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Curveball did not increase injury when compared to fastball pitching
Biomechanical and most epidemiologic studies did not demonstrate an increased risk of pain or injury for baseball pitchers, including youths, who threw curveballs compared with fastballs, according to results of a systematic review.
Researchers reviewed Ovid MEDLINE from 1946 to March 1, 2012, and searched the terms “curveball” and “baseball pitching injuries.” Ten biomechanical studies focusing on kinematic or electromyographic analysis of pitching a curveball and five epidemiologic studies assessing pain and injury incidence in pitchers throwing the curveball were included. Demographic, methodology, kinetics, and kinematics variables and pain/injury incidence data were included when possible.
The studies were published between 1979 and 2011. Three of the epidemiologic studies included athletes aged 8 to 14 years, while the other two focused on high school and college athletes aged 14 to 20 years. In the biomechanical studies, youth athletes were included in one, high school-aged pitchers in one and college and/or professional athletes in the other eight.
Greater horizontal adduction of the shoulder at ball release and less shoulder internal torque were findings of two biomechanical studies. Less proximal force and torque at the elbow as the arm accelerated during the throwing of a curveball compared with a fastball, and greater supination of the forearm and less wrist extension were results of two other studies. During curveballs, increased activity of extensor and supinator muscles was suggested through electromyographic data.
Pitching a curveball and upper extremity pain or injury showed no significant association in three epidemiologic studies. There was a 52% increase in shoulder pain when throwing a curveball, which might have been the result of confounders, in one retrospective epidemiologic study.
“Despite much debate in the baseball community about the curveball’s safety in youth pitchers, limited biomechanical and most epidemiologic studies do not demonstrate an increased risk of injury when compared with the fastball,” the researchers concluded.
Disclosures: Researcher Christopher S. Ahmad, MD, received consulting fee(s) or honorarium from Acumed LLC and Arthrex Inc., and received payment to his institution from Stryker.