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1
Erickson, Brandon J., Peter N. Chalmers, Michael J. Axe, and Anthony A. Romeo. "Exceeding Pitch Count Recommendations in Little League Baseball Increases the Chance of Requiring Tommy John Surgery as a Professional Baseball Pitcher." Orthopaedic Journal of Sports Medicine 5, no. 3 (March 1, 2017): 232596711769508. http://dx.doi.org/10.1177/2325967117695085.
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Background: Empirical evidence has suggested a connection between youth pitch counts and subsequent elbow injury. For players within the Little League World Series (LLWS), detailed historical player data are available. Some of these players progress to both professional play and require an ulnar collateral ligament reconstruction (UCLR). Purpose: To determine the percentage of LLWS pitchers who proceed to play professional (major or minor league) baseball, the rate of UCLR in former LLWS pitchers who played professional baseball, and the risk to those who exceeded current pitch count recommendations while playing in the LLWS. Study Design: Cohort study; Level of evidence, 3. Methods: All LLWS pitchers from 2001 through 2009 from all teams and countries were identified, and all performance data were extracted. A professional (major and minor league) baseball database was then searched to determine whether each former LLWS pitcher played professional baseball. These professional players were then searched for using publicly available databases to determine whether they underwent UCLR. Results: Overall, 638 adolescents pitched in the LLWS between 2001 and 2009; 62 (10%) progressed to professional play. Of the 56 minor league players, 25 (45%) pitched. Of the 6 Major League Baseball players, 3 (50%) pitched. Three former LLWS pitchers (5%) who played professionally underwent UCLR. In former LLWS pitchers who exceeded pitch counts and played professionally, 50% (2/4) required UCLR, while only 1.7% (1/58) of those who did not exceed pitch count recommendations required UCLR ( P = .009). Similarly, among former LLWS pitchers who subsequently played professionally, 23.1% of those who played as a pitcher required UCLR while 0% of those who also played other positions required UCLR ( P = .008). Conclusion: Progression from LLWS pitching to professional baseball is uncommon. Among youth players, both diversification (playing other positions besides pitcher) as well as following current pitch limit regulations may protect against UCLR.
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Helfrich, Hede, and Philipp Weidenbecher. "Impact of Voice Pitch on Text Memory." Swiss Journal of Psychology 70, no. 2 (January 2011): 85–93. http://dx.doi.org/10.1024/1421-0185/a000042.
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Previous research on communication has demonstrated that the quality of a speaker’s voice affects the attitude of the audience toward the speaker. The present study aimed to find out whether the pitch of a speaker’s voice affects the listener’s memory for the contents of the texts read. Stimulus materials consisted of three different texts spoken by different male speakers in different average pitches (measured as F0 in Hz). The original speech samples were digitally manipulated to produce predefined pitches. Both original and manipulated texts were then presented to participants as learning material. The results indicate a linear correlation between pitch and speaker rating in so far as low-pitched voices were rated more positively than high-pitched voices. Concerning the retention of content, it was shown that, in long-term memory, both high- and low-pitched voices led to better results than medium-pitched voices. This result was independent of whether the speech samples represented natural or manipulated voices.
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Chalmers, Peter, Kathryn Mcelheny, John Dangelo, Kevin Ma, Dana Rowe, and Brandon Erickson. "Is Workload Associated with Ulnar Collateral Ligament Tears in Professional Baseball Players? An Analysis of Days of Rest, Innings Pitched and Batters Faced (126)." Orthopaedic Journal of Sports Medicine 9, no. 10_suppl5 (October 1, 2021): 2325967121S0026. http://dx.doi.org/10.1177/2325967121s00269.
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Objectives: To determine if workload; as measured by number of days rest between outings, innings pitched, batters faced, and being a starting pitcher; associates with risk for sustaining a subsequent UCL tear in professional baseball players. Methods: All professional baseball pitchers who sustained a UCL tear between 2011-2017 were identified using the major league baseball (MLB) Health and Injury Tracking System (HITS). A separate player usage was used to determine workload . We then compared these variables between player-games 2, 6, 12, and >12 weeks prior to a documented UCL tear and player games from a non-UCL tear control group. In a paired analysis, we compared the acute workload (2, 6, 12 weeks) prior to injury and the injured player’s workload >12 weeks prior to injury. Results: There were 2,204 elbow injuries within MLB, 369 of which were unique UCL tears in pitchers. In all time periods, player-games with more days rest, more innings pitched, and more batters faced associated with a subsequent UCL tear. Players who pitched 4 of more innings per outing had a 1.78-fold increase in percent of players with a subsequent UCL tear as compared to players with one inning pitched. Being a starting pitcher carried a relative risk of 1.51 (p<0.001) of subsequent UCL injury. In a paired analysis there were significantly more innings pitched and batters faced in the player-games 2 weeks prior to UCL injury than in the player-games >12 weeks prior to UCL injury (p=0.028 and p=0.017). Conclusions: Being a starting pitcher, pitching more innings per game, and facing more batters per game increased the risk of a UCL tear. An increase in workload in the 2 weeks prior to injury over that player’s baseline also significantly increased the risk for injury.
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Solomito, Matthew J., Erin J. Garibay, and Carl W. Nissen. "DECELERATION PHASE MOMENTS: A POTENTIAL CAUSE FOR ELBOW INJURY IN COLLEGIATE LEVEL BASEBALL PITCHERS." Orthopaedic Journal of Sports Medicine 7, no. 3_suppl (March 1, 2019): 2325967119S0007. http://dx.doi.org/10.1177/2325967119s00072.
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Background: Over the past three decades there has been an increase in the incidence of elbow and shoulder pain experienced by baseball pitchers, which can limit or lead to an end of pitching activities. Although there are a number of theories that suggest poor pitching mechanics or throwing breaking pitches prior to skeletal maturity may be the cause, biomechanical investigations have yet to elucidate a single cause for this rise in injuries. It is also well established that the highest stresses and fastest angular velocities experienced by pitchers occurs during the acceleration phase of the pitch cycle, which has led to extensive biomechanical investigations of this portion of the pitching cycle. However, the deceleration phase of the pitch, although 150% longer than the acceleration phase, still requires an abrupt reversal of motion to allow pitchers to get into a fielding position after they have delivered the pitch. Therefore, the purpose of this study was to determine if the elbow joint was subjected to an additional varus stress during the deceleration phase of the pitch cycle. Methods: NCAA Division I and Division III baseball pitchers were recruited for this study and underwent a comprehensive biomechanical pitching evaluation. All pitchers were injury free at the time of data collection and reported no history of an upper extremity injury within the previous six months of the analysis date. Additionally, all pitchers had at least two years of pitching experience. All participants pitched from a 10” mound towards a target with a designated strike zone set 60’6” away. Kinematic data was collected using a 12-camera motion capture system, and kinetic data was calculated using standard inverse dynamic techniques. The typical pitching cycle, starting with lead foot contact and ending with maximum internal rotation of the glenohumeral joint (MIR), was expanded to end when the pedestal foot reached its maximum height; allowing for the analysis of deceleration phase moments at the elbow joint. The deceleration phase elbow varus (EV) moment was compared across multiple pitch types (i.e. fastball, curveball, slider, and change-up) using the type III effects from a random intercept mixed effects model. Additionally, the deceleration phase EV moment was compared to the peak EV moment occurring during the acceleration phase of the pitch cycle. Results: The results of this study are based on 87 baseball pitchers with a mean age of 19.9 ± 1.4 years. All participants pitched a fastball, 78 pitched a curveball, 31 pitched a slider, and 60 pitched a change-up. The results indicated that there was the presence of an elbow varus moment for all pitch types that occurred during the deceleration phase of the pitching cycle after MIR that was on average about half of the peak acceleration phase moment (Table 1). Overall 26% of pitchers pitching a fastball, 33% of pitchers throwing a curveball and change-up, and 55% of pitchers throwing a slider had deceleration EV moments greater than 50% of their peak acceleration phase EV moment. There was a statistically significant difference in the number of pitchers with a deceleration phase EV moment greater than half of the acceleration phase EV moment when pitching the slider when compared to the other pitch types (p=0.029). Conclusion/Significance: The majority of pitching biomechanics research focuses on the acceleration phase of the pitching cycle because the highest speeds and moments are achieved during this portion of the pitch. However, the pitcher’s need to rapidly decelerate during the pitch does expose them to an additional elbow varus moment. This additional moment could be a potential source of injury as it is a second stress exposure for the UCL. Additionally, given that the highest deceleration EV moments were noted in the slider this may potentially explain why pitchers and coaches believe that sliders are more harmful than other pitch types. [Table: see text]
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Okoroha, Kelechi R., Jason E. Meldau, Vincent A. Lizzio, Fabien Meta, Jeffrey P. Stephens, Vasilious Moutzouros, and Eric C. Makhni. "Effect of Fatigue on Medial Elbow Torque in Baseball Pitchers: A Simulated Game Analysis." American Journal of Sports Medicine 46, no. 10 (June 28, 2018): 2509–13. http://dx.doi.org/10.1177/0363546518782451.
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Background: The incidence of overuse injury to the elbow among baseball pitchers continues to rise, despite extensive efforts at pitch count regulations and emphasis on proper throwing mechanics. Purpose: To determine if the medial elbow experiences increased torque levels as a baseball pitcher fatigues through the course of a simulated game. Study Design: Descriptive laboratory study. Methods: High school and collegiate baseball pitchers were recruited for this simulated game study. Each pitcher completed a simulated game consisting of 6 innings and a standardized pitching scheme of fastballs, curveballs, and changeups. In total, each pitcher threw 90 pitches. Fatigue was reported per inning with a visual analog scale, and pitch velocity was captured per pitch with a radar gun. Outcome measures were assessed with a validated mobile sensor and included medial elbow torque, arm speed, arm rotation, and arm slot. Linear and quadratic regression modeling was used to evaluate the relationship between pitcher fatigue and pitching kinematics. Results: A total of 11 pitchers (mean age, 17.6 years; range, 15-20 years) completed the study. Visual analog scale fatigue scores increased 0.72 points per inning pitched ( P < .01, effect size = 0.64). Medial elbow torque also increased beyond inning 3, with an increase of 0.84 N·m each inning ( P < .01, effect size = 0.08), while pitch velocity decreased (0.28 mph per inning, P < .01, effect size = 0.27). Fastballs generated the greatest amount of medial elbow torque (49.3 ± 1.4 N·m, P < .01, effect size = 0.24). There were no differences in arm rotation ( P = .42) or arm speed ( P = .80) as the game progressed. However, arm slot decreased with each successive inning (0.73° on average per inning, P = .03, effect size = 0.12). No adverse outcomes were noted with use of the mobile sensor. Conclusion: In this simulated game analysis, pitchers experienced increased fatigue after each successive inning. While the average pitch velocity declined with each successive inning, the torque on the medial elbow increased after inning 3. These findings signify a possible relationship between fatigue and injury risk.
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Chalmers, Peter, Kathryn Mcelheny, John Dangelo, Kevin Ma, Dana Rowe, and Brandon Erickson. "Poster 168: Is Workload Associated with Internal Impingement in Professional Baseball Players? An Analysis of Days of Rest, Innings Pitched and Batters Faced." Orthopaedic Journal of Sports Medicine 10, no. 7_suppl5 (July 1, 2022): 2325967121S0072. http://dx.doi.org/10.1177/2325967121s00729.
