{"id":3910,"date":"2015-06-29T20:43:02","date_gmt":"2015-06-29T20:43:02","guid":{"rendered":"http:\/\/www.lifeandnews.com\/articles\/?p=3910"},"modified":"2016-08-15T02:31:46","modified_gmt":"2016-08-15T02:31:46","slug":"could-video-technology-help-prevent-injuries-in-young-pitchers","status":"publish","type":"post","link":"https:\/\/www.lifeandnews.com\/articles\/could-video-technology-help-prevent-injuries-in-young-pitchers\/","title":{"rendered":"Could video technology help prevent injuries in young pitchers?"},"content":{"rendered":"<p><a href=\"http:\/\/theconversation.com\/profiles\/sakiko-oyama-163244\">Sakiko Oyama<\/a><em>, <a href=\"http:\/\/theconversation.com\/institutions\/the-university-of-texas-at-san-antonio\">The University of Texas at San Antonio<\/a><\/em><\/p>\n<p>These days, it seems like elbow surgery for pitchers is a rite of passage.<\/p>\n<p>Whether it\u2019s stars like Miami Marlins ace Jose Fernandez or lesser-known players like Colorado Rockies reliever Adam Ottavino, the number of pitchers going under the knife to correct torn elbow ligaments \u2013 so-called Tommy John surgery \u2013 <a href=\"https:\/\/twitter.com\/BillPetti\/status\/466017847974846465\">continues to rise<\/a>.<\/p>\n<p>To date, <a href=\"https:\/\/docs.google.com\/spreadsheets\/d\/1gQujXQQGOVNaiuwSN680Hq-FDVsCwvN-3AazykOBON0\/edit#gid=0\">988<\/a> of these procedures have been performed. But in recent years, numbers have skyrocketed. Today, <a href=\"http:\/\/grantland.com\/the-triangle\/tommy-john-epidemic-elbow-surgery-glenn-fleisig-yu-darvish\/\">25%<\/a> of major league pitchers have had the procedure done, while <a href=\"http:\/\/grantland.com\/the-triangle\/tommy-john-epidemic-elbow-surgery-glenn-fleisig-yu-darvish\/\">40%<\/a> of all Tommy John surgeries are being performed on adolescent ballplayers.<\/p>\n<p>In order to better understand this trend, it\u2019s important to look at when most professional players began playing the game: as kids.<\/p>\n<p>It\u2019s become <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21391806\">increasingly common<\/a> among youth sport participants to specialize in a sport at a young age. For baseball players, this means picking a position and sticking to it. And if you\u2019ve decided to be a pitcher, it means putting added mileage on the bones and ligaments of a developing arm.<\/p>\n<p>As the numbers show, many are paying the price with surgery down the road. But this is far from inevitable; existing research \u2013 along with recent research I conducted with colleagues \u2013 presents simple techniques and practices that could help young pitchers avoid injury.<\/p>\n<h2>The stress of throwing<\/h2>\n<p>While pitching is a whole-body movement, most of the injuries in pitchers take place at the shoulder and elbow joints. This happens because during a pitcher\u2019s stride, the momentum produced by the powerful muscles in the legs and trunk is funneled to the throwing arm.<\/p>\n<p>The momentum transferred to the arm causes the arm to rotate backwards \u2013 to the point where the forearm becomes near or past parallel to the ground \u2013 and then rotate forward in a whip-like motion.<\/p>\n<figure class=\"align-center zoomable\"><a href=\"https:\/\/62e528761d0685343e1c-f3d1b99a743ffa4142d9d7f1978d9686.ssl.cf2.rackcdn.com\/files\/83581\/area14mp\/image-20150601-6981-veo7p6.jpg\"><img src=\"https:\/\/62e528761d0685343e1c-f3d1b99a743ffa4142d9d7f1978d9686.ssl.cf2.rackcdn.com\/files\/83581\/width668\/image-20150601-6981-veo7p6.jpg\" alt=\"\" \/><\/a><figcaption><span class=\"caption\">Roger Clemens&#8217; throwing motion, frame by frame.<\/span><br \/>\n<span class=\"attribution\"><a class=\"source\" href=\"https:\/\/www.flickr.com\/photos\/glasgows\/131547232\">M&amp;R Glasgow\/flickr<\/a>, <a class=\"license\" href=\"http:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY<\/a><\/span><\/figcaption><\/figure>\n<p>Accordingly, the pitching movement creates a great amount of stress on bones, ligaments, capsules and muscles that make up shoulder and elbow joints, and any of these structures can become damaged. The surface of the bone (the cartilage) may become worn out, growth plates may become damaged, and ligaments and muscles may weaken or tear. Youth pitchers are susceptible to growth plate injuries since their growth plates are still open.<\/p>\n<p>Pitchers&#8217; joints experience constant stress over the course of games, seasons and years of playing. For this reason, it\u2019s not uncommon to see <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/998840\">pitchers with damage<\/a> to the cartilage, growth plate or tendons even when they\u2019re <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/998841\">not experiencing any joint pain<\/a>.