Shoulder Horizontal Adduction Research Articles

Literature review of specific techniques in catching and throwing in infield defense in baseball - retrospective article

<p>目的：內野手可以是整個棒球守備的核心，棒球守備各階段全身上下的協調，有許多值得探討的專項技巧。方法：本研究使用Google scholar，以Baseball infielder、內野、野球守備、內野捕球、守備ゴロ等關鍵字，搜尋台灣、日本、美國三國關於棒球內野守備專項技巧的文獻做歸納，以不同角度探討內野守備的專項技巧：一、內野守備接球，二、內野守備傳球，三、守備的分期與各分期之動作控制。結果：本篇回顧性論文發現，一、移動腳步到好接球的彈跳點是良好守備的關鍵。二、減少軸心腳在接球位置上的變化和較為前面的接球點，對於接球的穩定性至關重要，甚至會影響到後續傳球的動能。三、精簡接傳的動作相較於增加傳球球速可能可以更能有效減少整體守備時間。四、優秀選手在接球的過程中會儘早讓軸心腳著地，並前期和中期將重心保留在軸心腳。五、內野手傳球在前導腳接觸時，軀幹向後扭轉和肘部伸展角度都會比投手小。結論：無論是接球前腳步移動的節奏和精確性，還是接球時的接球點和接短彈跳的能力，甚至是軀幹和骨盆前傾的時機點，對於內野守備過程都產生一定的影響。建議在日常練習時，就能將接短彈跳、腳步移動，納入訓練課表中，並且在動作過程中，加以檢視軀幹的姿勢，方能在比賽時擁有良好的守備表現。</p> <p> </p><p>The standing throw with run-up is the best approach to evaluate the performance of energy transfer and the efficiency of throwing motions for handball players. Purpose: This research aims at analyzing the usage of the standing throw with run-up among the handball players in Taiwan. The roles of body kinematics, strength of core muscles and standing balance of the drive leg played in the standing throw with run-up are also discussed. Methods: Nine Division I handball players from college went through a series of tests. The motions and the speed of the handball throwing were detected by a 3D electromagnetic motion analysis system and a sports radar gun, respectively. The maximum isometric muscle strength of trunks and hips were measured by a torque sensor and a home-made device of strength measurement. The standing balance of the drive leg was measured by a force plate with a mat. Results: The maximal shoulder external rotation angle in the arm cocking phase, the maximal trunk rotation velocity in the arm acceleration phase and the maximal shoulder horizontal adduction velocity showed moderate positive relationships with the ball velocity. The strength of back muscles had a moderate negative relationship with the ball velocity. The correlation between the balance ability of the drive leg and the ball velocity was not observed. Conclusion: The importance of proximal segments to the standing throw with run-up is analyzed by kinematical analysis. It is suggested that the energy of handball throwing is generated by the upper extremities or other limb segments in the processes of the standing throw with run-up. Our findings can serve as a helpful reference for both coaches and players.</p> <p> </p>

Shoulder External Over Internal Rotation Ratio Is Related to Biomechanics in Collegiate Baseball Pitching.

Altering baseball pitching mechanics affects both performance and the risk of injury. The purpose of this study is to investigate the relationships of shoulder external over internal rotation ratio (SEIR) and other shoulder rotational properties during physical exam and biomechanics of pitching for 177 collegiate baseball pitchers. The shoulder range of motion was quantitatively measured using a custom-made wireless device. Pitching motion data were collected at 240Hz, and a custom program was created to calculate the throwing arm motion and loading during baseball pitching. Linear regression and analysis of variance tests were performed to investigate the relationships between the shoulder physical exam outcomes and throwing arm biomechanics. SEIR had significant correlations with shoulder horizontal adduction angle at foot contact, maximum shoulder external rotation angle, maximum shoulder linear velocity, and elbow angle at ball release. SEIR groups had significant differences in shoulder proximal force, adduction torque, internal rotation torque, and horizontal adduction torque, and in elbow medial force and varus torque. Glenohumeral internal rotation deficit and total rotational motion deficit had no relationships with throwing arm motions or joint loadings. Shoulder health should be monitored to improve understanding of pitching mechanics in collegiate baseball pitchers.

Association of Head-Neck Rotation With History of Pitching-Related Elbow Pain in Youth Baseball Players.