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Objectives: The purpose of this study was to determine if number of days of rest between outings, number of innings pitched in each outing, number of batters faced in each outing, and being a starting pitcher are risk factors for internal impingement in professional baseball pitchers. Methods: All professional baseball pitchers who were diagnosed with internal impingement between 2011-2017 were identified using the Major League Baseball (MLB) Health and Injury Tracking System (HITS). A separate player usage dataset was used to determine workload. We then compared workload variables between pitcher-games 2, 6, 12, and >12 weeks prior to documented internal impingement to pitcher-games from a control group who were never diagnosed with internal impingement. In a paired analysis, we compared the acute workload (2, 6, 12 weeks) prior to injury to the injured pitcher’s workload >12 weeks prior to injury. Results: There were 624 professional baseball pitchers who were documented in the MLB HITS database as having had internal impingement between 2011-2017. Across all time points, players with more innings pitched per game and more batters faced per game were associated with a higher incidence of subsequent internal impingement compared to controls. However, there were not significantly more innings pitched, more batters faced, or fewer days rest in the acute period (12 weeks) prior to injury when compared to baseline workload. Being a starting pitcher was associated with a higher incidence of internal impingement. Conclusions: Greater pitcher workload and being a starting pitcher were associated with increased risk for internal impingement in professional baseball players. However, this injury was not associated with an acute increase in workload, suggesting that internal impingement may be due to the cumulative effects of workload over a career. [Table: see text]
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Makhni, Eric C., Jason E. Meldau, Jeff Stephens, Kelechi Okoroha, Vincent A. Lizzio, Fabien Meta, Christopher S. Ahmad, and Vasilios Moutzouros. "Relationship Between Pitcher Fatigue and Medial Elbow Torque in Baseball Pitchers: A Simulated Game Analysis." Orthopaedic Journal of Sports Medicine 6, no. 7_suppl4 (July 1, 2018): 2325967118S0007. http://dx.doi.org/10.1177/2325967118s00073.
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Objectives: The incidence of overuse injury to the elbow in baseball pitchers continues to rise, despite exhaustive efforts at pitch count regulations and emphasis on proper throwing mechanics. The goal of this study was to determine if the medial elbow experiences increased torque levels as the pitcher fatigues through the course of a simulated game. Methods: Competitive baseball pitchers were recruited for this simulated game study. Medial elbow torque was assessed using a validated mobile sensor that recorded medial elbow torque during the throwing motion. A radar gun was used to capture pitch velocity for each recorded pitch. Each pitcher completed a simulated game consisting of 6 innings and a standardized pitching scheme of fastballs, curveballs, and change-ups. Visual analog scores (VAS) measuring fatigue were recorded in between each inning. In total, each pitcher threw 90 pitches. Data was recorded every pitch to include ball velocity, medial elbow torque, arm speed, arm rotation, and arm slot. Results: A total of 11 pitchers (average age 17.6 years; range 15-20 years) completed the study. No adverse outcomes were noted with use of the mobile sensor. VAS scores increased 0.716 points per inning pitched (p<0.001). Medial elbow torque also was found to increase with successive innings, with an increase of 0.836 Nm each inning (p<0.001), while average pitch velocity was found to decrease as the game progressed (0.28 mile per hour decrease per inning; p<0.001). Fastballs generated the highest amount of medial elbow torque. There were no differences found in arm rotation or arm speed as the game progressed. However, the arm slot was found to decrease with each successive inning (0.731 degree decrease per inning; p<0.001). Conclusion: In this simulated game analysis, pitchers were noted to experience increase fatigue after each successive inning. While the average fastball velocity decreased from inning-to-inning, the medial elbow torque was found to increase, signifying a possible risk factor for overuse injury to the medial elbow.
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Wen, Bor-Jiunn, Che-Rui Chang, Chun-Wei Lan, and Yi-Chen Zheng. "Magnus-Forces Analysis of Pitched-Baseball Trajectories Using YOLOv3-Tiny Deep Learning Algorithm." Applied Sciences 12, no. 11 (May 30, 2022): 5540. http://dx.doi.org/10.3390/app12115540.
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This study analyzed the characteristics of pitched baseballs from TV broadcast videos to understand the effects of the Magnus force on a pitched-baseball trajectory using aerodynamic theory. Furthermore, an automatic measurement and analysis system for pitched-baseball trajectories, ball speeds, and spin rates was established, capturing the trajectory of the baseball thrown by the pitcher before the catcher catches it and analyzing its related dynamic parameters. The system consists of two parts: (1) capturing and detecting the pitched baseball in all frames of the video using the YOLOv3-tiny deep learning algorithm and automatically recording the coordinates of each detected baseball position; (2) automatically calculating the average speed and spin rate of the pitched baseball using aerodynamic theory. As the baseball thrown by the pitcher is fast, and live-action TV videos like sports and concerts are typically at least 24 fps or more, this study used YOLOv3-tiny algorithm to speed up the calculation. Finally, the system automatically presented pitching data on the screen, and the pitching information in the baseball game was easily obtained and recorded for further discussion. The system was tested using 30 videos of pitched baseballs and could effectively capture the baseball trajectories, throw points, catch points, and vertical displacements. Compared with the values from the TV broadcast, the average errors on the calculated ball speed and spin rate were 1.88% and 7.51%, respectively. Using the ratio of the spin rate and ball speed as a parameter to analyze the pitching state of the pitcher’s four-seam fastball in the Nippon Professional Baseball and Major League Baseball matches, it was observed that when this ratio increased, the Magnus displacement of the ball increased, thereby decreasing its late break. Therefore, the developed system provides scientific pitching data to improve the performance of baseball pitchers.
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McGraw, Michael H., Michael Vrla, Dean Wang, Christopher L. Camp, John M. Zajac, Dave Pearson, Alec A. Sinatro, Joshua S. Dines, and Struan H. Coleman. "Shoulder and Elbow Range of Motion Can Be Maintained in Major League Baseball Pitchers Over the Course of the Season, Regardless of Pitching Workload." Orthopaedic Journal of Sports Medicine 7, no. 2 (February 1, 2019): 232596711882506. http://dx.doi.org/10.1177/2325967118825066.
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Background: Studies examining the evolution of shoulder and elbow range of motion (ROM) in baseball pitchers over a single season have yielded inconsistent results. Purpose: To evaluate shoulder and elbow ROM in Major League Baseball (MLB) pitchers over a single season and to assess for correlations between these changes and measures of a pitcher’s workload. Study Design: Case-control study; Level of evidence, 3. Methods: Bilateral shoulder ROM (internal rotation [IR], external rotation [ER], and total range of motion [TROM]) was assessed in 92 MLB pitchers pre- and postseason. Shoulder forward flexion (FF) was measured in 64 pitchers, horizontal adduction (HA) was measured in 87 pitchers, and elbow ROM was measured in 86 pitchers. Data collected included demographics (age, height, weight, and body mass index) and measures of workload for pitchers (pitches thrown, innings pitched, and mean fastball velocity). Pitchers were not specifically excluded if they had an injury during the season but had recovered and were actively pitching at the time of postseason measurements. The change in motion from pre- to postseason was measured and the associations with player demographics and workload were calculated by use of the Pearson correlation coefficient. Results: On average, pitchers demonstrated an increase in dominant shoulder ER from 118.8° to 125.4° ( P < .001) and TROM from 173.1° to 181.7° ( P < .001). HA was increased by an average of 15.7° ( P < .001). The average shoulder IR ( P = .189), FF ( P = .432), and elbow ROM (flexion, P = .549; extension, P = .185) remained similar over the span of the season. Average glenohumeral IR deficit did not increase. Pitcher demographics and measures of throwing workload (total pitches thrown, innings pitched, mean fastball velocity) were not significantly correlated with changes in shoulder or elbow ROM. Conclusion: Significant increases in dominant shoulder ER, TROM, and HA were identified in MLB pitchers over the course of a single baseball season. These ROM changes were not correlated with measures of pitching workload.
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Fudin, Robert, Lesley Renninger, and Jordon Hirshon. "Analysis of Data from Reichler's (1979) the Baseball Encyclopedia: Right-Handed Pitchers are Taller and Heavier than Left-Handed Pitchers." Perceptual and Motor Skills 78, no. 3 (June 1994): 1043–48. http://dx.doi.org/10.1177/003151259407800367.
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In 1989 Coren concluded right-handed Major League pitchers whose careers began up to 1975 are significantly taller and heavier than left-handed pitchers. His source of data, Reichler's 1979 edition of The Baseball Encyclopedia, however, lists heights and weights for pitchers whose careers began through 1978 and for individuals who pitched but who almost always appeared at a different position or positions. Coren did not indicate why he did not analyze all of the relevant data in Reichler nor did he explain how he decided that an individual's usual position was that of pitcher. Further, there is evidence from Topp which suggests that the era during which the pitchers began their careers should be considered when comparing their heights and weights because relatively recent rookies (from 1980 through 1986) are taller and heavier than rookies who began their careers 50 and 100 years prior to that era. Classifying an individual as a pitcher if he pitched in at least 50% of the games in which he played at a position, using all relevant data in Reichler, and considering the era during which dextral and sinistral pitchers began their careers, we found strong corroborative evidence for Coren's 1989 findings.
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Li, Wenxun, and Leonard Matin. "Visually Perceived Eye Level is Influenced Identically by Lines from Erect and Pitched Planes." Perception 25, no. 7 (July 1996): 831–52. http://dx.doi.org/10.1068/p250831.
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The physical elevation that appears to correspond to eye level (VPEL), as measured with a small visual target, changes systematically with the orientation in depth (‘visual pitch’) of a visual field consisting of one or two pitched-from-vertical lines in darkness. The influence is large and, with a one-line stimulus, is only 15% smaller than the influence exerted by a complexly structured, well-illuminated, pitched visual field. A line from a frontoparallel plane can be presented to the same retinal locus as a pitched-from-vertical line; the three experiments in the present report were aimed at determining the influence on VPEL from such lines. In the first two experiments the subject viewed a visual field consisting of a one-line or two-line pitched-from-vertical stimulus from a pitched-only plane or an oblique one-line or two-line stimulus from an erect plane. Each of the pitched-from-vertical stimuli was presented at seven different orientations separated by 10° over a ±30° range. Each of the oblique-line stimuli was presented at an orientation that resulted in stimulation to the same retinal locus as one of the conditions with pitched-from-vertical lines, and thus a range of ‘equivalent pitches’ was examined that corresponded to the range of pitches for the pitched-from-vertical lines. The variation in orientation of the oblique-line stimulus and the pitched-from-vertical stimulus each produced systematic changes in VPEL; the two were indistinguishable. A third experiment specifically designed to examine the possibility that either stimulus sequencing or lack of naivity of the subjects might have been involved turned up no such effects. It is concluded that the aspect of a line stimulus that controls the influence on VPEL is the orientation of the image of the line on a projection sphere centered on the nodal point of the eye or, as in the present experiments with viewing in primary position, the retinal locus stimulated; the orientation-in-depth of the stimulating line provides no additional influence on VPEL for the stationary, erect, monocularly viewing observer. The results are interpreted within the framework of the great-circle model.
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Erickson, Brandon J., Peter N. Chalmers, John D’Angelo, Kevin Ma, Dana Rowe, and Christopher S. Ahmad. "Do Injury Rates in Position Players Who Convert to Pitchers in Professional Baseball Differ From Players Who Have Always Been Pitchers?" Orthopaedic Journal of Sports Medicine 9, no. 10 (October 1, 2021): 232596712110509. http://dx.doi.org/10.1177/23259671211050963.
