A Review of Workload-Monitoring Considerations for Baseball Pitchers

A Model for Causality of Pitching-related Overuse Injuries in Women's Fastpitch Softball

Fastpitch softball is a popular women's sport, and athletes, particularly pitchers, are at high risk for overuse injury. Softball-related injury rates are low; however, the prevalence of overuse injuries is high. Injuries at the high school and collegiate levels occur early in the season, and approximately 50% of shoulder and elbow injuries in softball are attributable to overuse. Survey research showed 77% of high school pitchers pitch with pain, and 73% of collegiate pitchers reported an overuse injury in the previous season. Modifiable and non-modifiable intrinsic and extrinsic risk factors contribute to injury risk in a model that can be used in history taking, clinical examination, and management of softball-related injuries. In this manuscript, we present a scoping review of fastpitch softball injury research by competitive levels from 1990 to present. We also introduce a model for overuse injury causality in this athlete population. With this information, clinicians will be able to identify risk factors related to injury in softball pitchers. More research is needed to make evidence-based recommendations for injury prevention in this athlete population.

Workload Risk Factors for Pitching-Related Injuries in High School Baseball Pitchers

BACKGROUND

Pitch counts are only one measure of the true workload of baseball pitchers. Newer research indicates that workload measurement and prevention of injury must include additional factors. Thus, current monitoring systems gauging pitcher workload may be considered inadequate.

PURPOSE/HYPOTHESIS

The purpose of this study was to develop a novel method to determine workload in baseball pitchers and improve processes for prevention of throwing-related injuries. It was hypothesized that our pitching workload model would better predict throwing-related injuries occurring throughout the baseball season than a standard pitch count model.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

This prospective observational study was conducted at an academic medical center and community baseball fields during the 2019 to 2023 seasons. Pitchers aged 13 to 18 years were monitored for pitching-related injuries and workload (which included pitching velocity; intensity, using preseason and in-season velocity as a marker of effort; and pitch counts).

RESULTS

A total of 71 pitchers had 313 recorded pitcher outings, 11 pitching-related injuries, and 24,228 pitches thrown. Gameday pitch counts for all pitchers ranged from 19 to 219 (mean, 77.5 ± 41.0). Velocity ranged from 46.8 to 85.7 mph (mean, 71.3 ± 5.8 mph). Intensity ranged from 0.7 to 1.3 (mean, 1.0 ± 0.08). The mean workload was 74.7 ± 40.1 for all pitchers. Risk factors significant for injury included throwing at a higher velocity in game (P = .001), increased intensity (eg, an increase in mean velocity thrown from preseason to in-season; P < .001), and being an older pitcher (P = .014). No differences were found for workload between injured and noninjured pitchers because the analysis was underpowered.

CONCLUSION

Our workload model indicated that throwing at a higher velocity, throwing at a higher intensity, and older age were risk factors for injury. Thus, this novel workload model should be considered as a means to identify pitchers who may be at greater risk for injury.

Evaluation of Hip Characteristics in Baseball and Softball Athletes with and Without Throwing Arm Pain

During throwing, the lower extremity assists in the generation and transfer of momentum. Lower extremity stability assists in this transfer by providing a base for distal mobility of the arm segments. This study aimed to determine differences between hip rotational range of motion and strength based on the presence of throwing-arm pain (yes/no) and throwing sport (baseball/softball). We hypothesized those experiencing pain would display decreases in hip range of motion and strength, and that softball players would display greater range of motion than baseball, but less strength based on sex-specific characteristics. Forty-four baseball (13±2 years, 165.2±13.0 cm, 58.5±13.4 kg) and 50 softball players (13±2 years, 160.9±11.2 cm, 62.7±17.9 kg) participated. Multivariate analysis of variance tests (2×2) determined differences in bilateral hip range of motion, total arc of motion, and strength between pain status and sport. There were no significant interactions (>0.05) for pain status and sport on hip range of motion, total arc of motion, and strength. Furthermore, no significant main effects (>0.05) were found for pain status or sport alone on range of motion or strength. Future work should be directed at explaining the effects of hip characteristics on the throwing motion and how it equates to throwing-arm health.

Machine Learning Approach for Pitch Type Classification Based on Pelvis and Trunk Kinematics Captured with Wearable Sensors

The large stream of data from wearable devices integrated with sports routines has changed the traditional approach to athletes' training and performance monitoring. However, one of the challenges of data-driven training is to provide actionable insights tailored to individual training optimization. In baseball, the pitching mechanics and pitch type play an essential role in pitchers' performance and injury risk management. The optimal manipulation of kinematic and temporal parameters within the kinetic chain can improve the pitcher's chances of success and discourage the batter's anticipation of a particular pitch type. Therefore, the aim of this study was to provide a machine learning approach to pitch type classification based on pelvis and trunk peak angular velocity and their separation time recorded using wearable sensors (PITCHPERFECT). The Naive Bayes algorithm showed the best performance in the binary classification task and so did Random Forest in the multiclass classification task. The accuracy of Fastball classification was 71%, whilst the accuracy of the classification of three different pitch types was 61.3%. The outcomes of this study demonstrated the potential for the utilization of wearables in baseball pitching. The automatic detection of pitch types based on pelvis and trunk kinematics may provide actionable insight into pitching performance during training for pitchers of various levels of play.

