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

Author:

Manzi Joseph E.1,Dowling Brittany2,Wang Zhaorui1,Sudah Suleiman Y.3,Quan Theodore4,Moran Jay5,McElheny Kathryn L.6,Carr James B.7,Gulotta Lawrence V.6,Dines Joshua S.6

Affiliation:

1. Weill Cornell Medicine, New York, New York, USA.

2. Sports Performance Center, Midwest Orthopaedics at Rush, Oak Brook, Illinois, USA.

3. Department of Orthopedics, Monmouth Medical Center, Long Branch, New Jersey, USA.

4. Yale School of Medicine, New Haven, Connecticut, USA.

5. The George Washington School of Medicine and Health Sciences, Washington DC, USA.

6. Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.

7. Sports Medicine Institute, Hospital for Special Surgery Florida, West Palm Beach, Florida, USA.

Abstract

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. Methods: High school (n = 41) and professional (n = 196) pitchers threw 8 to 12 fastballs while being assessed with a 3-dimensional motion-capture system (480 Hz). Pitchers at each playing level were divided into a supination or pronation subgroup depending on degree of forearm pronation at FC. Regression models were built to observe the relationship between forearm pronation at FC and kinetic and kinematic parameters of interest. Results: At both the individual and the group level of high school and professional pitchers, there was no significant correlation between forearm pronation at FC and elbow varus torque ( P min = .21). For every 10° increase in forearm pronation at FC in the individual high school pitcher, elbow flexion at FC decreased by 5°, whereas maximum elbow extension velocity was achieved 0.6% later in the pitch. In addition, elbow medial force increased by 4.1 N and elbow varus torque increased by 0.8 N·m for every 10° increase in forearm supination at FC. For every 10° increase in forearm supination in the individual professional pitcher, ball velocity increased by 0.5 m/s, shoulder external rotation at FC decreased by 11°, and elbow medial force decreased by 5.5 N. Conclusion: Supination- or pronation-predominant forearm motion during the pitch did not significantly differ between playing levels. Excessive forearm pronation at FC was not a significant risk factor for increased throwing arm kinetics for high school or professional pitchers. There was a weak positive association between forearm supination at FC and elbow varus torque in the individual high school pitcher. Ultimately, coaches and pitchers may be better served by redirecting their focus to other mechanical aspects of the pitch that may have stronger associations with injury risk implications as well as performance.

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine

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1. The Physical Examination of the Throwing Elbow;Clinics in Sports Medicine;2024-06

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