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Background: There are some professional baseball players who begin their career as a position player and later convert to a pitcher; injury rates in these players are unknown. Purpose: To compare injury rates of professional baseball players who started their career as position players and converted to pitchers with a control group of pitchers who have been only pitchers throughout their professional career. Hypothesis: Injury rates would be lower in the conversion players. Study Design: Cohort study; Level of evidence, 3. Methods: All players who began their professional baseball career as position players and converted to pitchers between 2011 and 2018 were included. All injuries that occurred after they converted to pitchers were included. The conversion players were matched 1 to 1 with a control group of pitchers who entered professional baseball as pitchers and never changed position. Injury rates were compared between groups. The performance between groups was also compared. Results: Overall, 221 players were identified who converted from position players to pitchers. There were significantly more injuries per year in the control pitcher group (0.8 ± 0.9) than in the conversion pitcher group (0.7 ± 0.9; P = .015). Injuries in the control group resulted in 61 ± 112 days missed per injury, while injuries in the conversion player group resulted in 54 ± 102 days missed per injury ( P = .894). Injury characteristics differed between groups. However, in both groups, most of the injuries were related to pitching or throwing, were noncontact or gradual overuse injuries, and involved the upper extremity. Converted pitchers had lower pitcher usage, with fewer games and innings pitched ( P < .001), with significantly worse statistics for walks plus hits per inning pitched ( P = .018). Conclusion: Professional baseball players who convert from position players to pitchers are injured at lower rates than control pitchers. Conversion pitchers have lower pitcher usage, which may contribute to their reduced injury rates.
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Collins, Dylon, Ryan Geringer, Champ Baker, and Julia Fink. "Poster 181: Pitching Regimens and Prevalence of Injuries in Youth Fastpitch Softball Windmill Pitchers." Orthopaedic Journal of Sports Medicine 10, no. 7_suppl5 (July 1, 2022): 2325967121S0074. http://dx.doi.org/10.1177/2325967121s00742.
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Objectives: Female youth fastpitch softball pitchers experience stresses to their pitching arms similar to overhand baseball pitchers, placing them at increased risk of overuse injuries. However, they continue to have demanding pitching regimens without tracking of pitch counts or dedicated days of rest. Unlike youth baseball, there is scarce literature documenting incidence of injuries and pitching regimens of female youth fastpitch softball pitchers. Our purpose was to perform an analysis of youth fastpitch pitchers reported pitching regimens, levels of competition and injuries to each major joint of both the upper and lower extremities. Methods: Institutional review board approval was obtained for this survey study. This approval included a waiver of parental or informed consent. A 2-part survey was created; the first part focused on pitching regimens while the second part focused on reported injuries. The web-based survey was managed by an online survey software system (Version 1.0, 2021 SurveyPlanet, LLC). Surveys were distributed to coaches and USA softball state commissioners with available email addresses found of the USA Softball website. they were then distributed to youth fastpitch softball pitchers age 7 to 21 years old. Responses were analyzed as a whole as well as broken up into four separate age groups; less than 10 years old (Group A), 10-13 years old (Group B), 14-17 years old (Group C) and 18-21 years old (Group D). Statistical analysis was performed with a univariable and multivariable regression analysis. Results: Regarding pitching regimens in all participants, more than 89% were right handed pitchers. Greater than 90% played on a travel team, year round and participated in private pitching lessons. The majority also pitched 3-4 days per week until the 18-21 age group. The number of innings pitched per game, pitches thrown per game and total games pitched per season increased with age. Days of rest per week decreased from 2-3 days to 0-1 day over the age of 18 (Table 1). From the reported pitching injuries per age group, no injuries were reported in pitchers under 10 years old, however injuries were reported in 51% of participants age 10-13, 80% age 14-17 and 96% age 18-21. More than 85% of all pitchers with reported injuries played on a travel team, year round and participated in private lessons. The majority pitched 3-4 days per week (B 89%, C 71%), increasing frequency especially in the 18-21 age group (D 59%). Greater than 65% of pitchers with reported injuries in all age groups threw 60-100 pitches per game. More than 50% of pitchers reported pitching in 21-30+ games per season, comparable to a starting position. Days of rest per week also decreased from 2-3 days to 0-1 day over age 18 (Table 2). The most common reported injury was to the shoulder. Elbow, knee, foot and ankle as well as back injuries were also reported in up to 40% of participants. Surgeries were reported only in participants over 14 years old about the shoulder, elbow and knee (Figure 1). Other important trends in pitchers with reported injuries were greater than 60% starting pitching before age 9 (B 89%, C 62%, D 64%). 62-68% of pitchers over 14 years old threw five or more different pitches. Unfortunately, approximately 10% (8/85) of injured pitchers did not return to pitching following their injury. Statistical analysis demonstrated pitchers were approximately two times more likely to have an injury if they threw 60-100 pitches per game (P 0.16, P 0.25). However, pitchers age 14-17 were 5-6 times more likely to have an injury than younger groups (P <0.001) and pitchers age 18-21 were 28-30 times more likely to have an injury than younger groups (P 0.002) As a single variable, participants who began pitching at less than 9 years old were two times more likely to have an injury than participants beginning over 10 years old (P 0.14, P 0.97) (Table 3). Conclusions: The windmill motion of fastpitch pitchers is not as benign as once thought. Young female pitchers are experiencing injuries at an exponentially increasing rate with age. These athletes are pitching more frequently at younger ages on year-round travel teams without concern for pitch counts or time for rest and recovery. As softball continues to grow in popularity and participation, the focus needs to turn to protecting youth pitching arms to allow for high level competition beyond high school without significant injury. A prospective study following regimens and pitch counts as well as injury surveys will help to identify risk of injury and provide guidelines for youth pitchers and coaches. [Table: see text][Table: see text][Figure: see text][Table: see text]
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Chalmers, Peter, Kathryn Mcelheny, John Dangelo, Kevin Ma, Dana Rowe, and Brandon Erickson. "Is Workload Associated with Internal Impingement in Professional Baseball Players? An Analysis of Days of Rest, Innings Pitched and Batters Faced (221)." Orthopaedic Journal of Sports Medicine 9, no. 10_suppl5 (October 1, 2021): 2325967121S0032. http://dx.doi.org/10.1177/2325967121s00329.
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Objectives: Determine if workload; as measured by number of days rest between outings, innings pitched, batters faced, and being a starting pitcher; associates with risk for internal impingement in professional baseball pitchers. Methods: All professional baseball pitchers who were diagnosed with internal impingement between 2011-2017 were identified using the major league baseball (MLB) Health and Injury Tracking System (HITS). A separate player usage dataset was used to determine workload. We then compared workload variables between pitcher-games 2, 6, 12, and >12 weeks prior to documented internal impingement and pitcher games from a control group who were never diagnosed with internal impingement. In a paired analysis, we compared the acute workload (2, 6, 12 weeks) prior to injury and the injured pitcher’s workload >12 weeks prior to injury. Results: There were 624 pitchers who suffered from internal impingement in professional baseball. Across all time points, players with more innings pitched per game, more batters faced per game, and fewer days rest in between games were associated with a subsequent internal impingement compared to controls. Pitchers who threw four or more innings per game had a 1.3-fold increase in percent of players with subsequent internal impingement compared to pitchers who threw only one inning per game. Significantly more starting pitchers were diagnosed with internal impingement over multiple time points compared to controls. Conclusions: Greater pitcher workload was associated with increased risk for internal impingement in professional baseball players. Throwing four or more innings per game increase a pitcher’s risk for internal impingement 1.3-fold compared to pitchers who threw one inning per game. Starting pitchers are more likely to sustain a LD/TM tear than control pitchers.
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Stodden, David F., Glenn S. Fleisig, Scott P. McLean, Stephen L. Lyman, and James R. Andrews. "Relationship of Pelvis and Upper Torso Kinematics to Pitched Baseball Velocity." Journal of Applied Biomechanics 17, no. 2 (May 2001): 164–72. http://dx.doi.org/10.1123/jab.17.2.164.
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Generating consistent maximum ball velocity is an important factor for a baseball pitcher’s success. While previous investigations have focused on the role of the upper and lower extremities, little attention has been given to the trunk. In this study it was hypothesized that variations in pelvis and upper torso kinematics within individual pitchers would be significantly associated with variations in pitched ball velocity. Nineteen elite baseball pitchers were analyzed using 3-D high-speed motion analysis. For inclusion in this study, each pitcher demonstrated a variation in ball velocity of at least 1.8 m/s (range: 1.8–3.5 m/s) during his 10 fastball pitch trials. A mixed-model analysis was used to determine the relationship between 12 pelvis and upper torso kinematic variables and pitched ball velocity. Results indicated that five variables were associated with variations in ball velocity within individual pitchers: pelvis orientation at maximum external rotation of the throwing shoulder (p= .026), pelvis orientation at ball release (p= .044), upper torso orientation at maximum external rotation of the throwing shoulder (p= .007), average pelvis velocity during arm cocking (p= .024), and average upper torso velocity during arm acceleration (p= .035). As ball velocity increased, pitchers showed an increase in pelvis orientation and upper torso orientation at the instant of maximal external rotation of the throwing shoulder. In addition, average pelvis velocity during arm cocking and average upper torso velocity during arm acceleration increased as ball velocity increased. From a practical perspective, the athlete should be coached to strive for proper trunk rotation during arm cocking as well as strength and flexibility in order to generate angular velocity within the trunk for maximum ball velocity.
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Downs, Jessica, Kenzie Friesen, Adam W. Anz, Jeffrey R. Dugas, James R. Andrews, and Gretchen D. Oliver. "Effects of a Simulated Game on Pitching Kinematics in Youth Softball Pitcher." International Journal of Sports Medicine 41, no. 03 (January 6, 2020): 189–95. http://dx.doi.org/10.1055/a-1062-6475.
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AbstractDespite evidence that overuse is the most common mechanism of injury, softball pitchers currently have no pitch count regulations. Pain has been associated with certain pitching pathomechanics, and some reports indicate increased pain following a single pitching bout. Therefore, the purpose of this study was to examine trunk and lower extremity kinematics during the first and last inning of a game, as well as last inning pitch volume in youth softball pitchers. Thirty-two youth softball pitchers (12.4±1.6 years, 159.4±8.9 cm, 62.0±13.6 kg) pitched a simulated game. Three fastballs were averaged and analyzed from the first and last inning. Kinematic data were collected at 100Hz using an electromagnetic system, synced with motion analysis software. A Wilcoxon signed rank test revealed pitchers exhibited less trunk rotation toward their pitching arm side in the last inning. A bivariate Pearson’s correlation showed volume of pitches was correlated with stride length (r=0.367, p=0.039) and center of mass (r=0.364, p=0.041) at the start of the pitch, and trunk flexion at top of pitch (r=−0.392, p=0.026), foot contact (r=−0.413, p=0.019), and follow-through (r=−0.436, p=0.013). This study found that pitching a simulated game did result in altered pitching mechanics, meanwhile pitch volume was also correlated with pitching mechanics.
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Shanahan, Daniel, and David Huron. "Heroes and Villains: The Relationship between Pitch Tessitura and Sociability of Operatic Characters." Empirical Musicology Review 9, no. 2 (November 25, 2014): 141. http://dx.doi.org/10.18061/emr.v9i2.4441.
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<p>ABSTRACT: Research in speech prosody and ethology suggests that pitch height indexes positive and negative social affects. For example, higher pitched voices are used to convey friendliness, whereas lower pitched voices are used to convey aggression (Bolinger, 1964). Research concerning animal calls suggests that this association generalizes to many species. In a study of the calls for 56 species, Morton (1977, 1994) proposed a sound-size model in which large size (and low pitch) is associated with aggression, whereas small size (and high pitch) is associated with friendliness, fear, or appeasement. We examine whether this association can be observed in music. Specifically, the results of three studies are reported in which the pitch-height of various voices is related to estimates of the sociability of the corresponding operatic characters. Results are consistent with lower-pitched voices being associated with less sociable characters, and higher-pitched voices being associated with more sociable characters. In addition, older male characters tend to exhibit lower-pitched voices, consistent with known physiological changes (Linville, 2004; Reubold, Harrington & Kleber, 2010).</p>
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Apicella, Coren L., and David R. Feinberg. "Voice pitch alters mate-choice-relevant perception in hunter–gatherers." Proceedings of the Royal Society B: Biological Sciences 276, no. 1659 (December 2, 2008): 1077–82. http://dx.doi.org/10.1098/rspb.2008.1542.
