Biceps Tendon Changes and Pitching Mechanics in Youth Softball Pitchers
With the lack of pitch count regulation, youth softball pitchers are experiencing unremitting high stresses on the anterior shoulder. The purpose of this study was to examine the association of acute changes in the long head of the biceps tendon with pitching kinematics and kinetics in youth softball pitchers following an acute bout of pitching. Twenty-three softball pitchers (12.17±1.50 yrs.; 160.32±9.41 cm; 60.40±15.97 kg) participated. To investigate the association between biceps tendon changes and kinematic and kinetic changes from pre- to post-simulated game, each biceps tendon measure was split into those whose biceps tendon thickness, width, and/or area increased pre- to post-simulated game, and those whose did not. There were significant differences in biceps tendon longitudinal thickness (Z=− 2.739, p=0.006) and pitch speed; as well as a difference between groups in biceps tendon transverse thickness and the amount of change in trunk rotation at the start of the pitching motion (p=0.017) and the amount of change in trunk flexion at ball release (p=0.030). This study illustrates the association of trunk and lower extremity kinematics and shoulder kinetics with morphologic changes in the biceps tendon with an acute bout of windmill softball pitching.
Received: 01 May 2020
Accepted: 03 August 2020
18 September 2020 (online)
© 2020. Thieme. All rights reserved.
© Georg Thieme Verlag KG
Stuttgart · New York
- 1 Skillington SA, Brophy RH, Wright RW. et al. Effect of pitching consecutive days in youth fast-pitch softball tournaments on objective shoulder strength and subjective shoulder symptoms. Am J Sports Med 2017; 45: 1413-1419
- 2 Smith MV, Davis R, Brophy RH. et al. Prospective player-reported injuries in female youth fast-pitch softball. Sports Health 2015; 7: 497-503
- 3 Krajnik S, Fogarty KJ, Yard EE. et al. Shoulder injuries in US high school baseball and softball athletes, 2005-2008. Pediatrics 2010; 125: 497-501. DOI: 10.1542/peds.2009-0961.
- 4 Powell JW, Barber-Foss KD. Injury patterns in selected high school sports: A review of the 1995-1997 seasons. J Athl Train 1999; 34: 277-284
- 5 Pytiak AV, Kraeutler MJ, Currie DW. et al. An Epidemiological comparison of elbow injuries among United States high school baseball and softball players, 2005-2006 through 2014-2015. Sports Health 2018; 10: 119-124. DOI: 10.1177/1941738117736493.
- 6 Rechel JA, Yard EE, Comstock RD. An epidemiologic comparison of high school sports injuries sustained in practice and competition. J Athl Train 2008; 43: 197-204. doi:10.4085/1062-6050-43.2.197
- 7 Shanley E, Rauh MJ, Michener LA. et al. Incidence of injuries in high school softball and baseball players. J Athl Train 2011; 46: 648-654
- 8 Roos KG, Marshall R, Kerr ZY. et al. Epidemology of overuse injuries in collegiate and high school athletics in the United States. Am J Sports Med 2015; 43: 1790-1797
- 9 Shanley E, Rauh MJ, Michener LA. et al. Shoulder range of motion measures as risk factors for shoulder and elbow injuries in high school softball and baseball players. Am J Sports Med 2011; 39: 1997-2006. DOI: 10.1177/0363546511408876.
- 10 Sauers EL, Dykstra DL, Bay RC. et al. Upper extremity injury history, current pain rating, and health-related quality of life in female softball pitchers. J Sport Rehabil 2011; 20: 100-114
- 11 Marshall SW, Hamstra-Wright KL, Dick R. et al. Descriptive epidemiology of collegiate women's softball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train 2007; 42: 286-294
- 12 Loosli AR, Requa RK, Garrick JG. et al. Injuries to pitchers in women's collegiate fast-pitch softball. Am J Sports Med 1992; 20: 35-37
- 13 Lear A, Patel N. Softball pitching and injury. Curr Sports Med Rep 2016; 15: 336-341
- 14 Hill JL, Humphries B, Weidner T. et al. Female collegiate windmill pitchers: Influences to injury incidence. J Strength Cond Res 2004; 18: 426-431
- 15 Holtz KA, O’Connor RJ. Upper extremity functional status of female youth softball pitchers using the Kerlan-Jobe Orthopaedic Clinic questionnaire. Orthop J Sports Med 2018; 6: 232596711774899 doi:10.1177/2325967117748599
- 16 Oliver GD, Plummer HA, Keeley DW. Muscle activation patterns of the upper and lower extremity during the windmill softball pitch. J Strength Cond Res 2011; 25: 1653-1658 doi:10.1519/JSC.0b013e3181db9d4f
- 17 Rojas IL, Provencher MT, Bhatia S. et al. Biceps activity during windmill softball pitching: injury implications and comparison with overhand throwing. Am J Sports Med 2009; 37: 558-565. DOI: 10.1177/0363546508328105.
- 18 Werner SL, Jones DG, Guido JA. et al. Kinematics and kinetics of elite windmill softball pitching. Am J Sports Med 2006; 34: 597-603. DOI: 10.1177/0363546505281796.
