to occur at specific intervals. Segment-based reference frames were established, and resultant joint kinetics were projected onto each reference frame. Kinetic data were normalized and calculated along or about the anterior/posterior, medial/lateral, and proximal/distal axes. RESULTS: Maximum trunk rotation and external shoulder rotation were observed during arm cocking. Each of the remaining kinematic parameters peaked after ball release. All maximum values for joint kinetics were measured during arm cocking with the exception of compressive forces experienced at the shoulder and elbow, which peaked after the instant of ball release. CONCLUSIONS: Data produced in this study indicate that youth pitchers initiate trunk rotation early in the movement, which can lead to shoulder hyperangulation. Opposing torques at each end of the humerus also produce a large net torque about the longitudinal axis of the humerus during late arm cocking and may increase humeral retrotorsion in youth pitchers. Underdeveloped musculature in the rotator cuff may lead to difficulty controlling throwing-arm deceleration, causing an increase in horizontal adduction across the torso. CLINICAL RELEVANCE: An improved understanding of youth pitching mechanics is gained from the data collected, analyzed, and discussed in this study. Through increases in the knowledge pertaining specifically to the mechanics of youth pitchers, the opportunity to develop pitching mechanics specifically designed for preventing injuries in little league pitchers arises. LEVEL OF EVIDENCE: This study is a Level 4 study describing youth pitching biomechanics and how they relate to possible injuries.

The effects of a commercially available warm-up program on landing mechanics in female youth soccer players.

The purpose of this study was to examine lower extremity kinematics following implementation of the Sportsmetrics Warm-Up for Injury Prevention and Performance (WIPP) training program. The hypothesis was that there would be no difference in landing mechanics between 2 groups of female youth soccer players (9-11 years of age), with 1 group (Treatment) completing the 8-week-duration (2 days per week) WIPP program and the other serving as a Control group. We recruited 21 female youth soccer players. Treatment (n = 12) and Control (n = 9) groups were established. Using the Sportsmetrics Software for Analysis of Jumping Mechanics, we analyzed lower extremity movement during landing after subjects jumped off a 30.5-cm box and immediately went into a vertical jump. No significant changes in knee separation values were observed in the Treatment group after 8 weeks of WIPP training. The results indicate that 8 weeks of WIPP training did not significantly alter landing strategies.

Biomechanics of the shoulder in youth baseball pitchers: implications for the development of proximal humeral epiphysiolysis and humeral retrotorsion.

BACKGROUND: The effects of repetitive throwing on the shoulders of developing athletes are not well understood because of the paucity of data describing the biomechanics of youth pitchers and the plasticity of the developing skeleton. HYPOTHESIS: The direction and magnitude of the stresses that exist at the proximal humeral physis during the fastball pitching motion are consistent with the development of proximal humeral epiphysiolysis (Little League shoulder) and/or humeral retro-torsion. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 14 elite youth baseball pitchers (mean age, 12.1 +/- 0.4 years) were filmed from the front and dominant side while throwing fastballs in a simulated game. The net force and torque acting on the humerus throughout the throwing motion were calculated using standard biomechanical techniques. RESULTS: The external rotation torque about the long axis of the humerus reached a peak value of 17.7 +/- 3.5 N.m (2.7% +/- 0.3% body weight x height) just before maximum shoulder external rotation. A shoulder distraction force of 214.7 +/- 47.2 N (49.8% +/- 8.3% body weight) occurred at, or just after, ball release. CONCLUSION: Shear stress arising from the high torque late in the arm-cocking phase is large enough to lead to deformation of the weak proximal humeral epiphyseal cartilage, causing either humeral retrotorsion or proximal humeral epiphysiolysis over time. The stresses generated by the external rotation torque are much greater than those caused by distraction forces generated during the pitching motion of youth baseball pitchers. CLINICAL RELEVANCE: The motion of throwing fastballs by youth baseball pitchers results in force components consistent with proposed mechanisms for 2 clinical entities.

The effect of seat position on wheelchair propulsion biomechanics.

This study examined the effect of seat position on handrim biomechanics. Thirteen experienced users propelled a wheelchair over a smooth level floor at a self-selected speed. Kinetic and temporal-distance data were collected with the use of an instrumented rim and a motion analysis system. A custom-designed axle was used to change the seat position. We used repeated measures analysis of variance to evaluate if differences existed in the temporal-distance and kinetic data with change in seat position. Results showed that a shorter distance between the axle and shoulder (low seat height) improved the push time and push angle temporal variables (p < 0.0001). Tangential force output did not change with seat position. Axial and radial forces were highest in the lowest seat position (p < 0.001). Propulsion efficiency as measured by the fraction of effective force did not significantly change with seat position.