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In humans, voice pitch is thought to be a cue of underlying quality and an important criterion for mate choice, but data from non-Western cultures have not been provided. Here we test attributions to and preferences for voices with raised and lowered pitch in hunter–gatherers. Using a forced-choice playback experiment, we found that both men and women viewed lower pitched voices in the opposite sex as being better at acquiring resources (e.g. hunting and gathering). While men preferred higher pitched women's voices as marriage partners, women showed no overall preference for voice pitch in men. However, women who were currently breastfeeding had stronger preferences for higher pitched male voices whereas women not currently breastfeeding preferred lower pitched voices. As testosterone is considered a costly signal associated with dominance, heritable immunity to infection and low paternal investment, women's preferences potentially reflect a trade-off between securing good genes and paternal investment. Men's preferences for higher pitched female voices are probably due to an evolved preference for markers of fecundity, reflected in voice pitch.
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Trotter, Cameron A., Justin J. Greiner, Tim McGuine, and Geoffrey S. Baer. "PITCHING IN YOUTH SOFTBALL: HOW MUCH ARE PITCHERS THROWING?" Orthopaedic Journal of Sports Medicine 9, no. 7_suppl3 (July 1, 2021): 2325967121S0004. http://dx.doi.org/10.1177/2325967121s00049.
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Background: Softball is a popular sport among youth female athletes. While multiple youth baseball studies have evaluated the relationship of injury to pitch counts, there is a paucity of literature for youth softball. In contrast to the numerous youth baseball leagues adhering to pitching guidelines, pitch counts are frequently not enforced in youth softball which results in pitchers with exceedingly high volumes. Purpose: The purpose of this study was to perform a quantitative analysis of pitching volume in youth softball players. We hypothesized that the majority of pitches would be thrown by a small proportion of pitchers on each team. Methods: Seventy youth softball teams including 538 pitchers competing in age brackets eight and under (8U) to fourteen and under (14U) between Spring 2017 and Fall 2019. Game dates and pitch counts were collected for each player using an electronic application. Games played on two or more consecutive days were defined as a tournament. The three highest-volume pitchers from each team defined by total season pitches were analyzed for comparison to the average pitcher. Results: 538 pitchers on 70 teams were included. The average pitcher threw 813 pitches per year and appeared in 20.0% of games and the average high-volume pitcher threw 2500 pitches per year and appeared in 54.5% of games. The highest-volume pitcher from each team threw 40% of all recorded pitches, the second highest 27.2%, and the third highest 15.2%, totaling 82.4% of all team pitches. Single day pitch counts of >100 and >200 occurred in 17.7%, and 1.1% of same day games with the average pitcher and in 31.2%, and 2.4% of same day games with the average highest-volume pitcher. Tournament pitch counts of >100 and >200 occurred in 51.0% and 13.8% of tournaments with the average pitcher and in 81.4% and 30.8% of tournaments with the average highest-volume pitcher. The average and highest-volume pitcher threw pitches in two or more games on the same day in 37.5% and 48.6% of possible games while pitching two or more consecutive days in 64.0% and 79.6% of possible games, respectively. Conclusion: Softball pitchers throw high volumes of pitches while also pitching multiple days consecutively. A disparity among pitchers on softball teams exists as 82.4% of team pitches are thrown by three pitchers. These high-volume pitchers may be engaging in unsustainable pitching practices that could predispose to injury. Tables: [Table: see text]
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Mair, Hailey, Nicholas A. Kenney, Timothy L. Uhl, L. Robert Ullery, and Robert G. Hosey. "Effect of Pitching Restrictions and Mound Distance on Youth Baseball Pitch Counts." Orthopaedic Journal of Sports Medicine 10, no. 7 (July 1, 2022): 232596712211105. http://dx.doi.org/10.1177/23259671221110547.
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Background: Studies have shown that higher pitch counts are directly related to a greater incidence of elbow and shoulder pain among youth baseball pitchers. Purpose/Hypothesis: The purpose of this study was to examine the effect of different pitching restriction rules on the number of pitches thrown in youth baseball leagues. We hypothesized that more pitches would be thrown in leagues with inning restrictions versus leagues with pitch count restrictions as well as in leagues with a longer mound distance (from pitching mound to home plate). Study Design: Cohort study; Level of evidence, 2. Methods: Pitch count data were collected for 2 consecutive years over a 10-week season from 3 different leagues of 9- to 12-year-old baseball players in a single city. The Eastern league had a pitch count restriction and 46-ft (14.02-m) mound distance. The Southeastern and South leagues’ pitching restrictions were based on innings per week. The Southeastern league had a 50-ft (15.24-m) mound distance, while the South league had a 46-ft mound distance. Comparisons of total seasonal pitches thrown were made of the 3 highest-volume pitchers on each team. League averages for each value were then compared utilizing analysis of variance with Bonferroni post hoc analysis. The number of pitchers in each league who threw >600 pitches per season was compared using the chi-square test. Results: No significant difference in seasonal pitch counts or innings pitched was noted between the Eastern and South leagues, which differed only in their pitching restrictions. The Southeastern league, with a longer mound distance, was found to have higher seasonal pitch counts per thrower (598 ± 195 pitches) than the South league (463 ± 198 pitches) for the 3 highest-volume throwers for each team ( P = .004). The Southeastern league also had a significantly larger number of pitchers who threw >600 pitches per season (33 vs 20 for Eastern and 13 for South; P = .009). Conclusion: There was no significant difference in seasonal pitch counts when the leagues in this study differed based on pitching restrictions. However, the league with a greater mound distance (Southeastern) had higher seasonal pitch counts for the highest-volume throwers. Pitching restrictions based on pitch counts, as opposed to innings, may be advisable.
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Matsuura, Tetsuya, Yuki Takata, Toshiyuki Iwame, Jyoji Iwase, Kenji Yokoyama, Shoichiro Takao, Susumu Nishio, Kokichi Arisawa, and Koichi Sairyo. "Limiting the Pitch Count in Youth Baseball Pitchers Decreases Elbow Pain." Orthopaedic Journal of Sports Medicine 9, no. 3 (March 1, 2021): 232596712198910. http://dx.doi.org/10.1177/2325967121989108.
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Background: Reducing the number of pitches thrown is regarded as the most effective way to prevent throwing injuries in youth baseball pitchers. However, few studies have compared the effectiveness of limiting the pitch count versus the limiting the number of innings pitched in terms of elbow injuries. Hypothesis: We hypothesized that, compared with inning limits, pitch count limits would lead to greater decreases in elbow pain, range of motion deficits, positive moving valgus stress test results, and the risk of capitellar osteochondritis dissecans (OCD). Study Design: Cohort study; Level of evidence, 3. Methods: This study retrospectively reviewed baseball pitchers aged 8 to 12 years in 2017 and 2018. Inning and pitch count limits in games were set to a daily maximum of 7 innings in 2017 and 70 pitches in 2018. Elbow pain, range of motion, and moving valgus stress test results were evaluated. The presence of capitellar OCD was assessed on ultrasonographic and radiographic images. Results: A total of 352 pitchers in 2017 and 367 pitchers in 2018 participated. The mean pitch count per game was lower in the pitch count limit (CL) group (52.5 ± 16.0) than in the inning limit (IL) group (98.2 ± 19.5) ( P < .001). Compared with the IL group, the CL group had significantly lower rates of elbow pain (40.9% vs 31.9%, respectively; P = .01) and reduced flexion (19.0% vs 10.6%, respectively; P = .001). Multivariate analysis revealed a significant association between elbow pain and age in both the IL and the CL groups ( P < .0001 and P = .02, respectively) and between OCD and elbow pain in the CL group ( P = .04). Conclusion: A pitch count limit of ≤70 pitches per day for baseball pitchers ≤12 years could be more protective against elbow pain and reduced flexion than a limit of ≤7 innings per day, but it may not be effective for reducing the risk of capitellar OCD.
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Garcia, Grant, Anirudh K. Gowd, Brandon C. Cabarcas, Joseph N. Liu, Anthony A. Romeo, and Nikhil N. Verma. "Radiographic Predictors of Elbow Injury and Surgery in Major League Baseball Pitchers." Orthopaedic Journal of Sports Medicine 6, no. 7_suppl4 (July 1, 2018): 2325967118S0008. http://dx.doi.org/10.1177/2325967118s00085.
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Objectives: To evaluate predictive ability of asymptomatic screening MRI’s of Major League Baseball (MLB) pitchers and compare associated findings with future DL placement, pitching statistics, and elbow surgery. Methods: A total of 40 consecutive asymptomatic elbow MRI’s in MLB pitchers at a single organization were analyzed from 2005 - 2017. Asymptomatic MRI was defined as a screening MRI at time of contract signing having been performed at least 6 months prior to DL placement for any elbow-related injury. Publicly available DL data, career innings pitched, career games started, career pitch count, and career max velocity of pitch were obtained. A blinded investigator examined each MRI for pathological signals. Data was analyzed on players that were eventually placed on the DL compared to those with no DL placement. Results: 40 consecutive elbow MRIs of MLB players were reviewed. The average age of the injured cohort was 28.3 ± 3.2 years (16 players) and 28.8 ± 5.5 years (24 players) for the non-injured cohort. There was no statistical difference in age, handedness, height, weight, or pitching stats between the injured and non-injured cohorts. Abnormal radiographic signal intensity in the UCL (p<0.001) and humeral elevation of the UCL (p=0.01) were significantly associated with future DL placement. Those injured spent an average of 200.7 days and 191.7 days in the DL with signal in the UCL and those with humeral elevation of the UCL, respectively. Ulnar elevation/signal of the UCL (p=0.06), and posteromedial impingement (p=0.08) were approaching statistical significance. Of those injured 68.8% (11/16) underwent elbow surgery. Findings of ligament signal intensity (p<0.001), ulnar-sided UCL elevation (p=0.018), humeral-sided UCL elevation (p=0.002), and posteromedial impingement (p=0.042) were all significantly associated with future surgery. There was no significant correlation between injury and radiocapitellar or ulnohumeral chondral lesion, bone edema, loose bodies, or flexor-pronator mass muscle defect. The presence of a flexor-pronator mass muscle defect was associated with a significantly reduced number of innings pitched (53.7 ± 74.3 vs. 304.4 ± 305.5 innings, p=0.0317), games started (5 ± 7.1 vs. 40.1 ± 49.0 games, p=0.004), and pitch count (680.5 ± 919.9 vs. 40.1 ± 49.0 pitches, p=0.022). The presence of ligament signal (26.2 ± 37.1 vs. 51.7 ± 56.5 games, p=0.036) and ulnar elevation (6.3 ± 9.3 vs. 41.2 ± 9.3 games, p=0.003) was associated with significantly fewer games started. The presence of bone edema was associated with significantly decreased pitch count (1451.2 ± 1746.8 vs. 4128.0 ± 4718.0 pitches, p=0.023). There was no association between humeral UCL elevation, flexor-pronator mass tendon, or posteromedial impingement with innings pitched, games started, or pitch count. Conclusion: The heavy demand placed on the elbow joint in professional pitching produces degenerative changes visible on MRI prior to any symptoms, as demonstrated in previous studies. Specific degenerative changes in the UCL Ligament, particularly humeral sided elevation of the UCL, are significantly associated with future injury. [Table: see text]
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Fury, Matthew S., Luke S. Oh, Shannon E. Linderman, Joshua Wright-Chisem, Jacob N. Fury, Donna M. Scarborough, and Eric M. Berkson. "Return to Performance After Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers: A Case-Control Assessment of Advanced Analytics, Velocity, Spin Rates, and Pitch Movement." Orthopaedic Journal of Sports Medicine 9, no. 9 (September 1, 2021): 232596712110357. http://dx.doi.org/10.1177/23259671211035753.