Prevention of pitching-related elbow pain in youth baseball players is important. Overhead pitching involves a whole-body motion, including head-neck rotation. A limited range of motion of head-neck rotation may cause inefficient pitching motion; however, this association is unclear. To determine whether the range of motion of head-neck rotation is associated with the history of pitching-related elbow pain in youth baseball players. Cross-sectional study; Level of evidence, 3. A total of 311 youth baseball players were selected and asked to complete a questionnaire survey about their age, weight, height, sex, baseball experience, main position, pitching side, and previous/current elbow pain during pitching. The range of motion of the upper and lower limb joints, head-neck rotation, and thoracic kyphosis angle were measured. Binomial logistic regression analysis was used to identify factors associated with the history of elbow pain related to pitching. There were 101 players with a history of pitching-related elbow pain (history group) and 142 players with no pitching-related elbow pain (no-history group). The history group had significantly lower values than the no-history group regarding the range of motion of head-neck rotation on the nondominant side (74.9°± 9° vs 77.7°± 9.6°; P = .02) and overall head-neck rotation (150.6°± 14.7° vs 154.9°± 18.4°; P = .04). Binomial logistic regression analysis identified head-neck rotation on the nondominant side (odds ratio [OR], 0.97 [95% CI, 0.94-1.00]), shoulder horizontal adduction on the dominant side (OR, 0.98 [95% CI, 0.96-1.00]), height (OR, 1.04 [95% CI, 1.00-1.08]), and playing position (pitcher) (OR, 0.40 [95% CI, 0.21-0.76]) as factors associated with a history of pitching-related elbow pain. Our cross-sectional analysis demonstrated that youth baseball players with a history of pitching-related elbow pain had limited head-neck rotation range of motion on the nondominant side, and this was a significant factor associated with the history of pitching-related elbow pain.

Factors Associated with Medial Elbow Torque Measured Using a Wearable Sensor in Junior High School Baseball Pitchers

There are no reports investigating the relationship between shoulder range of motion (ROM) and pitching elbow torque in junior high school pitchers. Therefore, we aimed to evaluate the factors associated with medial elbow torque in this population. Sixty-three junior high school baseball pitchers were recruited for this study. The participants completed a questionnaire and passive ROM measurements of shoulder abduction and horizontal adduction. All pitchers pitched three fastballs at maximum effort while wearing a wireless sensor recording pitching mechanics and elbow valgus torque for each pitch. Age (r = 0.65, p < 0.001), height (r = 0.83, p < 0.001), body weight (r = 0.82, p < 0.001), BMI (r = 0.60, p < 0.001), and ball velocity (r = 0.80, p < 0.001) were significantly positively correlated with elbow valgus torque. Participants were divided into two groups based on elbow valgus torque, >30 (high torque [HT]) and <30 N·m (low torque [LT]). Age, height, body weight, BMI, and ball velocity were significantly higher in the HT group than in the LT group. The difference between dominant and non-dominant shoulder horizontal adduction ROM was 5.3 ± 9.3° and 1.0 ± 6.4° in the HT and LT groups, respectively, which was also significantly different. Ball velocity, age, larger physique, and increased restriction of the dominant shoulder’s horizontal adduction ROM were associated with higher medial elbow torque in junior high school pitchers. This suggests that improving the dominant shoulder’s horizontal adduction ROM contributes to preventing elbow injuries.

Multi-joint Assessment of Proprioception Impairments Poststroke

ObjectivesTo investigate shoulder, elbow and wrist proprioception impairment poststroke. DesignProprioceptive acuity in terms of the threshold detection to passive motion at the shoulder, elbow and wrist joints was evaluated using an exoskeleton robot to the individual joints slowly in either inward or outward direction. SettingA university research laboratory. ParticipantsSeventeen stroke survivors and 17 healthy controls (N=34). Inclusion criteria of stroke survivors were (1) a single stroke; (2) stroke duration <1 year; and (3) cognitive ability to follow simple instructions. InterventionsNot applicable. Main Outcome MeasuresThreshold detection to passive motion and detection error at the shoulder, elbow and wrist. ResultsThere was significant impairment of proprioceptive acuity in stroke survivors as compared to healthy group at all 3 joints and in both the inward (shoulder horizontal adduction, elbow and wrist flexion, P<.01) and outward (P<.01) motion. Furthermore, the distal wrist joint showed more severe impairment in proprioception than the proximal shoulder and elbow joints poststroke (P<.01) in inward motion. Stroke survivors showed significantly larger detection error in identifying the individual joint in motion (P<.01) and the movement direction (P<.01) as compared to the healthy group. There were significant correlations among the proprioception acuity across the shoulder, elbow and wrist joints and 2 movement directions poststroke. ConclusionsThere were significant proprioceptive sensory impairments across the shoulder, elbow and wrist joints poststroke, especially at the distal wrist joint. Accurate evaluations of multi-joint proprioception deficit may help guide more focused rehabilitation.