Relationship Between Pitch Counts and Shoulder Strength in Collegiate Baseball Players

ABSTRACT

Gagnon, A, Payette, J, Park, M, Juras, K, and Slater, L. Relationship between pitch counts and shoulder strength in collegiate baseball players. J Strength Cond Res 37(9): 1860-1864, 2023-Large volumes of throwing leads to changes in shoulder strength that have been associated with increased risk of injury. The purpose of this study was to investigate the relationship between throwing volume and eccentric shoulder strength. Twelve NCAA Division I baseball pitchers volunteered to participate. Prepractice and postpractice eccentric shoulder strength was measured using a handheld dynamometer at 30°/second. Change in strength was calculated as the prepractice strength measure subtracted from the postpractice strength measure. After initial testing, subjects self-reported pitch counts before completing postpractice strength testing. Subjects were separated into high-strength and low-strength groups based on the median external rotation strength. Paired t -tests were used to compare change in shoulder strength and Pearson's r correlations were used to quantify the association between pitches and change in strength. There were no changes between prestrength and poststrength assessments in external rotation strength or internal rotation strength for the entire group. When divided into strength groups, correlations between strength and total pitches were nonsignificant for the high-strength group but were strong for both external rotation ( r = -0.87, p = 0.025) and internal rotation ( r = -0.91, p = 0.013) in the low-strength group. Pitchers with lower shoulder eccentric strength at baseline demonstrated greater declines in strength, whereas pitchers with higher shoulder eccentric strength did not demonstrate changes in strength. Changes in strength during practice could lead to compensatory movement that may predispose athletes to injury. Sport performance professionals may benefit from obtaining eccentric shoulder strength to assist with performance periodization and rehabilitation after injury.

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 (t_30.548 = 2.894; P = .007) and mPSD force (t_29.231 = 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.

A Plague of Their Own: Injury Incidence Remains Elevated in the 2021 Major League Baseball Season Compared to Pre-COVID-19 Seasons

Background

Significant increases in injuries were observed in the 2020 Major League Baseball (MLB) season; these were attributed to an increased acute to chronic workload due to the interrupted preseason and compressed season during the coronavirus disease of 2019 (COVID-19) pandemic. In 2021, the MLB resumed its regular schedule.

Hypothesis/Purpose

The purpose of this study was to determine the injury incidence and epidemiology of the 2021 MLB season compared to the injury incidence in the 2020 season and pre-COVID-19 seasons. The hypothesis was that, with the return to normal preseason training, injury incidence in 2021 would return to pre-COVID-19 rates. Additionally, it was hypothesized that injury list (IL) placements at midseason 2021 would be decreased relative to 2020 due to the uninterrupted preseason yet increased at full season 2021 due to increased overall workload from 2020.

Study Design

Descriptive epidemiology study.

Methods

The MLB transactions database was searched for players placed on the IL between 2018 and 2021. Injuries were categorized by body part and player position. Incidence per 1000 athlete-exposures was calculated for the pre-COVID-19 (2018-2019), 2020, and 2021 seasons. The z test for proportions was used to determine significant differences between injury incidences.

Results

The injury incidence rate by midseason 2021 (9.32) compared to 2020 (8.66) was not significantly different (p=0.234). At full season 2021, injury incidence rate (8.69) was significantly higher than pre-COVID-19 seasons (5.13, p<0.001), but not 2020 (p=0.952). When comparing full season 2021 to 2020, increased foot/ankle (0.50 vs 0.14, respectively, p<0.001) and miscellaneous (1.92 vs 0.68, respectively, p<0.001) injuries were observed.

Conclusion

The overall injury incidence in 2021 was significantly higher than pre-COVID-19 seasons, and no significant difference was observed between both mid- and full season 2021 and 2020, refuting the hypotheses. This signifies that injury incidence remained elevated in the 2021 season despite resumption of preseason training and a regular season.

Level of Evidence

3.

Survey with Innovations to Increase Response Rate Reveals Low Compliance with Guidelines among Youth Baseball Coaches - Including a Survey of Differences between Cities

Background

Compliance rates of youth baseball team coaches with guidelines regarding pitch count limits have been reported, but response rates from previous surveys have not been high, which may introduce substantial non-response bias. In addition, differences between cities in guideline compliance rates have remained unclear.

Purpose

The aim of the present study was to obtain data on coach compliance with guidelines for pitch count limits with a high survey response rate. Secondary aims were to determine compliance with guidelines other than pitch count limits, and to determine whether differences in compliance exists between cities.

Methods

A questionnaire was developed for coaches of youth baseball teams in Gunma to assess knowledge of and compliance with the Japan Softball Baseball Association's recommendations for preventing injuries. In the preparation, distribution, and collection of the questionnaire, four strategies were applied to increase the response rate. The questionnaire surveyed basic descriptive information about the team and coach and coaches compliance with guidelines. Survey items were compared between compliant and non-compliant groups for pitch count limits, and by city.

