Elbow Flexion Excursion: Intra- and Inter-Throwing Arm Kinetic Evaluations in High School and Professional Baseball Pitchers.

Background: Elbow flexion at stagnant time points of the pitch has been associated with increased elbow varus torque (EVT) and elbow injury history.

Purpose: To determine how elbow flexion angle throughout the pitch (excursion) between individual pitchers and a cohort of pitchers influences throwing arm kinetics in high school (HS) and professional (PRO) pitchers.

Study Design: Descriptive laboratory study.

Professional baseball pitchers with increased in-pitch stance hip flexion excursion demonstrate higher shoulder internal rotation torque and elbow varus torque with no appreciable ball speed benefit.

Hypothesis And Background: Relationships between the stance leg's lumbopelvic control and throwing arm kinetics have been established in baseball pitchers; however, no study to date has analyzed the role hip flexion excursion may play in generation of throwing arm kinetics/ball velocity. It was hypothesized that pitchers with increased lead hip flexion would have increased shoulder external rotation and increased ball velocity.

Methods: PRO (n = 283) pitchers instructed to throw 8-12 fastball pitches were evaluated with 3D-motion capture (480 Hz).

A comparison of throwing arm kinetics and ball velocity in professional baseball pitchers with the fastest maximum joint and segment velocities.

Background: Significant associations have been established among individual maximum joint and segment velocities with throwing arm kinetics and ball velocity in baseball.

Methods: Professional (n = 338) pitchers threw 8-12 fastball pitches while evaluated with 3D-motion capture (480 Hz). Pitches (ideal and nonideal sequence order) were classified as 'High Velocity' for each segment/joint velocity subcategory or 'Population' with any pitch eligible for inclusion in multiple subcategories.

Is Workload Associated With Oblique Injuries in Professional Baseball Players?

Background: Oblique strains have become a common injury among professional baseball players. The influence of player workload on oblique strains remains unknown.

Purpose/hypothesis: To determine whether workload is a risk factor for oblique strains in professional baseball players.

Is Workload Associated With Internal Impingement in Professional Baseball Pitchers? An Analysis of Days of Rest, Innings Pitched, and Batters Faced.

Background: Internal impingement is a common cause of shoulder pain and dysfunction in baseball pitchers.

Purpose/hypothesis: The purpose of this study was to determine if the amount of rest days between outings, the number of innings pitched in each outing, and the number of batters faced in each outing are risk factors for internal impingement in professional baseball pitchers. It was hypothesized that a higher workload would significantly increase a pitcher's risk of developing internal impingement.

Forearm Pronation at Foot Contact: A Biomechanical Motion-Capture Analysis in High School and Professional Pitchers.

Background: It has previously been speculated that baseball pitchers who display excessive forearm pronation at foot contact (FC) have a higher propensity toward ulnar collateral ligament injury and subsequent surgery.

Purpose: To evaluate the association between degree of forearm pronation/supination at FC and throwing arm kinetics in high school and professional pitchers, at both the individual (intrapitcher) and the group (interpitcher) level.

Study Design: Descriptive laboratory study.

Primary Care Considerations for the Baseball Athlete.

Purpose Of Review: To summarize current guidance and best practices surrounding non-orthopedic medical concerns in baseball.

Recent Findings: Discussion of COVID19-related practice changes pertaining to the prevention and screening of communicable respiratory illness, concussion protocol updates, the enhanced role of a multi-disciplinary team of mental health professionals. Prevention, appropriate screening, and early identification remain cornerstones of effective primary care both within the general population as well as for the baseball athlete.

Training patterns associated with injury in New York City Marathon runners.

Objective: Training patterns are commonly implicated in running injuries. The purpose of this study was to measure the incidence of injury and illness among marathon runners and the association of injuries with training patterns and workload.

Methods: Runners registered for the New York City Marathon were eligible to enrol and prospectively monitored during the 16 weeks before the marathon, divided into 4-week 'training quarters' (TQ) numbered TQ1-TQ4.

Lower Extremity Muscle Injuries in the Overhead Athlete.

Purpose Of Review: Lower extremity (LE) injuries are a common source of disability and time-loss for overhead athletes, and muscles have been found to be the predominant soft tissue structure affected. The current review highlights the orthopaedic literature examining lower extremity muscle injuries in overhead athletes in regard to epidemiology, diagnosis, and conventional and emerging treatment measures.

Recent Findings: The hamstring muscles have been found to be the most commonly injured lower extremity muscle group in professional baseball, followed by the adductors, quadriceps, iliopsoas, and gastrocnemius-soleus complex.

Variability in Pitch Count Limits and Rest Day Requirements by State: Implications of Season-Long Pitch Counts in High School Baseball Pitchers.

Background: It is unknown how different pitch count limits and rest day requirements affect cumulative pitch counts during a baseball season.

Purpose: To determine (1) the variability of pitch count rules in high school baseball and (2) the theoretical effect of different pitch count limits and rest day combinations on game, weekly, and seasonal pitch totals in high school baseball pitchers.

Study Design: Cross-sectional study.

The Most Common Type, Severity, and Expected Frequency of Injuries Vary by Defensive Position in Professional Baseball Players.

Background: Location, frequency, and severity of in-game injuries by defensive position played have never been determined in professional baseball players.