A new method to quantify demand on the upper extremity during manual wheelchair propulsion.

OBJECTIVE: To use an ergonomics-based rating that characterizes both demand on, and capacity of, upper-extremity muscle groups during wheelchair propulsion to help identify the muscle groups most at risk for pain or overuse injury in a relatively demanding wheelchair propulsion task. DESIGN: Case series. SETTING: Biomechanics research laboratory. PARTICIPANTS: Sixteen manual wheelchair users with complete (American Spinal Injury Association grade A) T6-L2 paraplegia. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Internal peak joint moments required by each of the major upper-extremity muscle groups for propelling a wheelchair up a ramp; isometric strength of each of the muscle groups in positions simulating wheelchair propulsion; and wheelchair propulsion strength rating (WPSR) for each muscle group, calculated by normalizing the joint demands to their capacity. RESULTS: The largest joint moment was for shoulder flexion, at 39.7+/-13.9Nm. Shoulder flexion also accounted for the peak WPSR value of 66.5%+/-20.3%. Supination and pronation movements had low peak moment requirements (3.4Nm, 5.0Nm, respectively) but high WPSR values (41%, 53%, respectively). CONCLUSIONS: Even a relatively benign ramp (2.9 degrees ) places a large demand on the musculature of the upper extremity, as assessed by using the WPSR to indicate muscular demand.

Humeral torque in professional baseball pitchers.

BACKGROUND: Spontaneous fracture of the humeral shaft in throwers is a rare but well-known phenomenon. Although it has been hypothesized that the biomechanics of the throw cause such fractures, it is not clear how or when the fractures occur in the pitching motion. METHODS: The torque acting about the long axis of the humerus was calculated in 25 professional baseball pitchers throwing in game situations. RESULTS: Peak humeral axial torque reached a mean value of 92 +/- 16 Nm near the time of maximum shoulder external rotation at the end of the cocking phase. This torque tended to externally rotate the distal end of the humerus relative to its proximal end. The direction of the torque was consistent with the external rotation spiral fractures of the humerus noted to occur in throwers. The magnitude of the peak humeral torque averaged 48% of the theoretical torsional strength of the humerus, suggesting that repetitive stress plays a role in humeral shaft fractures. CONCLUSIONS: Fractures are most likely to occur near the time of maximum shoulder external rotation when humeral torque peaks. Pitchers whose elbows were more extended at stride foot contact tended to have lower peak humeral torques.

Valgus torque in youth baseball pitchers: A biomechanical study.

The purpose of this study was to determine the biomechanical and anthropometric factors contributing to elbow valgus torque during pitching. Video data of 14 youth pitchers throwing fastballs were used to calculate shoulder and elbow kinematics and kinetics. Peak elbow valgus torque averaged 18 Nm and occurred just before maximal shoulder external rotation. The magnitude of valgus torque was most closely correlated with the thrower's weight. When subject weight and height were controlled for, maximum shoulder abduction torque and maximum shoulder internal rotation torque were most strongly associated with elbow valgus torque, accounting for 85% of its variance (P <.001). When only kinematic variables were considered, maximum shoulder external rotation accounted for 33% of the variance in valgus torque. Given that the biomechanical variables correlated with peak valgus torque are not easily modifiable, limiting the number of innings pitched is likely the best way to reduce elbow injury in youth pitchers.

An analysis of the constraint properties of the distal radioulnar ligament attachments to the ulna.

Nine cadaver upper extremities were tested to evaluate the constraint properties of the dorsal and palmar radioulnar ligaments at their foveal and styloid attachments to the ulna. The specimens were tested by anterior and posterior displacement of the radius relative to the ulna with the forearm in pronation, supination, and neutral rotation. There were no statistically significant differences in the relative percent of constraint contribution of the styloid and foveal ligament insertions. In neutral forearm rotation total displacement after sectioning both ligament insertions tended to be larger in palmar than in dorsal displacement. A similar trend was observed with 60 degrees forearm supination. In the pronated position, however, the trend was reversed with larger total displacement in dorsal displacement.