<\/p>\n<p>As the innings add up, the arm wears down. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11689728\">Research shows<\/a> that pitchers who pitch more than 100 innings over the course of a year and pitchers who pitch in multiple leagues at the same time have higher risk of injury. In addition, throwing with a fatigued arm, playing baseball year-round, and pitching for traveling teams and in showcase tournaments are <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15262637\">all linked<\/a> to arm injuries.<\/p>\n<p>There\u2019s also been more heightened awareness of arm injuries in the medical community, which has led to more diagnoses. Injuries that used to be considered general joint pain and soreness are now being correctly identified as injuries.<\/p>\n<h2>Pitching smart<\/h2>\n<p>While some level of deterioration is impossible to avoid, recent research has identified a number of ways young pitchers can improve their chances of avoiding major injuries that require surgery, which can sideline pitchers for over a year.<\/p>\n<p>To protect a young pitcher\u2019s arm, there are three important things to keep in mind:<\/p>\n<ul>\n<li>Proper care of the throwing arm<\/li>\n<li>Adequate rest between pitching appearances<\/li>\n<li>A focus on good pitching technique<\/li>\n<\/ul>\n<p><a href=\"http:\/\/m.mlb.com\/pitchsmart\/\">Pitch Smart<\/a>, a website developed by Major League Baseball, offers recommendations for pitchers of differing ages. Throwing too many pitches without adequate rest will gradually weaken the throwing arm, making it more susceptible to injury.<\/p>\n<p>For this reason, the site suggests following pitch counts and rest period guidelines to avoid over-pitching. And because it\u2019s been documented that a pitcher\u2019s arm loses strength and flexibility <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15611006\">after pitching in a game<\/a>, it\u2019s important to do exercises to keep the arm strong and joints flexible throughout the season.<\/p>\n<p>Focusing on good technique \u2013 and not compromising technique for speed, especially as the pitchers start to get tired \u2013 is also very important. For example, the Pitch Smart site discourages the use of radar gun for young pitchers, as it can shift their focus from technique to ball speed.<\/p>\n<p>But employing good technique is easier said than done. This is because there\u2019s no real consensus on what \u201cgood technique\u201d should look like.<\/p>\n<figure class=\"align-right\"><img src=\"https:\/\/62e528761d0685343e1c-f3d1b99a743ffa4142d9d7f1978d9686.ssl.cf2.rackcdn.com\/files\/83979\/width237\/image-20150604-3368-aragx5.jpg\" alt=\"\" \/><figcaption><span class=\"caption\">Washington Nationals pitcher Stephen Strasburg has an \u2018inverted W\u2019 throwing motion.<\/span><br \/>\n<span class=\"attribution\"><a class=\"source\" href=\"http:\/\/pictures.reuters.com\/C.aspx?VP3=SearchResult&amp;VBID=2C0BXZYB3IADZ&amp;SMLS=1&amp;RW=1380&amp;RH=637&amp;RW=1380&amp;RH=637#\/SearchResult&amp;VBID=2C0BXZYB3IADZ&amp;SMLS=1&amp;RW=1380&amp;RH=637&amp;PN=2&amp;POPUPPN=101&amp;POPUPIID=2C0BF1WEZSVN\">Ray Stubblebine\/Reuters<\/a><\/span><\/figcaption><\/figure>\n<p>\u201cGood technique\u201d is often defined by anecdotal evidence and coaching philosophies, but there\u2019s not enough scientific evidence to support many claims.<br \/>\nSome even contradict themselves. For example, some coaches say having arms in an \u201cinverted W\u201d position during the stride is good, because having the arms in a mirror image helps to maintain balance, while some say this arm position causes a delay in arm movement, which can add stress on the joints. (A <a href=\"http:\/\/ojs.sagepub.com\/content\/3\/4\/2325967115581594.full\">recent study<\/a> found that this \u201cinverted W\u201d position is not associated with risk of surgery in Major League baseball players.)<\/p>\n<p>Another issue is that some movements during pitching that are linked to higher joint loading (such as the angle of a pitcher\u2019s elbow) are difficult to discern with the naked eye \u2013 and even video cameras.<\/p>\n<h2>Looking at the lean<\/h2>\n<p>For this reason, my colleagues and I wondered if there were certain unknown \u201ctells\u201d in the pitching motion that could indicate increased \u2013 and unnecessary \u2013 joint loading.