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Background: There are limited data on the performance or pitching metrics of Major League Baseball (MLB) pitchers who returned to play after ulnar collateral ligament reconstruction (UCLR). Purpose: To describe MLB pitcher performance after return from primary UCLR, compare the velocity and pitch characteristics against the preoperative season, and determine if performance analytics can predict successful return to pitching after UCLR. Study Design: Case-control study; Level of evidence, 3. Methods: This study included 63 pitchers who underwent primary UCLR between 2015 and 2019. Publicly available advanced analytics and pitch metrics from the first 2 postoperative seasons were compared with the preoperative (index) season as well as with an uninjured control group. Results: Overall, 57% of the pitchers successfully returned to the MLB level. Although they threw significantly fewer pitches ( P = .012) and innings ( P = .022) in postoperative year 1 as compared with the index season, there were no significant differences in pitch velocity, release extension, perceived velocity, or performance as measured by advanced analytics. Also, as compared with the index season, returners demonstrated increased postoperative spin rates on curveballs ( P = .001) and sliders ( P = .010), and curveball horizontal movement was significantly increased ( P = .007); however, horizontal movement was significantly decreased for 4-seam fastballs ( P = .026), changeups ( P = .005), and sinkers ( P = .019). The vertical movement on 4-seam fastballs was greater ( P < .001) in postoperative year 1, and the vertical movement on curveballs ( P = .031) and sinkers ( P = .010) was greater in postoperative year 2 when compared with the index season. Pitchers who failed to return to the MLB level had a lower preoperative strikeout percentage ( P = .047), fewer strikeouts per 9 innings pitched ( P = .046), fewer wins above replacement ([WAR]; P = .026), and lower player value ( P = .030) than the pitchers who returned. Conclusion: Pitchers returning to the MLB level after UCLR demonstrated changes in pitch movement profiles and spin rates postoperatively, but there were no differences in velocity or many advanced analytics upon return. Pitchers with lower strikeout metrics, fewer WAR, and less player value before surgery may have an elevated risk of failing to return to the MLB level.
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Darke, Jim D., Eshan M. Dandekar, Arnel L. Aguinaldo, Scott J. Hazelwood, and Stephen M. Klisch. "Effects of Game Pitch Count and Body Mass Index on Pitching Biomechanics in 9- to 10-Year-Old Baseball Athletes." Orthopaedic Journal of Sports Medicine 6, no. 4 (April 1, 2018): 232596711876565. http://dx.doi.org/10.1177/2325967118765655.
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Background: Pitching while fatigued and body composition may increase the injury risk in youth and adult pitchers. However, the relationships between game pitch count, biomechanics, and body composition have not been reported for a study group restricted to 9- to 10-year-old athletes. Hypothesis: During a simulated game with 9- to 10-year-old athletes, (1) participants will experience biomechanical signs of fatigue, and (2) shoulder and elbow kinetics will correlate with body mass index (BMI). Study Design: Descriptive laboratory study. Methods: Thirteen 9- to 10-year-old youth baseball players pitched a simulated game (75 pitches). Range of motion and muscular output tests were conducted before and after the simulated game to quantify fatigue. Kinematic parameters at foot contact, maximum external rotation, and maximum internal rotation velocity (MIRV), as well as maximum shoulder and elbow kinetics between foot contact and MIRV were compared at pitches 1-5, 34-38, and 71-75. Multivariate analyses of variance were used to test the first hypothesis, and linear regressions were used to test the second hypothesis. Results: MIRV increased from pitches 1-5 to 71-75 ( P = .007), and head flexion at MIRV decreased from pitches 1-5 to 34-38 ( P = .022). Maximum shoulder horizontal adduction, external rotation, and internal rotation torques increased from pitches 34-38 to 71-75 ( P = .031, .023, and .021, respectively). Shoulder compression force increased from pitches 1-5 to 71-75 ( P = .011). Correlations of joint torque/force with BMI were found at every pitch period: for example, shoulder internal rotation ( R2 = 0.93, P < .001) and elbow varus ( R2 = 0.57, P = .003) torques at pitches 1-5. Conclusion: Several results differed from those of previous studies with adult pitchers: (1) pitch speed remained steady, (2) shoulder MIRV increased, and (3) shoulder kinetics increased during a simulated game. The strong correlations between joint kinetics and BMI reinforce previous findings that select body composition measures may be correlated with pitching arm joint kinetics for youth baseball pitchers. Clinical Relevance: The results improve our understanding of pitching biomechanics for 9- to 10-year-old baseball pitchers and may be used in future studies to improve evidence-based injury prevention guidelines.
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Pareek, Ayoosh, Chad W. Parkes, Alexey A. Leontovich, Aaron J. Krych, Stan Conte, John A. Steubs, Corey A. Wulf, and Christopher L. Camp. "Are Baseball Statistics an Appropriate Tool for Assessing Return to Play in Injured Pitchers? Analysis of Statistical Variability in Healthy Players." Orthopaedic Journal of Sports Medicine 9, no. 11 (November 1, 2021): 232596712110509. http://dx.doi.org/10.1177/23259671211050933.
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Background: Basic pitcher statistics have been used to assess performance in pitchers after injury or surgery without being validated. Even among healthy pitchers, the normal variability of these parameters has not yet been established. Purpose: To determine (1) the normal variability of basic and advanced pitcher statistics in healthy professional baseball pitchers and (2) the minimum pitches needed to predict these parameters. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Publicly available data from the MLB Statcast and PITCHf/x databases were used to analyze MLB pitchers during the 2015 and 2016 seasons who recorded a minimum of 100 innings without injury. Basic and advanced baseball pitcher statistics were analyzed. The variability of each parameter was assessed by computing the coefficient of variation (CV) between individual pitchers and across all pitchers. A CV <10 was indicative of a relatively constant parameter, and parameters with a CV >10 were generally considered inconsistent and unreliable. The minimum number of pitches needed to be followed for each variable was also analyzed. Results: A total of 118 pitchers, 55 baseball-specific statistical metrics (38 basic and 17 advanced), and 7.5 million pitches were included and analyzed. Of the 38 basic pitcher statistics, only fastball velocity demonstrated a CV <10 (CV = 1.5), while 6 of 17 (35%) advanced metrics demonstrated acceptable consistency (CV <10). Release position from plate and velocity from the plate were the 2 most consistent advanced parameters. When separated by pitch type, these 2 parameters were the most constant (lowest CV) across every pitch type. Conclusion: We recommend against utilizing nonvalidated statistical measures to assess performance after injury, as they demonstrated unacceptably high variability even among healthy, noninjured professional baseball pitchers. It is our hope that this study will serve as the foundation for the identification and implementation of validated pitcher-dependent statistical measures that can be used to assess return-to-play performance after injury in the future.
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LaPrade, Christopher M., Mark E. Cinque, Marc R. Safran, Michael T. Freehill, Corey A. Wulf, and Robert F. LaPrade. "Using Advanced Data to Analyze the Impact of Injury on Performance of Major League Baseball Pitchers: A Narrative Review." Orthopaedic Journal of Sports Medicine 10, no. 7 (July 1, 2022): 232596712211111. http://dx.doi.org/10.1177/23259671221111169.
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Major league baseball (MLB) pitchers are at risk of numerous injuries during play, and there is an increasing focus on evaluating their performance in the context of injury. Historically, performance after return to play (RTP) from injury has focused on general descriptive statistics, such as innings or games played, or rate statistics with inherent variability (eg, earned run average, walks and hits per inning pitched, strikeouts per 9 innings, or walks per 9 innings). However, in recent years, MLB has incorporated advanced technology and tracking systems in every stadium, allowing for more in-depth analysis of pitcher-specific data that are captured with every pitch of every game. This technology allows for the ability to delve into the pitching performance on a basis that is more specific to each pitcher and allows for more in-depth analysis of different aspects of pitching performance. The purpose of this narrative review was to illustrate the current state of injury recording for professional baseball pitchers, highlight recent technological advances in MLB, and describe the advanced data available for analysis. We used advanced data in the literature to review the current state of performance analysis after RTP in MLB pitchers after injury. Finally, we strived to provide a framework for future studies to more meticulously assess RTP performance given the current available resources for analysis.
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Huang, Xun (Irene), and Aparna A. Labroo. "Cueing Morality: The Effect of High-Pitched Music on Healthy Choice." Journal of Marketing 84, no. 6 (January 9, 2019): 130–43. http://dx.doi.org/10.1177/0022242918813577.
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Managers often use music as a marketing tool. For example, in advertising, they use music to intensify emotions; in service settings, they use slow music to boost relaxation and classical music to convey sophistication. In this article, the authors posit a novel effect—higher-pitched music can boost healthier choices. Recognizing that many perceptual characteristics of higher pitch (e.g., lighter, elevated) are conceptually associated with morality, they theorize that listening to higher- (vs. lower-) pitched music can cue morality. Furthermore, thoughts about morality can prompt moral self-perceptions and, in turn, thoughts about “good” behaviors, including healthy choices. Thus, listening to higher-pitched music may increase healthier choices. Employing field settings and online studies, the authors find that listening to higher-pitched music increases consumers’ likelihood to choose healthy options (Studies 1, 3, and 5), choose lower-calorie foods (Study 2), and engage in health-boosting activities (Study 4). This effect arises because high pitch raises the salience of morality thoughts (Studies 4 and 5). The article concludes with a discussion of theoretical and managerial implications.
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Shen, Hung Che, and Chung Nan Lee. "Digital Storytelling Book Generator with MIDI-to-Singing." Applied Mechanics and Materials 145 (December 2011): 441–45. http://dx.doi.org/10.4028/www.scientific.net/amm.145.441.
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Creating a digital storytelling book is an important knowledge source for the blinds, but it usually takes a lot of time and efforts. In order to read the books from electronic contents, automatic procedures could be incorporated into a speech synthesis system. In this paper, we give a practical description using a free software Text-to-speech (TTS) program with a MIDI-to-Singing toolkit as a digital storytelling book generator. In this case, a certain amount of emotional TTS customization can be derived by using time-pitch manipulation of the synthesized acoustic waveform. MIDI-to-Singing voices can be generated automatically with special emphasis on lyrical or storytelling-styled contents that are usually discouraged by uninteresting natures of voices synthesized from traditional Text-to-speech (TTS) programs. Rule-based approaches rely on rules that describe the behavior of the pitch frequency along time to generate time-pitch values. Pitch values fluctuate within a certain range depending on the intended emotion. This MIDI-to-Singing voice synthesis relies on mapping the pitch frequency values to the 12 semi-tonal melodic scales and extracting semi-tonic intervals for each emotional state. In the current version of the system, a user can style the synthesized voice by selecting either male or female standard voice in combination with one of the predefined 12 expressive styles: Neutral, Monotonic, Lowly-pitched, Highly-pitched, Rising-pitched, Falling-pitched, Happy, Sad, Fear, Anger, Randomly-pitched, and Melody-aligning (singing) styles using a small set of musical notes. A subjective test shows that synthetic conversations based on MIDI-to-Singing with customized styles are more preferable, natural, intelligible and enjoyable than the traditional ones. Finally, the result of digital talking recordings can be heard on the web-site for the comparisons between human speech and MIDI-to-Singing synthesized speech.
