Injury Prevention Related to Pitching
اسلاید 1: Injury Prevention Related to PitchingE. David Osinski M.A.Glenn S. Fleisig, Ph.D.
اسلاید 2: Biomechanics of PitchingAdult pitchers (college & pro)ASMI 18 studies published in last ten yearsAll levels (youth thru pro)Kinematic (angular displacements and velocities) and kinetic (forces & torques) comparison of baseball pitching among various levels of development. (Fleisig et al, J Biomechanics, 1999)
اسلاید 3: Results - Position (°)
اسلاید 4: Results - Force (Newtons)Significant relationship between kinetic forces at shoulder & elbow joints for variables for pitching mechanics for youth through professional pitchers.
اسلاید 5: Results - Force (%Weight)Significant relationship between forces at shoulder & elbow joints for pitching mechanics variables when adjusted for physical differences.
اسلاید 6: Wind Up Commencement Movements
اسلاید 7: High SchoolStrideFoot ContactPelvis = 25° openUpper Torso = 20° closedShoulder:Abduction = 90°Rotation = 65°Elbow:Flexion = 80°
اسلاید 8: High SchoolArm CockingMax. RotationShoulder:Rotation = 175°Elbow:Flexion = 100°
اسلاید 9: High SchoolArm CockingShoulder:Anterior Force=290NIR Torque = 51 NmElbow:Varus Torque=48Nm(Weight = 740 N = 170 lb)
اسلاید 10: High SchoolArm AccelerationArm AccelerationElbow:Extension = 2200°/sShoulder:Rotation = 6800°/s
اسلاید 11: High SchoolArm AccelerationShoulder:Proximal Force = 750 NElbow:Proximal Force = 630 N (Weight = 740 N = 170 lb)
اسلاید 12: Deceleration & Follow-Through
اسلاید 13: Pathomechanics
اسلاید 14: PHYSEAL INJURY Little Leaguer’s ShoulderFirst by Dotter described in 1953Described in literature as osteochondrosis of the proximal humeral epiphysis proximal humeral epiphyseolysis stress fracture of proximal humeral epiphyseal plate rotational stress fracture
اسلاید 15: Adolescent Pitcher Shoulder Injury Typically males, 12 - 15 years of age14 y/o more prone due to rapid growth and more skilledAverage duration of symptoms before treatment is approximately 7 monthsAssociated with quantity and intensity of pitching, age at which pitching started, use of curveball
اسلاید 16: PHYSEAL INJURY Little Leaguer’s Shoulder
اسلاید 17: Elbow - Anatomy/MechanicsAnterior Band of UCL (main valgus stabilizer) attaches to the medial epicondyle apophysis
اسلاید 18: Elbow - Anatomy/MechanicsIncreased bone plasticity Hyperelasticity permits excessive joint translation
اسلاید 19: Elbow InjuriesSkeletally immature athletes are susceptible to unique injuries secondary to:Relatively weak growth plates (physes)Ligamentous laxityInadequate dynamic strength / stability to resist high biomechanical forces
اسلاید 20: Medial Epicondyle Apophysitis / AvulsionMost common injury seen in the adolescent throwing athleteCaused by acute valgus overloadX-rays may appear normal
اسلاید 21: 1996 Survey (USA Baseball News, 1996)Survey for USA Baseball28 Orthop. Surgeons & Baseball Coachesnumber of pitches more important than inningsIncrease pitch count limits with ageExamples: 8-10: 50 pitches. 17-18: 90 pitchesStart using pitches at different agesFastball (8), Change (10), Curve (14), Slider (16)
اسلاید 22: 1997-98 Study(Med Sci Sport Exerc, 2001)200 pitchers each Spring (300 total subjects)8-12 years old pitchers in Birmingham50% of pitchers had elbow/shoulder pain during studyIncreased pitches Increased pain risk75 pitches/game recommended limit600 pitches/season recommended limit
اسلاید 23: 1999 Study(Am J Sports Med, 2002)Funded by USA Baseball500 pitchers in Spring9-14 years old pitchers throughout AlabamaIncreased pitches Increased pain risk75 pitches/game recommended limit (15 batters)600 pitches/season recommended limit (120 batters)No relation found between mechanics - pain riskCurveballs/Sliders Increased pain risk
اسلاید 24: Conclusions - MechanicsSuccessful youth and adult pitchers use similar kinematics.Relationship between poor mechanics and risk of injury unproven
اسلاید 25: Conclusions - Pitch QuantityCorrelation between pitch count and pain in youth pitchersCollege/Pros use pitch counts to protect pitchers. Youth pitchers should do as well.
اسلاید 26: Conclusions - Pitch Quantity USA Baseball Medical Committee Recommendations 2003AgeWorkload Limit in PitchesGameWeek SeasonYear9-10 5075 1000100011-12 75100 1000300013-14 75125 10003000
اسلاید 27: American Baseball Foundation Thank youABF BASIC Program at Rickwood Field
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