Early Cocking Phase Mechanics and Upper Extremity Surgery Risk in Starting Professional Baseball Pitchers.

MedStar author(s):
Citation: Orthopaedic Journal of Sports Medicine. 3(4):2325967115581594, 2015 Apr.PMID: 26665056Institution: MedStar Health Research InstituteDepartment: Sports Medicine Research CenterForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2015ISSN:
  • 2325-9671
Name of journal: Orthopaedic journal of sports medicineAbstract: BACKGROUND: Early cocking phase pitching mechanics may affect risk of upper extremity injury requiring surgery in professional baseball players.CONCLUSION: The inverted-W throwing position was not associated with significantly greater risk of upper extremity injury requiring surgery in MLB pitchers. Early trunk rotation was associated with significantly elevated risk of injury requiring surgery.METHODS: For 250 MLB pitchers in the 2010 season, 15 to 20 pitches from the start and end of an outing were reviewed using slow-motion game video for presence of an inverted-W position and early trunk rotation. Previous or current incidence of upper extremity injury requiring surgery for each player was determined using the MLB injury database, minor league injury records, available collegiate data, and publicly available online injury databases. Upper extremity surgery associated with an injury was considered to result from pitching.PURPOSE: To assess the occurrence of inverted-W arm positioning and early trunk rotation in Major League Baseball (MLB) pitchers and to determine whether this throwing position is associated with upper extremity injury requiring surgery.RESULTS: Consensus between investigators was achieved for 99% of players for inverted-W positioning (248 players) and in 97% of players for early trunk rotation (243 players) for videos reviewed independently. Rate of surgery with and without inverted-W position was 28 of 93 (30%) and 42 of 155 (27%), respectively. Rate of surgery with and without early trunk rotation was 37 of 111 (33%) and 30 of 132 (23%), respectively. Using a Cox proportional hazards model for risk analysis using the measured number of innings pitched at time of surgery as an approximate index of exposure and adjusting for age and fastball speed at time of surgery, early trunk rotation was associated with significantly increased risk of shoulder and/or elbow surgery with hazard ratio estimate of 1.69 (95% CI, 1.02-2.80). Presence of the inverted-W position was not associated with significantly increased risk (hazard ratio, 1.30; 95% CI, 0.79-2.14).STUDY DESIGN: Cross-sectional study; Level of evidence, 3.All authors: Dolce DL, Douoguih WA, Lincoln AEFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2020-12-29
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Journal Article MedStar Authors Catalog Article 26665056 Available 26665056

BACKGROUND: Early cocking phase pitching mechanics may affect risk of upper extremity injury requiring surgery in professional baseball players.

CONCLUSION: The inverted-W throwing position was not associated with significantly greater risk of upper extremity injury requiring surgery in MLB pitchers. Early trunk rotation was associated with significantly elevated risk of injury requiring surgery.

METHODS: For 250 MLB pitchers in the 2010 season, 15 to 20 pitches from the start and end of an outing were reviewed using slow-motion game video for presence of an inverted-W position and early trunk rotation. Previous or current incidence of upper extremity injury requiring surgery for each player was determined using the MLB injury database, minor league injury records, available collegiate data, and publicly available online injury databases. Upper extremity surgery associated with an injury was considered to result from pitching.

PURPOSE: To assess the occurrence of inverted-W arm positioning and early trunk rotation in Major League Baseball (MLB) pitchers and to determine whether this throwing position is associated with upper extremity injury requiring surgery.

RESULTS: Consensus between investigators was achieved for 99% of players for inverted-W positioning (248 players) and in 97% of players for early trunk rotation (243 players) for videos reviewed independently. Rate of surgery with and without inverted-W position was 28 of 93 (30%) and 42 of 155 (27%), respectively. Rate of surgery with and without early trunk rotation was 37 of 111 (33%) and 30 of 132 (23%), respectively. Using a Cox proportional hazards model for risk analysis using the measured number of innings pitched at time of surgery as an approximate index of exposure and adjusting for age and fastball speed at time of surgery, early trunk rotation was associated with significantly increased risk of shoulder and/or elbow surgery with hazard ratio estimate of 1.69 (95% CI, 1.02-2.80). Presence of the inverted-W position was not associated with significantly increased risk (hazard ratio, 1.30; 95% CI, 0.79-2.14).

STUDY DESIGN: Cross-sectional study; Level of evidence, 3.

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