Correlation between run-up speed and throwing distance of elite javelin athletes

&lt;p&gt;目的：本研究探討台灣優秀標槍選手助跑速度與投擲距離之相關性。方法：8位國內優秀標槍選手 (身高：176.2 &amp;plusmn; 4.5公分，體重：87.7 &amp;plusmn; 10.7公斤，年齡：21.1 &amp;plusmn; 3.7歲，平均投擲距離：68.8 &amp;plusmn; 6.9公尺)，本研究採用實際比賽進行數據收集，本研究使用高速攝影機 (60Hz) 紀錄投擲標槍助跑過程，透過影像分析獲得助跑距離及時間。本研究採用相依樣本t檢定比較預賽及決賽的助跑速度及投擲表現及使用皮爾森積差相關分析比較助跑速度及投擲表現之相關性，顯著水準訂為 &amp;alpha; = .05。結果：研究結果發現，預賽與決賽的投擲表現顯著大於決賽有顯著差異 (p &lt; .05)，但預賽與決賽的助跑速度無顯著差異 (p &gt; .05)，另外，預賽與決賽的投擲距離與助跑速度相關性沒有顯著差異。結論：當助跑速度越快不會增加投擲距離。選手可能會有個別最佳的助跑速度。&lt;/p&gt;&lt;p&gt;The standing throw with run-up is the best approach to evaluate the performance of energy transfer and the efficiency of throwing motions for handball players. Purpose: This research aims at analyzing the usage of the standing throw with run-up among the handball players in Taiwan. The roles of body kinematics, strength of core muscles and standing balance of the drive leg played in the standing throw with run-up are also discussed. Methods: Nine Division I handball players from college went through a series of tests. The motions and the speed of the handball throwing were detected by a 3D electromagnetic motion analysis system and a sports radar gun, respectively. The maximum isometric muscle strength of trunks and hips were measured by a torque sensor and a home-made device of strength measurement. The standing balance of the drive leg was measured by a force plate with a mat. Results: The maximal shoulder external rotation angle in the arm cocking phase, the maximal trunk rotation velocity in the arm acceleration phase and the maximal shoulder horizontal adduction velocity showed moderate positive relationships with the ball velocity. The strength of back muscles had a moderate negative relationship with the ball velocity. The correlation between the balance ability of the drive leg and the ball velocity was not observed. Conclusion: The importance of proximal segments to the standing throw with run-up is analyzed by kinematical analysis. It is suggested that the energy of handball throwing is generated by the upper extremities or other limb segments in the processes of the standing throw with run-up. Our findings can serve as a helpful reference for both coaches and players.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Mechanism for control of ball spin rate by the upper limb in baseball pitching based on singular value decomposition

This study aims to examine the mechanism by which the ball spin rate during fastball pitching is controlled by synergistic joint torque. The participants were seven baseball players. The kinematics and kinetics of the fingers, wrist, elbow, and shoulder were calculated using the inverse dynamics method. The synergistic relationship between the joint torques was calculated using singular value decomposition. The similarity of the spatial pattern of the joint torque in each participant was evaluated using cosine similarity. The results indicated that there were three types of synergistic torque control: (1) two pitchers had a synergistic torque control that was primarily based on shoulder internal rotation torque, (2) two pitchers had a synergistic torque control that was primarily based on elbow extension torque, and (3) three pitchers had a synergistic torque control that was primarily based on shoulder horizontal adduction torque. In particular, pitchers with a high spin rate relative to the ball velocity (SPV) had a torque control of the shoulder internal rotation type. In contrast, pitchers with a low SPV had a torque control of the shoulder horizontal adduction type. It is considered that pitchers with a high SPV execute shoulder internal rotation torque, which has the same direction as that of ball spin, based on hierarchical control to increase the ball spin rate. These results suggest that pitchers with high and low SPVs exhibit different motor patterns. Pitchers and coach need to focus on the shoulder joint as well as the fingers when they throw fastball.

Effects of Repetitive Pitching on Trunk Muscle Endurance and Thoracic and Shoulder Kinematics.

Baseball players are aware of the potential of shoulder problems due to repetitive throwing. However, few studies have examined how pitching repeatedly affects the thoracic spine and shoulder. This study aimed to determine the effects of pitching repeatedly on the endurance of trunk muscles and kinematics of the thoracic spine and shoulder. Cohort study. Trunk muscle endurance was assessed in flexion, extension, and lateral flexion positions in 12 healthy amateur baseball players. The positions of stride foot contact (SFC) during the early cocking phase and maximal shoulder external rotation (MER) during the late cocking phase were used to compute the thoracic and shoulder kinematics in degrees. Participants were then asked to throw 135 fastballs (~9 innings with 15 throws per inning). Throwing motions were monitored throughout the first, seventh, eighth, and nine innings, whereas trunk muscular endurance was assessed before and after the repetitive throwing activity. Ball speed during pitching was measured using a radar gun. All outcome measures were statistically compared to examine differences over time. The trunk muscle endurance declined after the throwing task. In the eighth inning, compared with the first inning, the thoracic rotation angle at the SFC increased toward the throwing side. In contrast, the shoulder horizontal adduction angle at MER decreased in the seventh and ninth innings. With repeated pitching, trunk muscle endurance gradually declines, and repetitive throwing significantly altered kinematics of the thoracic rotation at SFC and shoulder horizontal plane at MER. 2a.

Comparison of shoulder functions between assembly workers with and without subacromial pain syndrome.

