Pitching puts heat on upper regions

FOR baseball players, the value of throwing the ball with great force is obvious.

For pitchers, high velocity pitching (throwing heat) is an important determinant of the success.

For infielders, it is often the difference in a batter being out or safe at first base. And for outfielders, it can lead to throwing out the crucial runner at home plate.

However, this repetitive throwing action at such high velocity frequently results in upper extremity injuries.

In collegiate baseball, 58 per cent of all injuries involved the upper extremity and accounted for 75 per cent of the total time lost from sport, longer than injuries to other parts of the body.

Pitchers sustain the majority of upper extremity injuries as the intense, repetitive throwing of pitching places significant stress on the shoulder complex, with rotational velocities greater than 6000 degrees per second; and, at the point of release, distraction forces at the glenohumeral joint 1.0-1.5 times the athlete’s body weight.

As a result, pitching acutely increases the width in important tendons of the shoulder (infraspinatus tendons) after as little as 50 pitches.

The long-term effect of this change is unknown and could be a potential warning sign of future tendon pathology.

Additionally, scapular dyskinesis (abnormal movement of the shoulder blade) has been observed in baseball pitchers.

Research from the Henry Ford Hospital, Detroit attempted to correlate pitching workload with risk of ulnar collateral ligament (UCL) injury in 29 MLB pitchers who underwent primary UCL reconstruction surgery.

A significant difference in workload was reported for total pitch counts (combined MLB and minor league), with the pitchers who required revision surgery pitching less than those who did not (primary: 1413 pitches vs revision: 959).