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Buss, Armands, Arturs Suleiko, Normunds Jekabsons, Juris Vanags, and Dagnija Loca. "Constraint Handling and Flow Control in Stirred Tank Bioreactors with Magnetically Coupled Impellers." Materials Science Forum 1071 (October 18, 2022): 189–96. http://dx.doi.org/10.4028/p-w35yei.
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In this study, Computational Fluid Dynamics (CFD), applied to a non-Newtonian fluid, was developed to characterize gas-liquid interaction and mixing process in a 15 m3 (working volume) bioreactor. The bioreactor was equipped with four arrangements of standard Rushton, Pitch-blade and Scaba® impellers. Gas-liquid hydrodynamics was estimated based on CFD results. The chosen operating conditions were defined by the settings used for production of xanthan gum via fermentation route by Xanthomonas campestris. The mixing process was simulated by using the k-epsilon turbulence model, Multiple Reference Frame and Population Balance Model approaches. The simulation results have been compared and analyzed by isosurfaces, volume fractions, velocity graphs, torques and flow analysis calculations. Obtained results revealed that for the Pitched-Pitched-Pitched arrangement to avoid the constraint-imposed overload torque limitations impeller diameter size should be reduced by 10%. The use of Rushton-Rushton-Rushton impeller arrangement was discouraged for non-Newtonian pseudoplastic fluid mixing, whereas Pitched-Rushton-Scaba and Scaba-Rushton-Pitched impeller arrangements were both acceptable.
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Motoki, Kosuke, Toshiki Saito, Rui Nouchi, Ryuta Kawashima, and Motoaki Sugiura. "A Sweet Voice: The Influence of Cross-Modal Correspondences Between Taste and Vocal Pitch on Advertising Effectiveness." Multisensory Research 32, no. 4-5 (2019): 401–27. http://dx.doi.org/10.1163/22134808-20191365.
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Abstract We have seen a rapid growth of interest in cross-modal correspondences between sound and taste over recent years. People consistently associate higher-pitched sounds with sweet/sour foods, while lower-pitched sounds tend to be associated with bitter foods. The human voice is key in broadcast advertising, and the role of voice in communication generally is partly characterized by acoustic parameters of pitch. However, it remains unknown whether voice pitch and taste interactively influence consumer behavior. Since consumers prefer congruent sensory information, it is plausible that voice pitch and taste interactively influence consumers’ responses to advertising stimuli. Based on the cross-modal correspondence phenomenon, this study aimed to elucidate the role played by voice pitch–taste correspondences in advertising effectiveness. Participants listened to voiceover advertisements (at a higher or lower pitch than the original narrator’s voice) for three food products with distinct tastes (sweet, sour, and bitter) and rated their buying intention (an indicator of advertising effectiveness). The results show that the participants were likely to exhibit greater buying intention toward both sweet and sour food when they listened to higher-pitched (vs lower-pitched) voiceover advertisements. The influence of a higher pitch on sweet and sour food preferences was observed in only two of the three studies: studies 1 and 2 for sour food, and studies 2 and 3 for sweet food. These findings emphasize the role that voice pitch–taste correspondence plays in preference formation, and advance the applicability of cross-modal correspondences to business.
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Hattori, Hiroshi, Kiyokazu Akasaka, Takahiro Otsudo, Toby Hall, Katsunobu Sakaguchi, and Yomei Tachibana. "Ulnar Collateral Ligament Laxity After Repetitive Pitching: Associated Factors in High School Baseball Pitchers." American Journal of Sports Medicine 49, no. 6 (April 8, 2021): 1626–33. http://dx.doi.org/10.1177/03635465211002507.
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Background: Medial elbow injury is common in baseball pitchers, with evidence of elbow valgus instability after only 60 consecutive pitches. However, the tissue-specific effects of repetitive pitching on medial elbow stabilizers are largely unknown. Purpose/Hypothesis: This study aimed to investigate changes in the ulnar collateral ligament (UCL) and forearm flexor-pronator muscles (FPMs) during repetitive pitching and factors that relate to identified change. We hypothesized that repetitive pitching would increase elasticity of the medial elbow stabilizers and therefore induce laxity. Study Design: Descriptive laboratory study. Methods: A total of 30 high school baseball pitchers participated (mean ± SD age, 16.6 ± 0.5 years). Each participant pitched 100 times (5 blocks of 20 pitches). The strain ratio, indicating elasticity in the UCL and FPMs, was measured using ultrasound before pitching and after every 20-pitch block. Data for each pitch block were compared using analysis of variance. Multiple regression analysis was used to investigate factors related to the change rate of the strain ratio. Results: The strain ratio of the UCL after 100 pitches was significantly less than that before pitching (before pitching, 4.83 ± 1.70; after 100 pitches, 3.59 ± 1.35; P = .013), but this was not the case for the FPMs (before pitching, 0.57 ± 0.24; after 100 pitches, 0.43 ± 0.18; P = .07). The ratio of the strain ratio in the UCL and FPMs (UCL/FPMs) before pitching (β = −0.385; P = .031) and the elbow flexion range of motion before pitching (β = −0.352; P = .046) were significantly and independently correlated with the change rate of the UCL. Conclusion: Elasticity significantly increased for the UCL, indicating laxity, but not for the FPMs after 100 pitches. Furthermore, the ratio of elasticity (UCL/FPMs) and the elbow flexion range of motion before pitching were significantly related to the change rate of UCL elasticity. Clinical Relevance: To reduce laxity of the UCL, pitchers should be limited to <100 pitches per game. Sustaining a lower level of relative FPMs to UCL elasticity at rest and maintaining a large muscle volume to avoid excessive elbow flexion range of motion may prevent UCL laxity that develops during repetitive pitching.
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DORSEY, J. KEVIN, and RON BENTON. "Saving Young Arms and Batters' Heads." Pediatrics 91, no. 3 (March 1, 1993): 679–80. http://dx.doi.org/10.1542/peds.91.3.679a.
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To the Editor.— The local baseball commission of the boys' 8- to 10-year-old league recently implemented several changes in an attempt to increase safety and improve instruction. One of these was the use of a pitching machine for the first three innings of every six-inning game. A neutral adult served as a "pitching coach" for both teams and adjusted the height of the pitched ball to correspond to the strike zone of the batter. Pitch speed was regulated to approximate the speed of a ball thrown by an average to good pitcher in that age group.
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Stodden, David F., Glenn S. Fleisig, Scott P. McLean, and James R. Andrews. "Relationship of Biomechanical Factors to Baseball Pitching Velocity: Within Pitcher Variation." Journal of Applied Biomechanics 21, no. 1 (February 2005): 44–56. http://dx.doi.org/10.1123/jab.21.1.44.
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To reach the level of elite, most baseball pitchers need to consistently produce high ball velocity but avoid high joint loads at the shoulder and elbow that may lead to injury. This study examined the relationship between fastball velocity and variations in throwing mechanics within 19 baseball pitchers who were analyzed via 3-D high-speed motion analysis. Inclusion in the study required each one to demonstrate a variation in velocity of at least 1.8 m/s (range 1.8–3.5 m/s) during 6 to 10 fastball pitch trials. Three mixed model analyses were performed to assess the independent effects of 7 kinetic, 11 temporal, and 12 kinematic parameters on pitched ball velocity. Results indicated that elbow flexion torque, shoulder proximal force, and elbow proximal force were the only three kinetic parameters significantly associated with increased ball velocity. Two temporal parameters (increased time to max shoulder horizontal adduction and decreased time to max shoulder internal rotation) and three kinematic parameters (decreased shoulder horizontal adduction at foot contact, decreased shoulder abduction during acceleration, and increased trunk tilt forward at release) were significantly related to increased ball velocity. These results point to variations in an individual's throwing mechanics that relate to pitched ball velocity, and also suggest that pitchers should focus on consistent mechanics to produce consistently high fastball velocities. In addition, pitchers should strengthen shoulder and elbow musculature that resist distraction as well as improve trunk strength and flexibility to maximize pitching velocity and help prevent injury.
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Oliver, Gretchen D., Jessica L. Downs Talmage, Kenzie B. Friesen, Michael G. Saper, and Jeffrey R. Dugas. "Decreased Shoulder and Elbow Joint Loads During the Changeup Compared With the Fastball and Curveball in NCAA Division I Collegiate Softball Pitchers." Orthopaedic Journal of Sports Medicine 9, no. 9 (September 1, 2021): 232596712110266. http://dx.doi.org/10.1177/23259671211026625.
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Background: Baseball leagues have implemented pitch count and pitch type restrictions based on biomechanical concepts associated with pitch type. Softball has not yet adopted these practices, although softball pitchers continue to pitch at a high volume and learn multiple pitches at a young age. Purpose: To examine shoulder and elbow kinetics between the fastball, curveball, and changeup, as well as to provide descriptive upper extremity pain data in National Collegiate Athletic Association (NCAA) softball pitchers. Study Design: Descriptive laboratory study. Methods: Study participants consisted of 27 female NCAA Division I softball pitchers (age, 20.2 ± 1.9 years; height, 175.7 ± 5.7 cm; weight, 83.6 ± 12.7 kg). The participants pitched 3 balls of each pitch type, and kinetic data were recorded. A one-way within-participants repeated-measures multivariate analysis of variance was used to determine significant differences in kinetics and pitch speed between pitch types. Results: Results revealed a statistically significant main effect for pitch type (Wilks λ = .087; F = 36.523; P < .001). Post hoc testing showed that the changeup produced less anterior elbow force compared with the fastball ( P < .001) and the curveball ( P = .012). In addition, the changeup produced less shoulder distraction force compared with the fastball ( P < .001) and the curveball ( P = .001). Additionally, there was a significant difference in pitch speed between all 3 pitch types ( P = .006). The curveball revealed no statistically significant kinetic differences compared with the fastball. Conclusion: The fastball and curveball placed similar stress on the upper extremity in collegiate softball pitchers. However, in comparison with the changeup, the fastball and curveball placed increased stress on the upper extremity. More research is needed to fully explain the differences seen between pitch type and injury risk. Clinical Relevance: Sports medicine professionals, coaches, and athletes should use the current study results to note these differences in shoulder distraction and elbow anterior forces between softball pitch types. The study results can be used as a reference and basis for future research investigating kinetic differences across varying pitch types.
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Whiteside, David, Douglas N. Martini, Ronald F. Zernicke, and Grant C. Goulet. "Changes in a Starting Pitcher’s Performance Characteristics Across the Duration of a Major League Baseball Game." International Journal of Sports Physiology and Performance 11, no. 2 (March 2016): 247–54. http://dx.doi.org/10.1123/ijspp.2015-0121.
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Purpose:With a view to informing in-game decision making as it relates to strategy and pitcher health, this study examined changes in pitching-performance characteristics across 9 innings of Major League Baseball (MLB) games.Methods:129 starting MLB pitchers met the inclusion criteria for this study. Pitch type, speed, ball movement, release location, and strike-zone data—collected using the MLB’s ball-tracking system, PITCHf/x—were obtained for 1,514,304 pitches thrown from 2008 to 2014.Results:Compared with the 1st inning, the proportion of hard pitches thrown decreased significantly until the 7th inning, while the proportions of breaking and off-speed pitches increased. Significant decreases in pitch speed, increases in vertical movement, and decreases in release height emerged no later than the 5th inning, and the largest differences in all variables were generally recorded between the 1st inning and the late innings (7–9). Pitchers were most effective during the 2nd inning and significantly worse in innings 4 and 6.Conclusion:These data revealed that several aspects of a starting pitcher’s pitching characteristics exhibited changes from baseline as early as the 2nd or 3rd inning of an MLB game, but this pattern did not reflect the changes in his effectiveness. Therefore, these alterations do not appear to provide reasonable justification for relieving a starting pitcher, although future work must address their relevance to injury. From an offensive standpoint, batters in the MLB should anticipate significantly more hard pitches during the early innings but more breaking and off-speed pitches, with decreasing speed, as the game progresses.
