Nebel Adam R, Fava Anthony W, Bordelon Nicole M, Oliver Gretchen D
Sports Medicine and Movement Laboratory, School of Kinesiology, Auburn University, Auburn, Alabama, USA.
Orthop J Sports Med. 2023 Jun 20;11(6):23259671231177320. doi: 10.1177/23259671231177320. eCollection 2023 Jun.
BACKGROUND: Increased shoulder distraction force during a baseball pitch may make a pitcher susceptible to rotator cuff or glenohumeral labral injuries. A precursor to a pitching injury may be pain experienced in the throwing arm. PURPOSE: To (1) compare peak shoulder distraction (PSD) forces in youth baseball pitchers with and without upper extremity pain when throwing a fastball and (2) assess if PSD forces across trials differ between pain and pain-free groups. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 38 male baseball pitchers aged 11 to 18 years were separated into a pain-free group (n = 19; mean age, 13.2 ± 1.7 years; mean height, 163.9 ± 13.5 cm; mean weight, 57.4 ± 13.5 kg) and a pain group (n = 19; mean age, 13.3 ± 1.8 years; mean height, 164.9 ± 12.5 cm; mean weight, 56.7 ± 14.0 kg). Pitchers in the pain group indicated that they experienced pain in their upper extremity while throwing a baseball. Pitching mechanical data from 3 fastballs per pitcher were recorded with an electromagnetic tracking system and motion capture software. The mean PSD (mPSD) was calculated as the mean PSD of 3 pitches per pitcher, the trial with the highest recorded PSD was determined as the maximum-effort PSD (PSDmax), and the PSD range (rPSD) was defined as the difference of the PSD force of the trial with the highest PSD and the lowest PSD for each pitcher. The PSD force was normalized to the pitcher's body weight (%BW). Pitch velocity was also recorded. RESULTS: The mPSD force was 114%BW ± 36%BW for the pain group and 89%BW ± 21%BW for the pain-free group. Pitchers in the pain group exhibited a significantly higher PSDmax force ( = 2.894; = .007) and mPSD force ( = 2.709; = .009) compared with those in the pain-free group. There were no significant between-group differences in the rPSD force or pitch velocity. CONCLUSION: The normalized PSDmax force was higher in pitchers who experienced pain while throwing fastballs compared with pitchers who were pain-free while throwing. CLINICAL RELEVANCE: Baseball pitchers who experience pain in their throwing arm are likely to have higher shoulder distraction forces. Improvement in pitching biomechanics and corrective exercises may assist in the mitigation of pain while pitching.
背景：在棒球投球过程中，肩部牵张力增加可能使投手易患肩袖或盂肱关节唇损伤。投球损伤的一个先兆可能是投掷手臂出现疼痛。 目的：（1）比较青少年棒球投手在投快球时上肢有疼痛和无疼痛情况下的肩部峰值牵张力（PSD）；（2）评估有疼痛组和无疼痛组在各试验中的PSD力是否存在差异。 研究设计：对照实验室研究。 方法：共38名年龄在11至18岁的男性棒球投手被分为无疼痛组（n = 19；平均年龄，13.2±1.7岁；平均身高，163.9±13.5厘米；平均体重，57.4±13.5千克）和疼痛组（n = 19；平均年龄，13.3±1.8岁；平均身高，164.9±12.5厘米；平均体重，56.7±14.0千克）。疼痛组的投手表示他们在投掷棒球时上肢有疼痛。使用电磁跟踪系统和动作捕捉软件记录每位投手3次快球的投球力学数据。平均PSD（mPSD）计算为每位投手3次投球的平均PSD，记录的PSD最高的试验被确定为最大用力PSD（PSDmax），PSD范围（rPSD）定义为每位投手PSD最高的试验与最低试验的PSD力之差。PSD力以投手体重（%BW）进行标准化。还记录了投球速度。 结果：疼痛组的mPSD力为114%BW±36%BW，无疼痛组为89%BW±21%BW。与无疼痛组相比，疼痛组的投手表现出显著更高的PSDmax力（ = 2.894； = .007）和mPSD力（ = 2.709； = .009）。rPSD力或投球速度在组间无显著差异。 结论：与投球时无疼痛的投手相比，投快球时经历疼痛的投手的标准化PSDmax力更高。 临床意义：投掷手臂有疼痛的棒球投手可能有更高的肩部牵张力。改善投球生物力学和矫正练习可能有助于减轻投球时的疼痛。
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