<\/p>\n<p>In our <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/23884305\">recent research<\/a>, we focused on pitchers&#8217; trunk movement pattern that can be identified using video recordings, and studied whether the movement pattern is linked to increased joint loading. Specifically, we looked at pitchers who lean too far to the side when pitching. While it\u2019s normal for pitchers to lean to the side when pitching, leaning <em>too<\/em> far is anecdotally <a href=\"http:\/\/www.amazon.com\/The-Art-Science-Pitching-House\/dp\/158518960X\">considered \u201cfaulty\u201d technique<\/a>.<\/p>\n<figure class=\"align-right\"><img src=\"https:\/\/62e528761d0685343e1c-f3d1b99a743ffa4142d9d7f1978d9686.ssl.cf2.rackcdn.com\/files\/83992\/width237\/image-20150604-3390-u87nwy.jpg\" alt=\"\" \/><figcaption><span class=\"caption\">Leaning too far to the left or right can increase joint loading.<\/span><br \/>\n<span class=\"attribution\"><a class=\"source\" href=\"https:\/\/www.flickr.com\/photos\/chemisti\/4588523303\/in\/photolist-7Zto7K-7ZwymE-7ZwyR3-7ZwyCj-7ZwyKG-aMg3rv-aMg3tv-6gxd59-6gt2aF-9wz4BZ-6gt2wF-9rSPy3-4bGoKp-dJVD5h-8mEKcr-8n4VKf-aaLoCS-nQpRpt-o7LUaL-o7AFnZ-o7UeaB-nQpzP1-o7LY2J-7hLaFe-tGnaEP-bk7qzu-bk7qy5-5iBXQ1-6gxe1J-6gxdqh-87zE7t-9x8XJr-NL7XK-4E2fvk-NgRqJ-81xYDs-4uDfge-9rPSQv-9rT9CC-etwYKF-5vCC4T-kQ8q1-33jruA-fDm2Zy-nraY7o-9Z9KLp-9UuHEt-bfHRmx-bfHRux-5UD6MJ\">chemisti\/flickr<\/a>, <a class=\"license\" href=\"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/\">CC BY-NC-ND<\/a><\/span><\/figcaption><\/figure>\n<p>Comparing the joint loading between pitchers who lean too much with those who didn\u2019t, we found that pitchers who lean too much achieved higher ball speed but also experienced approximately 10% higher stress loads on their shoulder and elbow joints. We also found that pitchers who failed to keep their head balanced over the feet (ie, leaned back) and planted their foot across their body were much more likely to lean too far during pitching.<\/p>\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19633301\">Another study<\/a> has shown that opening up the shoulders to the hitter too early could increase joint loading.<\/p>\n<p>It\u2019s likely that advancements in video camera technology will reveal more movement patterns that increase stress on the joints. Identifying these patterns will help us better understand what a \u201cgood technique\u201d is, and help us prevent injuries in baseball pitchers, young and old.<\/p>\n<hr \/>\n<p><em>This article is part of our youth sports series. To read the others in the series, click <a href=\"https:\/\/theconversation.com\/us\/topics\/youth-sports\">here<\/a>.<\/em><\/p>\n<p><img loading=\"lazy\" src=\"https:\/\/counter.theconversation.edu.au\/content\/40063\/count.gif\" alt=\"The Conversation\" width=\"1\" height=\"1\" \/><\/p>\n<p><a href=\"http:\/\/theconversation.com\/profiles\/sakiko-oyama-163244\">Sakiko Oyama<\/a> is Assistant Professor of Kinesiology, Health, and Nutrition at <a href=\"http:\/\/theconversation.com\/institutions\/the-university-of-texas-at-san-antonio\">The University of Texas at San Antonio<\/a>.<\/p>\n<p>This article was originally published on <a href=\"http:\/\/theconversation.com\">The Conversation<\/a>.<br \/>\nRead the <a href=\"http:\/\/theconversation.com\/could-video-technology-help-prevent-injuries-in-young-pitchers-40063\">original article<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Sakiko Oyama, The University of Texas at San Antonio These days, it seems like elbow surgery for pitchers is a rite of passage. Whether it\u2019s stars like Miami Marlins ace Jose Fernandez or lesser-known players like Colorado Rockies reliever Adam Ottavino, the number of pitchers going under the knife to correct torn elbow ligaments \u2013 [&hellip;]<\/p>\n","protected":false},"author":40,"featured_media":6283,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6],"tags":[],"_links":{"self":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/3910"}],"collection":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/users\/40"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/comments?post=3910"}],"version-history":[{"count":2,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/3910\/revisions"}],"predecessor-version":[{"id":6284,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/3910\/revisions\/6284"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media\/6283"}],"wp:attachment":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media?parent=3910"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/categories?post=3910"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/tags?post=3910"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}