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Li, Jie, and Hong Wei Ma. "Analysis of the Ecological Technology in Pitched Roof of Chinese Traditional Dwelling." Applied Mechanics and Materials 253-255 (December 2012): 37–40. http://dx.doi.org/10.4028/www.scientific.net/amm.253-255.37.
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The pitched roofs of Chinese traditional dwelling have good ecological adaptability. Deeply research to find out the valuable technology helps energy-efficient building today. Through the study of the technology of draining, waterproofing, wind protecting, ventilation, insulation, dissipation and heat preservation applied in pitched roofs, the paper summarizes the changes of roof pitch, material and construction technique according to the climate. The objective is to provide new ideas and ways for energy-efficient building to achieve better ecological adaptability today.
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Keyworth, Brian. "Pitched roof construction." Structural Survey 6, no. 3 (March 1988): 207–11. http://dx.doi.org/10.1108/eb006284.
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Falconer, Peter. "Pitched metal roofs." Structural Survey 10, no. 4 (April 1992): 332–38. http://dx.doi.org/10.1108/02630809210028315.
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Erickson, Brandon J., Peter N. Chalmers, John D’Angelo, Kevin Ma, and Anthony A. Romeo. "Open Reduction Internal Fixation of Medial Epicondyle Fractures After Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers." Orthopaedic Journal of Sports Medicine 7, no. 6 (June 1, 2019): 232596711985289. http://dx.doi.org/10.1177/2325967119852896.
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Background: Ulnar collateral ligament reconstruction (UCLR) is a common procedure among professional baseball pitchers. An uncommon complication after UCLR is a fracture of the medial epicondyle at the level of the humeral tunnel, which requires open reduction internal fixation (ORIF). Purpose/Hypothesis: The purpose of this study was to determine the performance upon and rate of return to sport (RTS) in professional baseball pitchers after ORIF of the medial epicondyle and examine whether there is a difference in the RTS rate and performance between players who underwent ORIF and matched controls. It was hypothesized that there would be a high rate of RTS in professional baseball pitchers after ORIF of the medial epicondyle, with no difference between the ORIF and control groups in the rate of RTS or performance, specifically related to the primary performance outcome variables of win-loss percentage, walks plus hits per inning pitched, fielding independent pitching, and wins above replacement. Methods: All professional baseball pitchers who underwent ORIF of the medial epicondyle between 2010 and 2016 were included in this study. Demographic and performance data (preoperative and postoperative) were recorded for each player. Performance metrics were then compared between the ORIF and control (no history of UCLR or ORIF) groups. Results: Overall, 15 pitchers (80.0% starters, 73.3% right-handed) underwent ORIF of a medial epicondyle fracture. All had undergone prior UCLR using either the American Sports Medicine Institute (n = 9; 60.0%) or docking (n = 6; 40.0%) technique. ORIF techniques included fixation with 1 screw (n = 13; 86.7%) and fixation with suture anchors (n = 2; 13.3%). Eleven (73.3%) pitchers were able to return to sport (did not differ from controls; P = .537); 55% returned to the same level or higher. No significant differences existed in the primary performance outcome variables when comparing preoperative with postoperative performance. No significant differences in the primary performance outcome variables were seen between the ORIF and control groups after surgery, although players in the ORIF group pitched fewer innings than controls after surgery ( P = .003). Conclusion: After ORIF of the medial epicondyle in professional pitchers with a history of UCLR, 73.3% were able to return to sport (only 55% of those who returned pitched at the same level or higher) without a significant decline in most performance variables when compared with their preoperative performance or matched controls. The number of innings pitched declined after surgery.
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ZAHNER, KATHARINA, MUNA SCHÖNHUBER, and BETTINA BRAUN. "The limits of metrical segmentation: intonation modulates infants' extraction of embedded trochees." Journal of Child Language 43, no. 6 (December 18, 2015): 1338–64. http://dx.doi.org/10.1017/s0305000915000744.
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AbstractWe tested German nine-month-olds’ reliance on pitch and metrical stress for segmentation. In a headturn-preference paradigm, infants were familiarized with trisyllabic words (weak–strong–weak (WSW) stress pattern) in sentence-contexts. The words were presented in one of three naturally occurring intonation conditions: one in which high pitch was aligned with the stressed syllable and two misalignment conditions (with high pitch preceding vs. following the stressed syllable). Infants were tested on the SW unit of the WSW carriers. Experiment 1 showed recognition only when the stressed syllable was high-pitched. Intonation of test items (similar vs. dissimilar to familiarization) had no influence (Experiment 2). Thus, German nine-month-olds perceive stressed syllables as word onsets only when high-pitched, although they already generalize over different pitch contours. Different mechanisms underlying this pattern of results are discussed.
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Brand, Jefferson C., Richard Hardy, Bowman Raymond, and Ajibewa Tiwaloluwa. "Do Innings Pitched Prior To Age 25 Affect MLB Pitcher Longevity?" Orthopaedic Journal of Sports Medicine 3, no. 7_suppl2 (July 2015): 2325967115S0016. http://dx.doi.org/10.1177/2325967115s00161.
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Marshall, Nathan E., Robert A. Keller, Orr Limpisvasti, Brian M. Schulz, and Neal S. ElAttrache. "Major League Baseball Pitching Performance after Tommy John Surgery and the effect of Tear Characteristics, Technique, and Graft Type." Orthopaedic Journal of Sports Medicine 7, no. 7_suppl5 (July 2019): 2325967119S0031. http://dx.doi.org/10.1177/2325967119s00312.
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Objectives: Return to play and player satisfaction has been quite high after ulnar collateral ligament reconstruction (UCLR), however, there has been little reported on how outcomes are affected by surgical technique, graft type and tear characteristics. The purpose was to evaluate surgical techniques, graft type and tear characteristics on MLB performance after UCLR. Methods: MLB pitchers that underwent primary UCLR at a single institution were included. Tear characteristics included tear location, tear grade and acuity. Surgical technique and graft type was also collected. Pitching performance statistics, including earned run average (ERA), Walks hits per innings pitched (WHIP), innings pitched, and fastball velocity were evaluated 3 years pre- and post-UCLR. Results: 46 MLB pitchers were identified having primary UCLR. Return to play was 96%, with 82% returning to MLB play. Technique performed showed no difference in performance. Pitchers with palmaris grafts were younger (p=0.043), played longer after surgery (p=0.007), and returned to play at 100% (35/35) vs. 82% (9/11) of gracilis grafts (p=0.011). Pitchers with distal tears pitched at higher velocity (93.0 vs. 90.6 mph)(p=0.023) and had better performance (ERA, p=0.003; WHIP, p=0.003) prior to surgery, with proximal tears improving to match this performance and velocity after reconstructionhigher . Pitchers with complete tears played longer after surgery (5.9 vs. 4.0 years)(p=0.033), had better ERA (p=0.041) prior to injury and better WHIP (p=0.037) and strikeouts/9 innings (p=0.025) after reconstruction vs. partial tears. Chronic tears had a significant improvement in ERA from 4.49 to 3.80 (p=0.040) postoperatively. Conclusion: Technique performed and graft type used did not affect performance, however, palmaris grafts returned at a higher rate than gracilis grafts. Distal tears occurred in pitchers with greater velocity and better performance prior to injury with proximal tears matching this performance after reconstruction. Pitchers with complete tears played longer after reconstruction. Pitchers who had partial tears had worse performance prior to injury and after reconstruction and chronic tears saw a significant improvement in ERA with reconstruction.
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Gutman, Brian, Christopher Hadley, Jacob Kirsch, Christopher Joyce, Surena Namdari, and Michael Gutman. "Performance in Major League Baseball Pitchers After Surgical Treatment of Thoracic Outlet Syndrome." Orthopaedic Journal of Sports Medicine 9, no. 7_suppl4 (July 1, 2021): 2325967121S0022. http://dx.doi.org/10.1177/2325967121s00221.
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Objectives: Thoracic outlet syndrome (TOS) can be a career threatening injury for baseball pitchers. The purpose of this study is to determine the efficacy of surgical management for TOS as a function of return to play and quantitative pitching metrics. Methods: Twenty-seven major league baseball pitchers underwent surgical treatment for TOS between January 2001 and December 2017. Analysis of pre and postoperative pitching metrics were used to assess the effect of surgery on 20 pitchers who returned to pitch in Major League Baseball (MLB). All pitching metrics were compared via assessing performance two years prior to surgery and two years after surgery. For 20 pitchers who returned to pitch, MLB pitching metrics of earned run average (ERA), walks plus hits per innings pitched (WHIP), wins above replacement (WAR), strikeouts per nine innings (K/9), average fastball velocity, and strike percentage, were used to assess a pitcher’s ability to return to preoperative performance level. Results: Of the 27 pitchers, 20 pitchers were diagnosed with neurogenic thoracic outlet syndrome (NTOS) and seven with venous thoracic outlet syndrome (VTOS). The average age of onset of TOS was 28.6 years. There was no significant difference between the age of onset between the NTOS and VTOS populations (p=0.272). Of the 27 pitchers, 20 (74.1%) were able to return to MLB play at a mean of 297 days (range, 105-638 days) after surgery. Pitching metrics demonstrated that pitcher ERA remained inferior postoperatively compared to baseline preoperative performance (3.66 vs 4.50, p=0.03). Fastball velocity (p=0.94), strike percentage (p=0.50), and K/9 (p=0.878) were equivalent to pre-injury performance. There was no difference in preoperative pitching metrics between pitchers who were able to return and pitchers who were unable to return to the MLB. Conclusions: About 3/4 of professional pitchers who undergo surgical intervention for TOS are able to return to play at the MLB level. With regards to performance, the majority of metrics were unchanged from prior to surgery, indicating return at a similar functional level.
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Carr, James, Joseph Manzi, Jennifer Estrada, Brittany Dowling, Kathryn Mcelheny, and Joshua Dines. "Comparison of Elbow Varus Torque During Interval Throwing Programs and Gameday Pitching in High School Baseball Pitchers (125)." Orthopaedic Journal of Sports Medicine 9, no. 10_suppl5 (October 1, 2021): 2325967121S0026. http://dx.doi.org/10.1177/2325967121s00268.