The occurrence of subacromial pain syndrome (SPS) is associated with the frequent handling and lifting of heavy loads and excessive repetitive work. Thus, assembly workers have a high prevalence of SPS. The purpose of this study was to investigate differences in shoulder ROM, muscle strength, asymmetry ratio, function, productivity, and depression between workers with and without SPS. Sixty-seven male workers (35 workers with SPS and 32 workers without SPS) participated in this study. Shoulder internal rotation (SIR), shoulder external rotation (SER), shoulder abduction (SAB), shoulder horizontal adduction ROM and SIR, SER, elbow flexion (EF), scapular depression and adduction, scapular protraction strength were measured. The asymmetry ratio was calculated using the asymmetry ratio formula; shoulder functions were measured using the shoulder pain and disability index (SPADI), disabilities of the arm, shoulder, and hand (DASH), and visual analogue scale (VAS); and Endicott work productivity scale (EWPS). The SPADI (p = 0.001), DASH (p = 0.001), and VAS (p = 0.001) values of workers with SPS were higher than those of workers without SPS. Also, workers with SPS had lower SIR (p = 0.001) and SAB (p = 0.002) ROM compared to workers without SPS. In addition, workers with SPS exhibited lower SIR (p = 0.012) strength than workers without SPS. Workers with SPS had higher asymmetry ratio in SIR (p = 0.015), SER (p = 0.005), and EF (p = 0.008) strength than workers without SPS. The SIR, SAB ROM, SIR strength, and the asymmetry ratio of SIR, SER, EF strengths could provide an important baseline comparison for the workers with SPS.

The biomechanical analysis of the standing throw with run-up

&lt;p&gt;為了解手球選手在投擲動作上的效率，墊步射門是檢視能量傳遞好壞的最佳方式。目的：分析臺灣手球選手使用墊步射門的情形，以及探討肢體運動學，核心肌群肌肉力量和前導腳站立平衡能力在墊步射門中的重要性。方法：9 位大專男子甲組選手 (年齡 22.0 &amp;plusmn; 1.3 歲、身高 177.1 &amp;plusmn; 3.1 公分、體重 78.4 &amp;plusmn; 5.1 公斤)，以三度空間電磁場動作分析系統擷取墊步射門動作，並以雷達測速槍測量球速；以力矩傳感器搭配特製測力裝置測量軀幹及髖關節各肌群之最大等長肌力；以軟墊置於測力板上測量前導腳站立平衡能力。使用肯德爾相關係數探討射門運動學參數、核心肌群肌肉力量和前導腳站立平衡能力與墊步射門球速之相關性，顯著水準定在 p &lt; .05。結果：引臂期的肩膀最大外轉角度 (Kendall’s tau-b = .54)，手臂加速期的軀幹最大旋轉速度 (Kendall’s tau-b = .54)、肩膀最大水平內收速度 (Kendall’s tau-b = .69) 與射門球速皆有中度的正相關。背部肌肉力量與射門球速有中度的負相關 (Kendall’s tau-b = -.57)。前導腳平衡能力參數與射門球速皆無相關性存在。結論：透過運動學分析了解到大專男子甲組選手在執行墊步射門時的動作表現，並發現身體近端對於墊步射門的重要性。建議應加強墊步射門時的軀幹動作，藉由較快的軀幹旋轉速度來帶動上肢的投擲表現，以提升射門球速。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;The standing throw with run-up is the best approach to evaluate the performance of energy transfer and the efficiency of throwing motions for handball players. Purpose: This research aims at analyzing the usage of the standing throw with run-up among the handball players in Taiwan. The roles of body kinematics, strength of core muscles and standing balance of the drive leg played in the standing throw with run-up are also discussed. Methods: Nine Division I handball players from college went through a series of tests. The motions and the speed of the handball throwing were detected by a 3D electromagnetic motion analysis system and a sports radar gun, respectively. The maximum isometric muscle strength of trunks and hips were measured by a torque sensor and a home-made device of strength measurement. The standing balance of the drive leg was measured by a force plate with a mat. Results: The maximal shoulder external rotation angle in the arm cocking phase, the maximal trunk rotation velocity in the arm acceleration phase and the maximal shoulder horizontal adduction velocity showed moderate positive relationships with the ball velocity. The strength of back muscles had a moderate negative relationship with the ball velocity. The correlation between the balance ability of the drive leg and the ball velocity was not observed. Conclusion: The importance of proximal segments to the standing throw with run-up is analyzed by kinematical analysis. It is suggested that the energy of handball throwing is generated by the upper extremities or other limb segments in the processes of the standing throw with run-up. Our findings can serve as a helpful reference for both coaches and players.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Prevalence of Upper Quadrant Musculoskeletal Disorders among Healthcare Professionals in a Tertiary Care Hospital

