Range of Motion Adaptations During a Simulated Game Exposure in Softball Pitchers

Hip and shoulder range of motion (ROM) alterations are correlated with increased risk of injury in softball athletes. The purpose of this study was to investigate bilateral shoulder and hip ROM adaptation during a simulated softball double-header exposure. It was hypothesized that shoulder and hip ROM would decrease after simulated game exposure and would not return to baseline following a 30-minute break. Thirty (14.8±1.9 yrs, 162.5±18.3 cm, 71.79±16.03 kg) adolescent softball pitchers participated. Testing included: bilateral hip and shoulder ROM (preSG), simulated game exposure (100 pitches), bilateral hip and shoulder ROM (postSG), 30-minute break, bilateral hip and shoulder ROM (preDH), pitching first inning of a simulated double header (12 pitches), and bilateral hip and shoulder ROM (postDH). Two separate repeated measures multivariate analyses of variance tests determined differences in ROM between time points. Dominant shoulder internal rotation ROM and non-dominant shoulder internal and external rotation ROM significantly decreased from preDG. Stride hip external rotation ROM and drive hip internal and external rotation ROM significantly decreased from preSG to preDH. Key results revealed the break given between games may not be sufficient recovery time for hip ROM. Thus, assessing ROM as workload progresses can be a useful strategy for monitoring a softball pitcher's injury risk.

Peak Elbow Flexion Does Not Influence Peak Shoulder Distraction Force or Ball Velocity in NCAA Division I Softball Pitchers

Background:

High shoulder distraction force has been observed in softball pitchers during the acceleration phase (top of the pitch to ball release) of a pitch. Increasing elbow flexion may reduce shoulder forces and the susceptibility to pain by shortening the lever arm of the throwing arm.

Purpose:

To determine the association of peak elbow flexion during the acceleration phase of the pitch with peak shoulder distraction force and ball velocity.

Study Design:

Descriptive laboratory study.

Methods:

A total of 61 female collegiate softball pitchers (mean age, 19.9 ± 1.9 years; mean height, 175.7 ± 5.7 cm; mean weight, 83.6 ± 12.7 kg; 49 right-handed) volunteered for this study. Biomechanical data were collected with a 3-dimensional electromagnetic tracking system while the pitchers threw 3 maximal-effort fastballs at a regulation distance. Peak elbow flexion and peak shoulder distraction force were calculated for the acceleration phase and averaged across the 3 trials. Ball velocity was assessed with a radar gun.

Results:

Simple linear regression analyses indicated that peak elbow flexion did not influence peak shoulder distraction force during the acceleration phase of the pitch (F(1,59) = 2.412; P = .126), with R² = 0.023. Additionally, peak elbow flexion during the acceleration phase of the pitch did not influence ball velocity (F(1,59) = 2.435; P = .124), with R² = 0.023. A bivariate correlation analysis showed a significant association between ball velocity and shoulder distraction force (R² = 0.343; P = .007) in which ball velocity constituted approximately 34% of the variance in shoulder distraction force.

Conclusion:

Peak elbow flexion did not influence ball velocity or peak shoulder distraction force during the acceleration phase of a windmill softball pitch. However, there was a significant and positive relationship between ball velocity and peak shoulder distraction force. These results may indicate that ball velocity and other kinematic variables may be more related to shoulder distraction force than elbow flexion.

Clinical Relevance:

Increasing elbow flexion can shorten the lever arm, but it did not reduce shoulder distraction force or increase ball velocity. Therefore, elbow flexion may be more useful as a description of the pitching style rather than a single measure related to increased performance or the risk of injuries. Future research should continue to examine the relationship between other kinematic parameters with shoulder distraction force.

Shoulder and Hip Range of Motion and Strength Changes Throughout a Season in College Softball Players

BACKGROUND

Many studies have been done on the strength and mobility of the shoulder and hip in baseball players, but fewer studies have examined these metrics in softball players.

PURPOSE

The purpose of this study was to observe and analyze changes in range of motion (ROM) and strength at the hip and shoulder that occur over the course of a competitive season, to describe preseason ROM and strength at the hip and shoulder in healthy college softball players through side-to-side comparison, and to compare measurements between pitchers and position players.

STUDY DESIGN

Descriptive Cohort Study.

METHODS

Data was collected over the course of six seasons, and a total of fifty-four healthy softball athletes (including pitchers and postiion players) who completed at least one set of preseason and postseason measurements were included. Subjects underwent passive ROM (External rotation [ER], internal rotation [IR], total arc of motion [TAM]) and strength (ER/IR at the shoulder, abduction/extension at the hip) measurements at preseason and postseason timepoints.