Hypothesis: Catchers would have a higher frequency of hip and knee injuries; infielders and outfielders would have a higher frequency of general lower extremity injuries; and pitchers would have a higher frequency and severity of shoulder and elbow/forearm injuries.

Study Design: Descriptive epidemiology study.

Interval Throwing Programs at Distances Beyond 150 Feet Can Be Equivalent to Pitching Over Five Innings.

Purpose: To determine the cumulative elbow varus torque (EVT) experienced during created interval throwing programs (ITP) and derive innings pitched equivalent for each step.

Methods: High school pitchers wearing the motusBASEBALL sensor who had at least 50 throws at 90, 120, 150, and 180 ft and game pitches were included in this analysis. Means for EVT per throw and torque per minute were calculated at each distance.

Is Workload Associated With Hamstring and Calf Strains in Professional Baseball Players? An Analysis of Days of Rest, Innings Fielded, and Plate Appearances.

Background: The influence of player workload on hamstring and calf injuries in professional baseball players remains unknown.

Hypothesis: Increased workload would significantly increase hamstring and calf strain injury risk.

Study Design: Case-control.

Kinematic and kinetic analyses of professional pitchers with history of core or groin injuries: A propensity-score matched analysis.

Background: Core injuries in professional baseball pitchers have been linked to both diminished performance and time missed during the season injury was sustained. It is currently unclear how a history of a core injury may affect the future pitching performance and mechanics of professional baseball pitchers.

Purpose: To compare kinetic and kinematic variables between professional baseball pitchers with prior core/groin injuries and those without prior injury.

Disparities in concussion diagnoses compared to ankle injuries.

Background: Health disparities related to concussions have been reported in the literature for certain minority populations. Given the significant impact of concussions on long- and short-term function, the mitigation of barriers to accessing care is an important public health objective.

Objective: To determine if racial and ethnic disparities exist in patients who seek care for concussions compared to a control group with orthopedic ankle injuries (sprains and fractures) to minimize confounding factors that predispose to injury.

Effect of Weather and Game Factors on Injury Rates in Professional Baseball Players.

Background: Injury rates in baseball players of all ages are increasing. Identifying modifiable risk factors is paramount to implementing injury prevention programs.

Purpose/hypothesis: The purpose was to evaluate the influence of weather (temperature, humidity, atmospheric pressure, and heat index) and game factors (start time, duration, single vs doubleheader) on injury rates in professional baseball players.

Joint and segment sequencing and its relationship to ball velocity and throwing arm kinetics in professional pitchers.

Background: Temporal variations during the pitch have demonstrated significant impacts on the kinetic chain, and as such, have implications in injury risk.

Purpose: To determine the effect of varying chronological orders of maximum joint and segment velocities on ball velocity and upper extremity kinetics.

Methods: Professional baseball pitchers (n = 287) were assessed with 3D-motion capture (480 Hz) while pitching.

How does the All-Star break affect injury rates in professional baseball?

Background: Injury rates in professional baseball players are increasing. It is unclear if the time of rest from the All-Star break affects injury risk.

Methods: Every professional baseball game (A-, A+, AA, AAA, and Major League Baseball) played between 2011 and 2017 was included.

Is workload associated with latissimus dorsi and teres major tears in professional baseball pitchers? An analysis of days of rest, innings pitched, and batters faced.

Background: Latissimus dorsi (LD) and teres major (TM) tears have become increasingly recognized injuries in professional baseball pitchers. The purpose of this study was to determine whether workload, as measured by the number of days of rest between outings, number of innings pitched, number of batters faced, and being a starting pitcher, is associated with an increased risk of sustaining an LD-TM tear in professional baseball pitchers.

Methods: All professional baseball pitchers who sustained an LD-TM tear between 2011 and 2017 were identified using the Major League Baseball Health and Injury Tracking System.

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.

Association of Pitch Timing and Throwing Arm Kinetics in High School and Professional Pitchers.

Background: Understanding the relationship between the temporal phases of the baseball pitch and subsequent joint loading may improve our understanding of optimal pitching mechanics and contribute to injury prevention in baseball pitchers.

Purpose: To investigate the temporal phases of the pitching motion and their associations with ball velocity and throwing arm kinetics in high school (HS) and professional (PRO) baseball pitchers.

Study Design: Descriptive laboratory study.

Communicable Illness Mitigation Strategies for Traveling Elite Sporting Organizations.

Context: Transmission of communicable diseases observed in sporting organizations is often preventable. Early detection, isolation, and treatment can significantly diminish time lost. Until recently, there has been a paucity of standardized guidelines outlining feasible, preventable measures to protect both athletes and staff from contagious illnesses.

The association of stride length to ball velocity and elbow varus torque in professional pitchers.

Professional basebal pitchers (n =315) were divided into quartiles based on increasing stride length and random intercept linear mixed-effect models were used to correlate stride length with ball velocity, pelvis and trunk rotation at foot contact, and throwing arm kinetics. Average stride length among all pitchers was 78.3±5.

Factors associated with injuries in first-time marathon runners from the New York City marathon.

Objectives: To determine how baseline characteristics of first-time marathon runners and training patterns are associated with risk of injuries during training and the race.

Methods: First-time adult marathon runners who were registered for the 2017 New York City Marathon were monitored starting 12 weeks prior to the race. Baseline data collection included demographics and running experience.