Background: Healthcare professionals (HCPs) are vulnerable to acquire musculoskeletal disorders during theirwork routine. Shortage of HCPs, long working hours and mandatory overtime results in overburden on thoseavailable, especially during pandemic such as in COVID -19. Objective of the study was to evaluate the prevalenceof upper quadrant musculoskeletal disorders (UQMSDs) among HCPs.Methodology: A total of 370 HCPs including doctors, dentists, physiotherapists and nurses were evaluated forthe presence of trigger points (TrPs) in upper trapezius, levator scapula, infraspinatus and sternocleidomastoidmuscles, severity of pain (NPRS), neck disability (NDI) and cervical and shoulder ROM (goniometer).Results: The prevalence rate of UQMSDs was found to be high among HCPs. TrPs were more prevalent in uppertrapezius muscle (46.21%) followed by levator scapulae, infraspinatus and sternocleidomastoid muscles. 4.1% ofHCPs reported severe pain, 16.7% reported moderate pain and 48.36% reported mild pain in upper quadrant.0.8% of HCPs had complete, 1.2% had severe, 5.3% had moderate and 37.6% had mild neck disability. The cervicalrotation and shoulder horizontal adduction ROM were found to be more restricted among HCPs.

Biomechanical, Anthropometric and Psychological Determinants of Barbell Bench Press Strength.

The purpose of this study was to improve our understanding of the relative contributions of biomechanical, anthropometric, and psychological factors in explaining maximal bench press (BP) strength in a heterogeneous, resistance-trained sample. Eighteen college-aged participants reported to the laboratory for three visits. The first visit consisted of psychometric testing. The second visit assessed participants' anthropometrics, additional psychometric outcomes, and bench press one repetition maximum (1RM). Participants performed isometric dynamometry testing for horizontal shoulder adduction and elbow extension at a predicted sticking point joint position. Multiple linear regression was used to examine the relationships between the biomechanical, anthropometric, and psychological variables and BP 1RM. Our primary multiple linear regression accounted for 43% of the variance in BP strength (F(3,14) = 5.34, p = 0.01; R2 = 0.53; adjusted R2 = 0.43). The sum of peak isometric net joint moments from the shoulder and elbow had the greatest standardized effect (0.59), followed by lean body mass (0.27) and self-efficacy (0.17). The variance in BP 1RM can be similarly captured (R2 = 0.48) by a single principal component containing anthropometric, biomechanics, and psychological variables. Pearson correlations with BP strength were generally greater among anthropometric and biomechanical variables as compared to psychological variables. These data suggest that BP strength among a heterogeneous, resistance-trained population is explained by multiple factors and is more strongly associated with physical than psychological variables.

Determinants of Biomechanical Efficiency in Collegiate and Professional Baseball Pitchers

Background: Biomechanical efficiency, defined as fastball velocity per unit of normalized elbow varus torque, is a relatively new metric applied to improving the performance and health of baseball pitching. Purpose/Hypothesis: The purpose of this work was to evaluate kinematic parameters influencing biomechanical efficiency among professional and collegiate pitchers. Kinematic differences were compared between pitchers of high and low biomechanical efficiency. We hypothesized that professional pitchers would have greater biomechanical efficiency than collegiate pitchers. Study Design: Descriptive laboratory study. Methods: A deidentified biomechanical database of 545 pitchers (447 professional, 98 collegiate) was analyzed. A multivariate linear regression model was used to evaluate significant findings a priori with α = .05. Additionally, biomechanical differences were identified between competition levels and between high and low biomechanical efficiency groups using Mann-Whitney U test (α = .05). Results: Competition level and 11 (of 21) kinematic variables explained 27% of the variance in biomechanical efficiency, with most of the predictors being throwing arm kinematics (elbow flexion at stride foot contact [SFC]: β, −1.47; SE, 0.26; shoulder abduction at SFC: β, −1.78; SE, 0.39; shoulder external rotation at SFC: β, 0.60; SE, 0.22; maximum external rotation [MER] angle: β, 1.82; SE, 0.42; shoulder horizontal adduction at MER: β, −3.42; SE, 0.71) (all P≤ .05). Professional pitchers had greater biomechanical efficiency than collegiate pitchers (711.0 ± 101.0 vs 657.0 ± 99.3, respectively; P < .001; d = 0.53). Compared with the low-efficiency group, the high-efficiency group had significantly lower normalized elbow varus torque with greater weight and height (high: 0.047 ± 0.004 %wt*ht vs. low: 0.063 ± 0.006 %wt*ht, P <.001; d = 3.20). At the instant of SFC, the high-efficiency group demonstrated greater shoulder external rotation and less elbow flexion, shoulder abduction, and pelvic rotation. The high-efficiency group also had greater MER and less shoulder horizontal adduction at MER, trunk side tilt at ball release, and knee excursion from foot contact to ball release. Conclusion: Professional pitchers had greater biomechanical efficiency than collegiate pitchers. Biomechanical efficiency was also affected by 11 kinematic variables identified in this study. Pitchers with higher efficiency had distinct differences in arm position, trunk side tilt, and lead-knee extension range of motion in the delivery. Thus, pitchers and baseball organizations should focus on these factors to lower normalized elbow varus torque relative to ball velocity.