RESULTS

Over a season, position players demonstrated an increase in all ROM metrics in both shoulders, except dominant IR, and a decrease in ER strength at the shoulder bilaterally (p<0.05). They also showed decreased ROM in all metrics across both hips (p<0.05). Pitchers had increased IR and TAM ROM in the dominant shoulder, decreased strength in both shoulders (ER throwing; ER and IR non-throwing), decreased ROM in both hips, and decreased abduction strength in the non-dominant hip (p<0.05). Position players showed less preseason IR in the dominant shoulder compared to non-dominant IR (Dominant: 31.7 ± 1.6°, Non-dominant: 37.0 ± 2.3°; p<0.05).

CONCLUSION

Softball pitchers and position players both show increased ROM at the shoulder and decreased ROM at the hip over the course of a season. Position players demonstrated side-to-side discrepancies and seasonal changes at the throwing shoulder similar to those seen in baseball players. The preseason mobility of the dominant shoulder of pitchers increased over the season while strength of hip abduction in the non-dominant side was reduced.

LEVEL OF EVIDENCE

3.

Influence of a Pre-throwing Protocol on Range of Motion and Strength in Baseball Athletes

Though chronic overhand throwing is known to result in range of motion and strength adaptations, there is limited research regarding interventions for maintenance of these characteristics. Therefore, the purposes of this study were to explore the use of a pre-throwing protocol focusing on lumbopelvic-hip complex musculature in high school baseball players and examine its effects on shoulder and hip range of motion and isometric strength over the course of a season. Four exercises were added to the intervention team's warm-up routine. The control and intervention teams' passive bilateral hip and shoulder range of motion and isometric strength were assessed pre/post-season. A multivariate analysis of variance revealed significant differences in delta scores between the teams for multiple shoulder and hip range of motion and isometric strength variables. Key results were the intervention team lost significantly more stride hip external rotation but gained more isometric strength than the control team. The intervention team was also able to better maintain shoulder range of motion than the control team. Practitioners should use the results of this study and consider incorporating exercises that target lumbopelvic-hip complex musculature into their current training program.

Functional differences in softball pitchers with and without upper extremity pain

OBJECTIVES

Though pitchers often throw during multiple games in a day, there are currently no pitch count restrictions in softball. The accumulation of high pitch counts over time may contribute to the development of upper extremity pain. The purpose of our study was to examine functional characteristics of shoulder and hip range of motion (ROM), isometric strength (ISO), and ball speed in softball pitchers with and without upper extremity (UE) pain.

DESIGN

Controlled laboratory design.

METHODS

Fifty-three NCAA Division I softball pitchers (20.0±1.4 years; 173.3±8.3cm; 80.9±12.3kg) participated and were divided into two groups: pain-free (n=30) and pain in the UE (n=23). Bilateral shoulder and hip external rotation (ER) and internal rotation (IR) ROM and ISO were measured prior to pitching to a catcher located 13.1m (43ft) away.

RESULTS

Independent samples t-tests revealed significantly greater throwing side (TS) hip ER ROM (p=0.012), TS hip IR ISO (p=0.038), glove side (GS) hip ER ISO (p=0.025), TS shoulder ER ISO (p=0.002), GS shoulder IR (p=0.006) and ER (p=0.004) ISO in the pain free group versus the UE pain group.

CONCLUSIONS

Differences in shoulder and hip ROM and ISO exist between those who have upper extremity pain and those who do not. Therefore, findings suggest that both the upper and lower extremities should be considered when treating softball pitchers with UE pain.

Unaccounted Workload Factor: Game-Day Pitch Counts in High School Baseball Pitchers-An Observational Study

Background:

Throwing injuries are common in high school baseball. Known risk factors include excessive pitch counts, year-round pitching, and pitching with arm pain and fatigue. Despite the evidence, the prevalence of pitching injuries among high school players has not decreased. One possibility to explain this pattern is that players accumulate unaccounted pitch volume during warm-up and bullpen activity, but this has not yet been examined.

Hypotheses:

Our primary hypothesis was that approximately 30% to 40% of pitches thrown off a mound by high school pitchers during a game-day outing are unaccounted for in current data but will be revealed when bullpen sessions and warm-up pitches are included. Our secondary hypothesis was that there is wide variability among players in the number of bullpen pitches thrown per outing.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Researchers counted all pitches thrown off a mound during varsity high school baseball games played by 34 high schools in North Central Florida during the 2017 season.

Results:

We recorded 13,769 total pitches during 115 varsity high school baseball starting pitcher outings. The mean ± SD pitch numbers per game were calculated for bullpen activity (27.2 ± 9.4), warm-up (23.6 ±8.0), live games (68.9 ±19.7), and total pitches per game (119.7 ± 27.8). Thus, 42.4% of the pitches performed were not accounted for in the pitch count monitoring of these players. The number of bullpen pitches thrown varied widely among players, with 25% of participants in our data set throwing fewer than 22 pitches and 25% throwing more than 33 pitches per outing.

Conclusion:

In high school baseball players, pitch count monitoring does not account for the substantial volume of pitching that occurs during warm-up and bullpen activity during the playing season. These extra pitches should be closely monitored to help mitigate the risk of overuse injury.