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Objectives: Completion of an interval throwing program (ITP) is a common benchmark for return to full competition following an injury to the dominant extremity of an overhead throwing athlete. While workload management for overhead athletes has evolved, the general structure of the ITP remains relatively unexamined. Furthermore, the daily and cumulative workload of ITPs is generally unknown. An ideal ITP would allow for a gradual increase in workload that eventually approximates, but does not exceed, workload measurements attained during competition. It is currently unknown if ITPs achieve this critically important objective. Therefore, the current study sought to 1) determine the daily and cumulative workload for common ITPs using elbow varus torque (EVT), and 2) compare EVT experienced during completion of ITPs to game pitching EVT values. Methods: A retrospective review identified high school pitchers with at least 50 throws at distances of 90, 120, 150, and 180 feet plus game pitches while wearing a MotusBASEBALL sensor. Averages for EVT per throw and torque per minute were calculated at each distance. Three throwing programs were created using a template of one phase at each distance with two steps per phase (Table 1). Programs varied only by number of throws per set (20, 25, and 30 throws for Programs A, B, and C, respectively). Total EVT for each step, phase, and program were calculated using average EVT values for each distance. Total torque for each step and program was converted to an average inning pitched equivalent (IPE) and maximum pitch count equivalent (MPE), respectively, using pitching EVT values and expected average pitch counts (16 pitches/inning and maximum 105 pitches/game). Results: 3,447 throws were analyzed from 7 pitchers with an average age of 16.7 yrs (0.8 yrs SD). EVT progressively increased with distance (range 36.9-45.5 N·m), comparable to game pitching (45.7 N·m). Average torque per minute was highest for 90 ft throws (193.4 N·m/min) and lowest for game pitches (125.0 N·m/min). Program A demonstrated the lowest range of IPE per step (2.0-3.7), and Program C had the highest range (3.0-5.6) (Figure 1). The phases of Program A never exceeded 1MPE. Program B exceeded this threshold after phase 1, and Program C exceeded 1MPE at every phase (Figure 2). Total program MPE ranged from 3.5 (Program A) to 5.2 (Program C). Conclusions: Performing long-toss throwing led to greater torque per minute compared to gameday pitching. Additionally, ITPs requiring 25 or more throws per set led to increased cumulative EVT, especially at distances greater than 150 ft, which can exceed typical values from gameday pitching. ITPs should be adjusted accordingly to encourage a slower pace of long-toss throws and less than 25 throws per set, especially at distances greater than 120 ft. Most ITPs currently recommend one rest day between steps. However, cumulative EVT at longer distances can exceed 5 IPE. Most pitch count rules require more than one rest day after a pitching outing that exceeds multiple innings pitched. Therefore, days off between steps and phases of an ITP should reflect these demands. We advocate for multiple days off between steps that require more than 3 IPE. Table 2 presents a novel ITP based on the findings of the current study.
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Gowd, Anirudh K., Timothy Luchetti, Jacob Birlingmair, Nikhil N. Verma, Anthony A. Romeo, and Antonia Zaferiou. "Role of the Long Head of the Biceps During Active Pitching in Healthy Collegiate Athletes: An Electromyographic Evaluation." Orthopaedic Journal of Sports Medicine 7, no. 7_suppl5 (July 2019): 2325967119S0043. http://dx.doi.org/10.1177/2325967119s00438.
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Objectives: Supraphysiologic forces placed on the glenohumeral joint during pitching leads to a high incidence of bicipital-labral pathology in competitive pitchers. Heavy debate in operative management between biceps tenodesis, labral repair, and debridement warrants further study in the role of the biceps during pitching. The purpose of this study was to evaluate the recruitment of the long and short heads of the biceps utilizing electromyographic evaluation and correlate activity with pitch velocity. Methods: Seventeen healthy, competitive, pitchers were recruited and consented to pitch in a controlled laboratory setting, under electromyographic observation. Surface electromyography (sEMG) was performed via electrodes placed on either head of the biceps, deltoid, infraspinatus, and latissimus dorsi, band pass filtered between 10-500 Hz and sampled at a rate of 1500 Hz during the pitching motion. sEMG was normalized to maximal volumetric isometric contraction (MVIC) via manual muscle testing (MMT). Pitch velocity was measured using a Speedster III radar gun, and then correlated to sEMG readings. Results: Average age of recruited subjects was 19.8 ± 1.4 years old. Average number of years pitched was 10.3 ± 3.6 years. Fourteen players reported their highest level of play was college, while two reported semi-professional, and one reported high-school. Average pitch velocity from included pitches was 70.6 ± 4.0 (range: 61 - 79). sEMG signals were interpreted in three modalities: median signal, integral sum of all signals, and time spent (ms) above 10% MVIC. Pitch velocity did not correlate to any sEMG analysis (p>0.05) by bivariate linear regression. Coefficient of variation was greater between pitchers than within pitchers. Greater than 80% of pitchers demonstrated statistically different activation of the long head of biceps muscle (LHBM) versus short head of biceps muscle (SHBM) (Figure 1). Three players had significantly greater short head activation, while 12 players had significantly greater long head activation. Conclusion: The long and short heads of the biceps are consistently activated during pitching, suggested they have a role during the late cocking and deceleration phase of pitching, although not correlated to ball acceleration. Preferential recruitment of either long or short head biceps suggest variability in fast ball pitching styles, that warrant further research for clinical implications. [Figure: see text]
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Gullbrekken, Lars, Tore Kvande, Bjørn Jelle, and Berit Time. "Norwegian Pitched Roof Defects." Buildings 6, no. 2 (June 21, 2016): 24. http://dx.doi.org/10.3390/buildings6020024.
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Watanabe, Koje. "Low‐pitched sound creator." Journal of the Acoustical Society of America 91, no. 2 (February 1992): 1202. http://dx.doi.org/10.1121/1.402516.
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Erickson, Brandon J., Peter Nissen Chalmers, John D’Angelo, Kevin Ma, and Anthony A. Romeo. "Open Reduction Internal Fixation of Medial Epicondyle Fractures After Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers." Orthopaedic Journal of Sports Medicine 7, no. 7_suppl5 (July 2019): 2325967119S0036. http://dx.doi.org/10.1177/2325967119s00369.
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Objectives: Ulnar collateral ligament reconstruction (UCLR) is a common procedure among professional baseball pitchers. Currently, 25% of starting Major league baseball (MLB) pitchers have undergone UCLR. Fracture of the medial epicondyle at the level of the humeral tunnel requiring open reduction internal fixation (ORIF) is an uncommon complication following UCLR. The purpose of this study was to determine the rate of return to sport (RTS) and performance upon RTS in professional baseball pitchers following ORIF of the medial epicondyle, and see if there is a difference in RTS rate and performance between players who underwent ORIF and matched controls. The authors hypothesized that there is a high rate of RTS in professional baseball pitchers following medial epicondyle ORIF with no significant difference in rate of RTS or performance, specifically related to the primary outcome performance variables of win-loss percentage (W-L%), WHIP ((walks +hits)/innings pitched), fielding independent pitching (FIP), and wins above replacement (WAR)) between cases and controls. Methods: All professional baseball pitchers who underwent medial epicondyle ORIF between 2010-2016 were included. Demographic and performance data (pre and post surgery) for each player was recorded. Performance metrics were then compared between cases and matched controls (no history of UCLR or ORIF). Results: Overall, 15 pitchers (80% starters, 73.3% right-handed) underwent ORIF of a medial epicondyle fracture. All underwent a prior UCLR using either the American Sports Medicine Institute (n=9, 60%) or docking (n=6, 40%) technique. ORIF techniques included fixation with one screw (n=13, 86.7%) and fixation with suture anchors (n=2, 13.3%). Eleven (73.3%) pitchers were able to RTS (which did not differ from controls p=0.537). No significant differences existed in the primary performance outcome variables when comparing pre-operative to post-operative performance. No significant differences in the primary performance outcome measures were seen between cases and controls following surgery although cases pitched fewer innings than controls following surgery (p=0.003) Conclusion: Following medial epicondyle ORIF of professional pitchers with a history of UCLR, 73.3% were able to RTS without a significant decline in most performance variables when compared to their pre-operative performance levels, or when compared to matched controls. Number of innings pitched declined following surgery.
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Marshall, Nathan E., Robert Keller, Orr Limpisvasti, Brian Schulz, and Neal ElAttrache. "Major League Baseball Pitching Performance After Tommy John Surgery and the Effect of Tear Characteristics, Technique, and Graft Type." American Journal of Sports Medicine 47, no. 3 (January 9, 2019): 713–20. http://dx.doi.org/10.1177/0363546518817750.
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Background: Return to play and player satisfaction have been quite high after ulnar collateral ligament reconstruction (UCLR); however, there has been little reported on how outcomes are affected by surgical technique, graft type, and tear characteristics. Purpose: To evaluate surgical techniques, graft type, and tear characteristics on Major League Baseball (MLB) performance after UCLR. Study Design: Cohort study; Level of evidence, 2. Methods: MLB pitchers who underwent primary UCLR at a single institution were included. Tear characteristics included tear location, tear grade, and acuity. Surgical technique and graft type were also collected. Pitching performance statistics, including earned run average (ERA), walks and hits per innings pitched (WHIP), innings pitched, and fastball velocity were evaluated 3 years before and after UCLR. Results: Forty-six MLB pitchers were identified as having primary UCLR. Return to play was 96%, with 82% returning to MLB play. Technique performed showed no difference in performance. As compared with pitchers with gracilis grafts, pitchers with palmaris grafts were younger ( P = .043), played longer after surgery ( P = .012), and returned to play at 100% (35 of 35) versus 82% (9 of 11, P = .010). When compared with pitchers with proximal tears, pitchers with distal tears pitched at higher velocity (93.0 vs 90.6 mph, P = .023) and had better performance before surgery (ERA, P = .003; WHIP, P = .021); however, those with proximal tears improved to match this performance and velocity after reconstruction. As compared with those having partial tears, pitchers with complete tears played longer after surgery (5.9 vs 4.0 years, P = .033), had a better ERA before injury ( P = .041), and had better WHIP ( P = .037) and strikeouts per 9 innings ( P = .025) after reconstruction. Pitchers with chronic tears had a significant improvement in postoperative ERA, from 4.49 to 3.80 ( P = .040). Conclusion: Technique performed and graft type used did not affect performance; however, pitchers with palmaris grafts returned at a higher rate than those with gracilis grafts. Distal tears occurred in pitchers with greater velocity and better performance before injury, yet pitchers with proximal tears matched this performance after reconstruction. Pitchers with complete tears played longer after reconstruction. Pitchers who had partial tears had worse performance before injury and after reconstruction, and those with chronic tears saw a significant improvement in ERA with reconstruction.
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Greiner, Justin J., Geoffrey S. Baer, and Timothy A. McGuine. "PITCH COUNTS IN YOUTH BASEBALL PLAYERS: A COMPARISON TO PITCH SMART GUIDELINES." Orthopaedic Journal of Sports Medicine 8, no. 4_suppl3 (April 1, 2020): 2325967120S0023. http://dx.doi.org/10.1177/2325967120s00234.
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Background: Overthrowing injuries in youth baseball players have been linked with pitching behaviors such as as high pitch counts, inadequate rest, and participating in throwing activities throughout the year. Pitch Smart guidelines were developed as an initiative between Major League Baseball and USA Baseball to provide recommendations for youth baseball athletes to help decrease the risk of injuries from overthrowing. Purpose: The purpose of this study was to perform a quantitative analysis of pitch counts in youth baseball players and evaluate compliance with Pitch Smart guidelines. Methods: Local youth baseball teams competing in nine and under (9U) to fourteen and under (14U) age brackets were recruited to track pitches during the summer baseball season. A tablet with a pitch counting application was used to record pitches for each pitcher of the study team and their opponents. Days of rest between games was calculated for the study teams only and not opponents. Pitch counts and days of rest for each pitcher were compared to the recommended Pitch Smart guidelines. Continued prospective collection of data is ongoing through the 2019 summer. Results: Interim review of 23 youth baseball teams using a tablet allowed analysis of 181 pitchers of the 23 study teams using tablets and 285 pitchers of 98 opponent teams. Violation of Pitch Smart guidelines occurred in 14 (60.9%) study teams and 29 (16.0%) pitchers. Of these violations, 27 (93%) pitchers had insufficient rest between games while 2 (7%) pitchers exceeded daily maximum pitches. Further, 8 (35%) teams had more than one player violate guidelines. Pitch smart daily maximum pitch counts were violated in 2 of 98 (2.0%) opponent teams and 2 of 285 (0.7%) of opponent pitchers Conclusion: A total of 61% of youth baseball teams and 16% of pitchers in this study violated Pitch Smart guidelines at interim analysis. The vast majority of guideline violations were due to inadequate rest between games. The high rate of Pitch Smart violations suggests that further education of coaches, parents, and athletes regarding these guidelines, with emphasis on rest recommendations, is necessary to prevent overthrowing injuries in youth baseball players. [Table: see text]