The Relationship Between Maximum Shoulder Horizontal Abduction and Adduction on Peak Shoulder Kinetics in Professional Pitchers.

Repetitive horizontal shoulder abduction during pitching can cause increased contact between the posterosuperior aspect of the glenoid and the greater tuberosity of the humeral head, theoretically putting baseball pitchers at increased risk of shoulder internal impingement and other shoulder pathologies. Increased shoulder horizontal abduction is associated with increased shoulder anterior force, while increased horizontal adduction is associated with increased shoulder distraction force. Descriptive laboratory study. Level 4. A total of 339 professional baseball pitchers threw 8 to 10 fastball pitches using 3D motion capture (480 Hz). Pitchers were divided into 2 sets of quartiles based on maximum shoulder horizontal abduction and adduction. Elbow flexion, shoulder external rotation, and peak shoulder kinetics were compared between quartiles with post hoc linear regressions conducted for the entire cohort. At maximum shoulder horizontal abduction, there was no difference in ball velocity between quartiles (P = 0.76). For every 10º increase in maximum shoulder horizontal abduction, shoulder anterior force decreased by 2.2% body weight (BW) (P < 0.01, B = -0.22, β = -0.38), shoulder adduction torque decreased by 0.5%BW × body height (BH) (P < 0.01, B = -0.05, β = -0.19), and shoulder horizontal adduction torque decreased by 0.4%BW × BH (P < 0.01, B = -0.04, β = -0.48). For every 10º increase in maximum shoulder horizontal adduction, shoulder anterior force increased by 2%BW and ball velocity decreased by 1.2 m/s (2.7 MPH). Professional pitchers with the least amount of maximum horizontal adduction had faster ball velocity and decreased shoulder anterior force. Pitchers with greater maximum shoulder horizontal abduction had decreased shoulder anterior force, shoulder adduction torque, and shoulder horizontal adduction torque. To maximize ball velocity as a performance metric while minimizing shoulder anterior force, pitchers can consider decreasing maximum shoulder adduction angles at later stages of the pitch. Identifying risk factors for increased throwing shoulder kinetics (ie, shoulder anterior force, shoulder adduction torque) has potential implications in injury prevention. Specifically, mitigating shoulder anterior forces may be beneficial in reducing risk of injury.

Force-Time Curve Variable Outcomes Following a Simulated Tennis Match in Junior Players.

This study examined the alterations induced by a simulated tennis competition on maximal isometric voluntary contraction (MVC), peak rate of force development (PRFD) and rate of force development (RFD) at different stages of contraction. Twenty junior tennis players performed an 80-minute simulated tennis match and two (pre and post) muscular performance tests. Variables tested included MVC, PRFD and RFD at 50, 100, 150 and 200 ms while performing a 90º shoulder internal rotation (IR90), 90º shoulder external rotation (ER90), shoulder horizontal adduction (ADD), shoulder horizontal abduction (ABD) and isometric mid-thigh pull (IMTP). Serve velocity (SV) was also registered. No significant changes were found regarding MVC, PRFD or SV. Non-significant moderate effect size (ES) towards a decrease in the IR90 RFD at 50 ms could be observed (16%; ES = 0.5) alongside an increase in the ADD and IMTP RFD at 150 ms (-15.8%, -8.2%; ES = -0.53, -0.54) and IMTP RFD at 200 ms (-13%; ES = -0.54). Results indicate that MVC, PRFD, RFD at different time intervals and SV are unaltered following an 80-minute simulated match, possibly due to insufficient alterations triggered on key factors affecting the tested variables.

Relationships between throwing mechanics and shoulder anterior force in high school and professional baseball pitchers.