- 19 Andrews JR, Carson WG, McLeod WD. Glenoid labrum tears related to the long head of the biceps. Am J Sports Med 1985; 13: 337-341 doi:10.1177/036354658501300508
- 20 Vangsness CT, Jorgenson SS, Watson T. et al. The orgin of the long head of the biceps from the scapula and glenoid labrum. J Bone Joint Surg Br 1994; 76: 951-954
- 21 Nhos J, Strausse J, Lenart BA. et al. Long head of the biceps tendinopathy: Diagnosis and management. J Am Acad Orthop Surg 2010; 18: 645-656
- 22 Baseball LL. Regular season pitching rules-baseball and softball In. 2019 https://www.littleleague.org/ status:18.08.2020
- 23 Oliver GD, Gilmer G, Anz AW. et al. Upper extremity pain and pitching mechanics in NCAA Division I softball. Int J Sports Med 2018; 39: 929-935. DOI: 10.1055/a-0658-1546.
- 24 Oliver GD, Friesen K, Barfield J. et al. Association of upper extremity pain with softball pitching kinematics and kinetics. Orthop J Sports Med 2019; 7 DOI: 10.1177/2325967119865171.
- 25 Barfield J, Oliver GD. What do we know about youth softball pitching and injury?. Sports Med Open 2018; 4: 50 doi:10.1186/s40798-018-0168-6
- 26 Janes W, Foreman M, Engsberg JR. et al. Fast-pitch softball players use biomechanical compensations to maintain pitch speed when fatigued. Am J Occup Ther 2017; 71 DOI: 10.5014/ajot.2017.71S1-PO3147.
- 27 Yang JS, Stepan JG, D’voracek L. et al. Fast-pitch softball pitchers experience a significant increase in pain and fatigue during a single high school season. HSS J 2016; 12: 111-118. DOI: 10.1007/s11420-016-9499-3.
- 28 Barfield J, Plummer H, Anz AW. et al. Biceps tendon changes in youth softball pitchers following an acute bout of pitching. Int J Sports Med 2018; 39: 1063-1067
- 29 Harriss D, MacSween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
- 30 Drolet P, Martineau A, Lacroix R. et al. Reliability of ultrasound evaluation of the long head of the biceps tendon. J Rehabil Med 2016; 48: 554-558. DOI: 10.2340/16501977-2095.
- 31 Oliver GD, Plummer H, Washington JK. et al. Pitching mechanics in female youth fastpitch softball. Int J Sports Phys Ther 2018; 13: 493-500
- 32 Oliver GD, Keeley DW. Pelvis and torso kinematics and their relationship to shoulder kinematics in high-school baseball pitchers. J Strength Cond Res 2010; 24: 3241-3246 doi:10.1519/JSC.0b013e3181cc22de
- 33 Oliver GD, Keeley DW. Gluteal muscle group activation and its relationship with pelvis and torso kinematics in high-school baseball pitchers. J Strength Cond Res 2010; 24: 3015-3022. doi:10.1519/JSC.0b013e3181c865ce
- 34 Wu G, van der Helm FCT, Veeger HEJ. et al. ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion—Part II: shoulder, elbow, wrist and hand. J Biomech 2005; 38: 981-992. DOI: 10.1016/j.jbiomech.2004.05.042.
- 35 Wu G, Siegler S, Allard P. et al. ISB recommendation on definitions of joint coordinate system of various joints for reporting of human joint motion-part I: ankle, hip, and spine. J Biomech 2002; 35: 543-548
- 36 Haung YH, Wu TY, Learman KE. et al. A comparison of throwing kinematics between youth baseball players with and without a history of medial elbow pain. Clin J Physiol 2010; 53: 160-166
- 37 Veeger HE. The position of the rotation center of the glenohumeral joint. J Biomech 2000; 33: 1711-1715
- 38 Wicke J, Keeley DW, Oliver GD. Comparison of pitching kinematics between youth and adult baseball pitchers: a meta-analytic approach. Sports Biomech. 2013 12. 315-323 doi:10.1080/14763141.2013.838692
- 39 Oliver GD, Plummer H. Effects of pitching a simulated game on upper extremity kinematics in youth baseball pitchers. Int J Sports Exerc Med 2015; 1: 016 doi: 10.23937/2469-5718/1510016
- 40 Oliver GD, Weimar W. Hip range of motion and scapula position in youth baseball pitching pre and post simulated game. J Sports Sci 2015; 33: 1447-1453. doi:10.1080/02640414.2014.990493
- 41 Popchak A, Hogaboom NS, Vyas D. et al. Acute response of the infraspinatus and biceps tendons to pitching in youth baseball. Med Sci Sports Exerc 2017; 49: 1168-1175
- 42 van Drongelen S, Boninger ML, Impink BG. et al. Ultrasound imaging of acute biceps tendon changes after wheelchair sports. Arch Phys Med Rehabil 2007; 88: 381-385. DOI: 10.1016/j.apmr.2006.11.024.
- 43 Chu SK, Jayabalan P, Kibler WB. et al. The kinetic chain revisited: New concepts on throwing mechanics and injury. PM R 2016; 8(3 Suppl): S69-S77 DOI: 10.1016/j.pmrj.2015.11.015.
- 44 Downs J, Friesen K, Anz AW. et al. Effects of a simulated game on pitching kinematics in youth softball pitcher. Int J Sports Med 2020; 41: 189-195 DOI: 10.1055/a-1062-6475.
- 45 Kibler WB, Wilkes T, Sciascia A. Mechanics and pathomechanics in the overhead athlete. Clin Sports Med 2013; 32: 637-651 doi:10.1016/j.csm.2013.07.003
- 46 Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med 2006; 36: 189-198