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Throwing rehab program that includes partial pitching may aid recovering pitchers
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NEW ORLEANS — Data presented here, at the American Academy of Orthopaedic Surgeons Annual Meeting, constitute the first research to look in-depth at the entire throwing progression that baseball pitchers undergo while rehabilitating a shoulder or elbow surgery. It ultimately supports making changes to the rehabilitation program that is now used, researchers said.
“The mechanical advantage of throwing from the mound, as well as using the crow-hop, is likely protective during the rehab phase, and it might be something that we need to focus on starting earlier in the throwing progression,” Nicholas R. Slenker, MD, said in a presentation.
Slenker and colleagues used motion capture technology with 29 healthy college pitchers and progressed them through the throwing program commonly used by pitchers during rehabilitation. This involved hard throws from flat ground at distances of 60 feet, 90 feet, 120 feet and 180 feet. Subjects were allowed to “crow-hop” during these throws. Three throws were then made from a pitcher’s mound, one at 60% effort, one at 80% effort and the last one at 100% effort.
The researchers recorded throw velocity, elbow valgus load and humeral internal rotational torque during the process with the latter two measurements normalized for the pitcher’s body weight and height.
This process produced a statistically significant increase in shoulder and elbow torque in the progression from 60% effort to 100% effort during throwing, according to the findings. Although the variable joint forces measured during throwing from any distance on flat ground vs. pitching from the mound were not statistically different, the velocity increased when the athlete pitched from the mound. According to Slenker, this findings suggests the program used when throwing from the mound provided increased efficiency.
Slenker and colleagues also found there was not a significant difference in joint forces when distances in flat ground throws increased due to a larger crow-hop.
“Partial effort pitching has significantly less stresses than full effort [pitching], so it is important during the rehabilitation process,” Slenker said. – by Christian Ingram
Reference:
Slenker N. Paper #208. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.
Disclosure: Slenker has no relevant financial disclosures.