Excessive shoulder anterior force has been implicated in pathology of the rotator cuff in little league and professional baseball pitchers; in particular, anterior laxity, posterior stiffness, and glenohumeral joint impingement. Distinctly characterized motions associated with excessive shoulder anterior force remain poorly understood. High school and professional pitchers were instructed to throw fastballs while being evaluated with 3D motion capture (480 Hz). A supplementary random forest model was designed and implemented to identify the most important features for regressing to shoulder anterior force, with subsequent standardized regression coefficients to quantify directionality. 130 high school pitchers (16.3 ± 1.2 yrs; 179.9 ± 7.7 cm; 74.5 ± 12.0 kg) and 322 professionals (21.9 ± 2.1 yrs; 189.7 ± 5.7 cm; 94.8 ± 9.5 kg) were included. Random forest models determined nearly all the variance for professional pitchers (R2 = 0.96), and less than half for high school pitchers (R2 = 0.41). Important predictors of shoulder anterior force in high school pitchers included: trunk flexion at maximum shoulder external rotation (MER) (X.IncMSE = 2.4, β = -0.23, p < 0.001), shoulder external rotation at ball release (BR)(X.IncMSE = 1.7, β = -0.34, p < 0.001), and shoulder abduction at BR (X.IncMSE = 3.1, β = 0.17, p < 0.001). In professional pitchers, shoulder horizontal adduction at foot contact (FC) was the highest predictor (X.IncMSE = 13.9, β = 0.50, p < 0.001), followed by shoulder external rotation at FC (X.IncMSE = 3.6, β = 0.26, p < 0.001), and maximum elbow extension velocity (X.IncMSE = 8.5, β = 0.19, p < 0.001). A random forest model successfully selected a subset of features that accounted for the majority of variance in shoulder anterior force for professional pitchers; however, less than half of the variance was accounted for in high school pitchers. Temporal and kinematic movements at the shoulder were prominent predictors of shoulder anterior force for both groups. : Our statistical model successfully identified a combination of features with the ability to adequately explain the majority of variance in anterior shoulder force among high school and professional pitchers. To minimize shoulder anterior force, high school pitchers should emphasize decreased shoulder abduction at BR, while professionals can decrease shoulder horizontal adduction at FC.

The influence of stride width on kinematic and kinetics in high school and professional baseball pitchers: A propensity-matched biomechanical evaluation

ObjectivesTo evaluate kinematic and kinetic parameters for high school (HS) and professional (PRO) pitchers differentiated by stride width. DesignDescriptive laboratory study. MethodsHS (n = 36) and PRO (n = 172) baseball pitchers pitched 8–12 fastballs using 3D-motion capture (480-Hz). Pitchers were 1:1 propensity-scored matched by age, height, weight, and ball velocity based on ‘narrow’ versus ‘wide’ stride widths and kinematics and kinetics were compared using independent t-tests. Independent associations between variables and stride width were determined utilizing linear regressions. ResultsAt foot contact, HS wide (n = 18) had significantly less lead knee flexion (41 ± 9° vs. 49 ± 6°, p = 0.007, d = −1.0) and less pelvis rotation (66 ± 9° vs. 57 ± 14°, p = 0.003 d = 0.8) compared to HS narrow (n = 18). PRO wide (n = 86) at ball release had significantly less pelvis rotation (−10 ± 10° vs. −15 ± 14°, p = 0.008, d = 0.4) and increased shoulder horizontal adduction (4±8° vs. −1±9°, p=0.003, d=0.5) compared to PRO narrow (n = 86). For every 10 cm increase in stride width, pelvis rotation at ball release decreased by 2° (B:0.10, β:0.20, p < 0.001) in HS and 1.3° (B:0.08, β:0.13, p = 0.002) in PRO. ConclusionsHS and PRO pitchers differentiated by stride width demonstrated no significant difference in throwing arm kinetics. For both groups, wider stride width was associated with decreased pelvis rotation, which may contribute to inefficient utilization of kinetic energy. Ultimately, coaches and players may better focus their efforts on refining other kinematics for enhanced performance outcomes and safe pitching mechanics.

Anteroinferior bundle of the acromioclavicular ligament plays a substantial role in the joint function during shoulder elevation and horizontal adduction: a finite element model

BackgroundPostoperative acromioclavicular (AC) ligament deficiency has been identified as a common cause of failure after isolated coracoclavicular reconstruction. The two-bundle arrangement of the acromioclavicular ligament has recently been reported in histological and anatomical research. In addition, a clear structural advantage of the superoposterior bundle (SPB) over the less consistent anteroinferior bundle (AIB) was also found. However, the current understanding of the function of the acromioclavicular ligament in joint stability is based on uniaxial bone loading experiments and sequential ligament sectioning. Consequently, these rigid biomechanics models do not reproduce the coupled physiological kinematics, neither in the normal joint nor in the postoperative condition. Therefore, our goal was to build a quasi-static finite element model to study the function of the acromioclavicular ligament based on its biomechanical performance patterns using the benefits of computational models.MethodsA three-dimensional bone model is reconstructed using images from a healthy shoulder. The ligament structures were modeled according to the architecture and dimensions of the bone. The kinematics conditions for the shoulder girdle were determined after the osseous axes aligned to simulate the shoulder elevation in the coronal plane and horizontal adduction. Three patterns evaluated ligament function. The peak von Mises stress values were recorded using a clock model that identified the stress distribution. In addition, the variation in length and displacement of the ligament during shoulder motion were compared using a two-tailed hypotheses test. P values < 0.01 were considered statistically significant.ResultsThe peak von Mises stress was consistently observed in the AIB at 2:30 in coronal elevation (4.06 MPa) and horizontal adduction (2.32 MPa). Except in the position 2:00, statistically significant higher deformations were identified in the two bundles during shoulder elevation. The highest ligament displacement was observed on the Y- and Z-axes.ConclusionsThe AIB has the primary role in restricting the acromioclavicular joint during shoulder motion, even though the two bundles of the AC ligament have a complementary mode of action. During horizontal adduction, the SPB appears to prevent anterior and superior translation.

