Lumbopelvic Control and the Development of Upper Extremity Injury in Professional Baseball Pitchers

Abstract

Background: The baseball-throwing motion requires a sequential order of motions and forces initiating in the lower limbs and transferring through the trunk and ultimately to the upper extremity. Any disruption in this sequence can increase the forces placed on subsequent segments. No research has examined if baseball pitchers with less lumbopelvic control are more likely to develop upper extremity injury than pitchers with more control. Purpose: To determine if baseball pitchers who sustain a chronic upper extremity injury have less lumbopelvic control before their injury compared with a group of pitchers who do not sustain an injury. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 49 asymptomatic, professional baseball pitchers from a single Major League Baseball organization participated. Lumbopelvic control was measured using an iPod-based digital level secured to a Velcro belt around each player’s waist to measure anteroposterior (AP) and mediolateral (ML) deviations (degrees) during single-leg balance with movement and static bridge maneuvers. During a competitive season, 22 of these pitchers developed upper extremity injuries, while the remaining 27 sustained no injuries. Separate 2-tailed t-tests were run to determine if there were significant differences in lumbopelvic control between groups ( P < .05). Results: There were no significant between-group differences for the stride leg (nondominant) during the bridge test in either the AP ( P = .79) or the ML ( P = .42) directions, or either direction during the drive leg bridge test ( P > .68). However, the injured group had significantly less lumbopelvic control than the noninjured group during stride leg balance in both the AP ( P = .03) and the ML ( P = .001) directions and for drive leg balance in both the AP ( P = .01) and the ML ( P = .04) directions. Conclusion: These results demonstrate that baseball pitchers with diminished lumbopelvic control, particularly during stride leg and drive leg single-leg balance with movement, had more upper extremity injuries than those with more control. Clinicians should consider evaluating lumbopelvic control in injury prevention protocols and provide appropriate exercises for restoring lumbopelvic control before returning athletes to competition after injury. Specific attention should be given to testing and exercises that mimic a single-limb balance task.

Drive-Leg Kinematics During the Windup and Pushoff Is Associated With Pitching Kinetics at Later Phases of the Pitch

“…These studies reported increased anteroposterior and mediolateral pelvic tilt in injured groups of baseball players. 3,21 The current study measured drive-leg knee valgus in a single-leg stance position during a pitcher's windup motion as well as the full pitching motion that followed. Therefore, the current study may be helpful in identifying early pitch mechanics associated with increased lateral GRFs and elbow kinetics at later pitching phases.…”

“…19 Comparable with the onset of the windup motion, a balance task requiring the transition from a double-leg stance to a single-leg stance by raising one’s dominant leg is useful in determining lumbopelvic control in baseball pitchers. 2,20,21 Additionally, an altered frontal-plane center of mass position was found to be caused by either contralateral pelvic tilt alone or accompained with trunk lean. 33 This change in the frontal-plane center of mass position was associated with increased knee adduction moments on the stance limb on loading; the stance limb serves as the drive leg in baseball pitchers.…”

“…The American Journal of Sports Medicine 2022;50 (5):1409-1415 DOI: 10.1177/03635465221077451 Ó 2022 The Author(s) determining lumbopelvic control in baseball pitchers. 2,20,21 Additionally, an altered frontal-plane center of mass position was found to be caused by either contralateral pelvic tilt alone or accompained with trunk lean. 33 This change in the frontal-plane center of mass position was associated with increased knee adduction moments on the stance limb on loading; the stance limb serves as the drive leg in baseball pitchers.…”

Biomechanical Analysis of the Throwing Athlete and Its Impact on Return to Sport

“…27 This was highlighted by a recent study comparing professional pitchers with upper-extremity injuries with those who completed the season without injury. 28 During both stride leg and drive leg balance tasks, injured pitchers were found to have significantly worse lumbopelvic control consistent with a dysfunctional kinetic chain.…”

Assessing the Association of Shoulder Pain Risk with Physical Fitness in Badminton Players at National Tournament Level

“…Badminton overhead motion can be understood as a kinetic chain that transfers energy to the lower limb via the trunk and subsequently through the upper limbs to release it to the shuttlecock. All the parts of the chain are interrelated, where a breakage in one component of the chain can affect shoulder pain and injury (11,12,16,17). In recent years, a positive association between shoulder pain and injury and physical dysfunction of trunk ROM (18,19), balance ability (16), upper limbs power (20,21), and muscle flexibility (22) have been reported in other overhead motion sports.…”