Jan 29, 2015
Hip to Elbow Injuries

By R.J. Anderson

Although the professional baseball season is barely a month old, a disturbing trend has already emerged. Since the start of spring training in February, 30 pitchers playing Major and Minor League Baseball had underwent Tommy John surgery to repair a torn ulnar collateral ligament. With so much focus on the breakdown of pitching elbows, researchers from the University of Florida are taking a different approach to find potential solutions to the problem. Their most recent research points to limited range of motion in the hips as a factor that may put a pitcher at increased risk for an UCL injury.
At the March meeting of the American Academy of Orthopaedic Surgeons, Kevin W. Farmer, MD, an assistant professor in the department of orthopaedics and rehabilitation at the University of Florida, presented research that shows a limited range of motion in a pitcher’s hips could be a risk factor in injury to his elbow.

“This could open up a whole new line of thought processes and research,” Farmer, who is also Team Physician at Florida, said at the meeting. “We’re going to be able to ask: Is there an associated risk of injury down the road with limited hip range of motion, and can we minimize that risk by improving hip range of motion?

“Most studies have looked at shoulders and elbows,” Farmer added. “While very few studies have looked at lower extremities, some have done early work looking at range of motion, but no one has really correlated hips with the risk of injury to the elbow.”

In testing how hip range of motion affects the elbow, Farmer and his fellow researchers performed biomechanical throwing analysis on seven NCAA Division I pitchers. Using a pitching mound surrounded by high-speed cameras, the researchers placed motion-detecting markers on various joints of each pitcher’s body.

With each throw, the markers noted the mechanics while the high-speed cameras recorded the movements. The results were synched and a computerized, 3-D stick figure was created for each pitcher. Researchers then analyzed arm angles, speed and torques for each pitch, as well as how the different parts of the throw interacted with one another.

In their findings, Farmer and his colleagues found that certain aspects of the throwing cycle increase the risk of torquing that elbow ligament, such as:

  • The pitcher hyperextending his arm when he throws
  • Whether his shoulder is too far back when he throws
  • Or whether the pitcher is opening his body toward home plate too soon.

Using pre-existing data related to existing UCL tear risk factors, the Florida researchers found that the less range of motion pitchers had in their hips, the higher the risk to the pitchers’ arms. In addition, Farmer said that pitchers unknowingly compensate for limited range of motion in their hips, which could place more torque on their elbows.

Based on these findings, Farmer said that coaches and athletic trainers should target improved hip flexibility to help pitchers decrease their risk of a throwing injury. Next up for the Florida researchers is examining how time affects a pitcher’s hip range of motion over the course of their career, and whether a stretching program can improve range of motion and reduce the risk of injury.

R.J. Anderson is the Online Editor at Training & Conditioning.

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