Effectiveness of a Shoulder Exercise Program in Division I Collegiate Baseball Players During the Fall Season.

BackgroundDeficits in shoulder range of motion (ROM) and strength are associated with risk of arm injury in baseball players.PurposeThe purpose of this study was to assess the effectiveness of a standardized exercise program, during the fall season, on shoulder ROM and rotational strength in collegiate baseball players.Study DesignProspective cohort studyMethodsPassive shoulder internal rotation (IR), external rotation (ER), and horizontal adduction ROM were measured with an inclinometer. Shoulder IR and ER strength was assessed using a hand-held dynamometer and normalized to body weight. Players performed a program of shoulder stretching and strengthening exercises, three times/week for one month and then one time/week for two months. Paired sample t-tests compared pre-intervention to post-intervention outcome measures.ResultsDivision I baseball players (n=43; 19.6±1.2years, 185.8±5.5cm, 90.5±7.0kg) volunteered. From pre- to post-intervention, there were increases in horizontal adduction ROM in the throwing (Mean Difference (MD)=6.1°, 95%CI=3.7,8.5; p<0.001) and non-throwing arm (MD=8.0°, 95%CI=5.6,10.3; p<0.001), and a decrease in non-throwing arm ER ROM (MD=2.8°, 95%CI= 0.2,5.5; p=0.039). The ER ROM surplus (throwing – non-throwing) increased (MD=5.6°, 95%CI= 1.1,10.2; p=0.016). Throwing arm (MD=1.3%BW, 95%CI=0.5-2.1, p=0.003) and non-throwing arm (MD=1.2%BW, 95%CI=0.4,2.0; p=0.004) ER strength decreased. A notable, but non-significant increase in IR strength on the throwing arm (MD=1.6%BW, 95%CI=0.1,3.0; p=0.055) and decrease on the non-throwing arm (MD=1.2%BW, 95%CI=0.0,2.4; p=0.055) occurred. Additionally, throwing arm ER:IR strength ratio (MD=0.16, 95%CI=0.08,0.25; p<0.001) also decreased.ConclusionChanges in shoulder horizontal adduction ROM, IR strength and relative ER surplus on the throwing arm were noted at the end of the season. The lack of change in IR and ER ROM and may be related to the lack of deficits at the start of the fall season.Level of Evidence2.

Increased Shoulder Distraction Force and Shoulder Horizontal Abduction in Professional Baseball Pitchers With Discordant Torso Rotation Order

Background: Inefficient energy transfer from the pelvis and trunk has been shown to increase compensation at the level of the shoulder. Kinetic chain sequencing of the core segments is underexamined in professional baseball pitchers, especially as it relates to changes in upper extremity kinetics. Purpose: To evaluate elbow and shoulder kinetics in a cohort of professional pitchers differentiated by instances of discordant pelvic to upper torso sequencing during the pitch. Study Design: Descriptive laboratory study. Methods: 285 professional baseball pitchers were evaluated using 3D motion capture (480 Hz). Pitchers were divided into “chronological” and “discordant” groups based on whether maximum pelvic rotation velocity occurred before (chronological) or after (discordant) maximum upper torso rotation velocity during the pitch motion. Pelvic, upper torso, and shoulder kinematic parameters, shoulder distraction force, shoulder internal rotation torque, and pitch efficiency (PE) were compared between groups. Results: Pitchers with discordant torso sequencing (n = 30; 110 pitches) had greater shoulder horizontal adduction at maximum external rotation (mean difference, 3.6°; 95% CI, −5.2° to −2.0°; t = −4.5; P < .001) and greater maximum shoulder external rotation (mean difference, 3.7°; 95% CI, 5.7° to 1.5°; t = −3.5; P < .001) than chronological pitchers (n = 255; 2974 pitches). PE did not differ between groups (P = .856), whereas ball velocity was significantly faster in the discordant group (mean difference, 0.6 m/s; 95% CI, −1.1 to −0.3 m/s; t = −3.3; P = .0012). Chronological pitchers had significantly reduced shoulder distraction force (mean difference, −4.7% body weight (BW); 95% CI, −7.9% to −1.5% BW; t = −2.9; P = .004) with no difference in shoulder internal rotation torque (P = .160). These kinematic and kinetic differences were not observed when accounting for interpitcher variability. Conclusion: Between pitchers, those who had a discordant pelvic to upper torso sequence experienced significantly greater shoulder distraction forces, potentially compensating by increasing maximum shoulder external rotation and horizontal abduction. Achieving maximal pelvic rotation velocity before maximal rotation velocity may be advantageous in preventing compensation at the upper extremity and excessive throwing arm loading. Clinical Relevance: Identifying risk factors for increased upper extremity forces has potential implications in injury prevention. Specifically, mitigating shoulder distraction forces may be beneficial in reducing risk of injury.