Results

Valid responses to the questionnaire were obtained from coaches of 58 of 62 teams surveyed for a response rate of 93.5%. Despite the fact that almost all coaches were aware of the recommendations regarding pitch count limits and felt these limits were needed, only 15.5% were compliant. For guidelines other than the pitch count limits, the recommended values were exceeded for practice time on holidays. Differences between cities were evident in the compliance rate with the pitch count limit, but no differences between cities in other items were observed.

Conclusion

The results of this research revealed that compliance with pitch count limits in this sample of youth baseball coaches was much lower than previously reported. Differences between cities were identified in rates of compliance with pitch count limits. These results suggest a need to increase compliance rates with guidelines for pitch count limits and to address differences between cities.

Level of Evidence

Cross-sectional survey study, 3b.

Anthropometrics, Athletic Abilities and Perceptual-Cognitive Skills Associated With Baseball Pitching Velocity in Young Athletes Aged Between 10 and 22 Years Old

Objective assessments of players performance and individual characteristics are increasingly used in baseball. However, evidence linking individual characteristics to players' performance are scarce. The purpose of the study was to identify across ages, in younger males and females, and to compare, in younger males, the anthropometrics, athletic abilities and perceptual-cognitive skills associated with baseball pitcher's ball velocity. A cross-sectional design was used to conduct this study. Male and female athletes completed a sociodemographic questionnaire followed by anthropometric, athletic ability, perceptual-cognitive skill and pitching velocity assessments. Athletes were categorized by their age categories (11U, 13U, 15U, 18U, 21U). To evaluate the athletes' anthropometrics, height and weight, BMI, waist circumference, arms segmental length and girth were measured. Athletic abilities were assessed using athletes' grip strength, upper body power, vertical jump height, sprint, change of direction, and dynamic balance. Perceptual-cognitive skills performance was assessed with the Neurotracker platform. Pitching performance assessment was completed using the athletes' average fastball velocity. Kendall Tau's correlation coefficient was used to assess relationships between variables and pitching velocity in male athletes (p &lt; 0.05). A 1-way ANOVA was performed to identify differences between age categories for all variables in male athletes (p &lt; 0.05). In male athletes, without age categories discrimination, all anthropometric, athletic ability and perceptual-cognitive skill factors were associated with pitching velocity with associations ranging from τ = 0.185 for perceptual-cognitive skills to τ = 0.653 for left arm grip strength. The results showed that significant differences exist between age categories for anthropometric, athletic ability and perceptual-cognitive skill assessments. The study showed that associations between anthropometrics and pitching velocity, and athletic abilities and pitching velocity vary across age categories. Descriptive data of female athletes results regarding anthropometrics, athletic abilities, perceptual-cognitive skills and pitching velocity are also presented. Gender differences should be investigated in future studies exploring baseball pitching performance.

Impact and workload are dominating on-field data monitoring techniques to track health and well-being of team-sports athletes

Participation in sports has become an essential part of healthy living in today's world. However, injuries can often occur during sports participation. With advancements in sensor technology and data analytics, many sports have turned to technology-aided, data-driven, on-field monitoring techniques to help prevent injuries and plan better player management. This review searched three databases, Web of Science, IEEE, and PubMed, for peer-reviewed articles on on-field data monitoring techniques that are aimed at improving the health and well-being of team-sports athletes. It was found that most on-field data monitoring methods can be categorized as either player workload tracking or physical impact monitoring. Many studies covered during this review attempted to establish correlations between captured physical and physiological data, as well as injury risk. In these studies, workloads are frequently tracked to optimize training and prevent overtraining in addition to overuse injuries, while impacts are most often tracked to detect and investigate traumatic injuries. This review found that current sports monitoring practices often suffer from a lack of standard metrics and definitions. Furthermore, existing data-analysis models are created on data that are limited in both size and diversity. These issues need to be addressed to create ecologically valid approaches in the future.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Baseball: 2014-2015 Through 2018-2019

CONTEXT

The National Collegiate Athletic Association has supported men's baseball championships since 1947. Since its inception, the number of participating teams and athletes has considerably expanded.

BACKGROUND

Frequently conducting injury surveillance of collegiate baseball athletes is essential for identifying developing temporal patterns.

METHODS

Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics; injury rate ratios were used to examine differential injury rates.

RESULTS

The overall injury rate was 3.16 per 1000 athlete-exposures. The preseason injury rate was significantly higher than the regular season injury rate. The most commonly injured body parts were shoulder (16.1%), arm or elbow (16%), and hand or wrist (13.9%). The most reported specific injury was hamstring tear (7.9%).

CONCLUSIONS

The findings of this study aligned with previous studies-most injuries were due to noncontact and overuse mechanisms, less than one-half of injuries were related to upper extremity body parts, and one-third of all injuries were reported among pitchers.