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Biomechanics and UCL injuries


ptatc

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People on this board seem to like to discuss reasons for injuries. Here is a good new article. This confirms many ideas we've had about mechanics.

 

Interesting new article on pitchers who have UCL surgery. 140 MLB pitchers who had UCL surgery between 2010-2017. Pitchers who undergo UCL surgery have a release point further away from the body. Not only that but the release point had moved away in the last 2 years prior to surgery.

UCL injuries and release point..pdf

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1 hour ago, [email protected] said:

There have been a lot of theories about this.

Most prominent was probably the "inverted w" thing which basically was derived from mike marshall's theory. Not sure if you can prove anything of it and if you can what kind of actions could prevent this.

The inverted w had 2 major issues.  1. It kept the elbow flexed too long and made the pitch"flip" his arm too quickly in external rotation which put the arm in a bad position which could lead to any number of arm problems. 2. With bringing both elbows up dramatically , the pitcher tended to lose balance backwards which threw off the whole motion. 

Keeping the front elbow high is a good way to stay in a straight line to the plate. However doing both just lead to many issues. 

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16 hours ago, [email protected] said:

There have been a lot of theories about this.

Most prominent was probably the "inverted w" thing which basically was derived from mike marshall's theory. Not sure if you can prove anything of it and if you can what kind of actions could prevent this.

This was actually proven to likely be nonsense.

Most mechanical pitching beliefs in regards to injuries are unfounded by studies. There are trends and correlation but no causation has been proven.

Pitching is bad for you no matter how you do it. Throwing harder is even worse. 

"Perfect motions" have led to career ending injuries and "dangerous motions" have led to long careers without many issues (see Sale for this.)

I'd argue sales 3/4 release is actually best on the arm but that's just my opinion.

There are muscle and ligament strengthening exercises that appear to have significant impact on health - shoulder centered. The Sox were actually pioneers with their shoulder program which kept their arms statistically healthier for over a decade. There are not deliveries that have a significant impact though.

Edited by Look at Ray Ray Run
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2 hours ago, Look at Ray Ray Run said:

This was actually proven to likely be nonsense.

Most mechanical pitching beliefs in regards to injuries are unfounded by studies. There are trends and correlation but no causation has been proven.

Pitching is bad for you no matter how you do it. Throwing harder is even worse. 

"Perfect motions" have led to career ending injuries and "dangerous motions" have led to long careers without many issues (see Sale for this.)

I'd argue sales 3/4 release is actually best on the arm but that's just my opinion.

There are muscle and ligament strengthening exercises that appear to have significant impact on health - shoulder centered. The Sox were actually pioneers with their shoulder program which kept their arms statistically healthier for over a decade. There are not deliveries that have a significant impact though.

Sure there are. Just read this study. By moving the release point laterally they put a tremendous amount of extra force on the elbow. There are a number of studies which show different aspects of a delivery that can put an increased amount of stress on one joint.

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9 hours ago, ptatc said:

Sure there are. Just read this study. By moving the release point laterally they put a tremendous amount of extra force on the elbow. There are a number of studies which show different aspects of a delivery that can put an increased amount of stress on one joint.

Yes, there is correlation but not proven causation. It's possible the release point  moving is a symptom of an injury they are nursing which leads to TJS. 

I'll look for it today but pretty much every arm study for injury has concluded the same thing - these things are connected but A doesnt necessarily cause B.

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43 minutes ago, Look at Ray Ray Run said:

Yes, there is correlation but not proven causation. It's possible the release point  moving is a symptom of an injury they are nursing which leads to TJS. 

I'll look for it today but pretty much every arm study for injury has concluded the same thing - these things are connected but A doesnt necessarily cause B.

Its always difficult to a direct causation in human subjects.  They really don't like it if we watch them throw with a UCL then cut it out to see if there is a direct difference. That's why there is so many different philosophies. However, studies that show there is an increase in the elbow stress while throwing are pretty much show the positions to avoid. The study showed a distinct difference between pitchers who needed surgery and those who didn't. That's pretty clear in the differences between the two. I've got another article that discusses how the entire kinematic chain from the lower leg to the arm that lead to increased stresses through the arm. Unfortunately, the file is to big and it won't allow to attach it. Here is the reference though: Patrick, RachelMcGinty, JoshLucado, AnnCollier, Beth; International Journal of Sports Physical Therapy, Aug2016; 11(4): 614-626. 

CHRONIC UCL INJURY: A MULTIMODAL APPROACH TO CORRECTING ALTERED MECHANICS AND IMPROVING HEALING IN A COLLEGE ATHLETE-A CASE REPORT.

It is only a case report but the info in the intro and discussion gets into it in depth.

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