Does High Medial Elbow Stress During Pitching Compromise the Dynamic Stabilizers of The Elbow?
# Background The flexor carpi ulnaris (FCU) and flexor digitorum superficialis (FDS) are thought to provide dynamic stability to the medial elbow, with a lesser contribution from the pronator teres (PT). # Hypothesis/Purpose The purpose of this study was to determine if baseball pitchers with hig...
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| Format: | Article |
| Language: | English |
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North American Sports Medicine Institute
2023-08-01
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| Series: | International Journal of Sports Physical Therapy |
| Online Access: | https://doi.org/10.26603/001c.81596 |
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| _version_ | 1825197014489497600 |
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| author | Malachy P. McHugh Michael J. Mullaney |
| author_facet | Malachy P. McHugh Michael J. Mullaney |
| author_sort | Malachy P. McHugh |
| collection | DOAJ |
| description | # Background
The flexor carpi ulnaris (FCU) and flexor digitorum superficialis (FDS) are thought to provide dynamic stability to the medial elbow, with a lesser contribution from the pronator teres (PT).
# Hypothesis/Purpose
The purpose of this study was to determine if baseball pitchers with higher valgus elbow torque experience greater FCU and FDS strength loss.
# Study Design
Controlled Laboratory Study
# Methods
A pilot study was performed to determine if middle and ring finger flexion strength tests preferentially activated the FCU and FDS versus the PT (10 men age 36±12 yr). EMG amplitudes, expressed as percent of maximal voluntary contraction (MVC) were compared between tests and muscles. In a field study of college baseball pitchers, middle finger, ring finger and grip strength were tested prior to, immediately after, and one day after 14 pitching performances in 10 pitchers (21±2 yr). Elbow valgus torque was measured from an inertial measurement unit, housed in a compression sleeve and pitchers were categorized as having high or low valgus torque.
# Results
For the pilot study EMG activations were 74% FDS, 66% FCU and 35% PT for the middle finger test (muscle effect p=0.032) and 93% FCU, 61% FDS and 23% PT for the ring finger test (muscle effect p=0.005). In the field study, pitchers with high valgus torque showed marked post-game middle finger fatigue (88% of baseline) and incomplete recovery the following day (95%), while pitchers with low valgus torque showed no strength loss (107% post game, 106% a day later; group x time p=0.022). Results were similar for ring finger strength (high torque: 94% post game 96% a day later; low torque: 114% post game 107% a day later; group x time p=0.048). By contrast, grip strength was not different between pitchers with high versus low valgus torque (p=0.143).
# Conclusion
High medial elbow stress during pitching fatigues the dynamic stabilizers of the medial elbow.
# Level of Evidence
Level 3 |
| format | Article |
| id | doaj-art-65918a563a714ee3bcccc34a48f31f3f |
| institution | Kabale University |
| issn | 2159-2896 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | North American Sports Medicine Institute |
| record_format | Article |
| series | International Journal of Sports Physical Therapy |
| spelling | doaj-art-65918a563a714ee3bcccc34a48f31f3f2025-02-11T20:27:42ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962023-08-01184Does High Medial Elbow Stress During Pitching Compromise the Dynamic Stabilizers of The Elbow?Malachy P. McHughMichael J. Mullaney# Background The flexor carpi ulnaris (FCU) and flexor digitorum superficialis (FDS) are thought to provide dynamic stability to the medial elbow, with a lesser contribution from the pronator teres (PT). # Hypothesis/Purpose The purpose of this study was to determine if baseball pitchers with higher valgus elbow torque experience greater FCU and FDS strength loss. # Study Design Controlled Laboratory Study # Methods A pilot study was performed to determine if middle and ring finger flexion strength tests preferentially activated the FCU and FDS versus the PT (10 men age 36±12 yr). EMG amplitudes, expressed as percent of maximal voluntary contraction (MVC) were compared between tests and muscles. In a field study of college baseball pitchers, middle finger, ring finger and grip strength were tested prior to, immediately after, and one day after 14 pitching performances in 10 pitchers (21±2 yr). Elbow valgus torque was measured from an inertial measurement unit, housed in a compression sleeve and pitchers were categorized as having high or low valgus torque. # Results For the pilot study EMG activations were 74% FDS, 66% FCU and 35% PT for the middle finger test (muscle effect p=0.032) and 93% FCU, 61% FDS and 23% PT for the ring finger test (muscle effect p=0.005). In the field study, pitchers with high valgus torque showed marked post-game middle finger fatigue (88% of baseline) and incomplete recovery the following day (95%), while pitchers with low valgus torque showed no strength loss (107% post game, 106% a day later; group x time p=0.022). Results were similar for ring finger strength (high torque: 94% post game 96% a day later; low torque: 114% post game 107% a day later; group x time p=0.048). By contrast, grip strength was not different between pitchers with high versus low valgus torque (p=0.143). # Conclusion High medial elbow stress during pitching fatigues the dynamic stabilizers of the medial elbow. # Level of Evidence Level 3https://doi.org/10.26603/001c.81596 |
| spellingShingle | Malachy P. McHugh Michael J. Mullaney Does High Medial Elbow Stress During Pitching Compromise the Dynamic Stabilizers of The Elbow? International Journal of Sports Physical Therapy |
| title | Does High Medial Elbow Stress During Pitching Compromise the Dynamic Stabilizers of The Elbow? |
| title_full | Does High Medial Elbow Stress During Pitching Compromise the Dynamic Stabilizers of The Elbow? |
| title_fullStr | Does High Medial Elbow Stress During Pitching Compromise the Dynamic Stabilizers of The Elbow? |
| title_full_unstemmed | Does High Medial Elbow Stress During Pitching Compromise the Dynamic Stabilizers of The Elbow? |
| title_short | Does High Medial Elbow Stress During Pitching Compromise the Dynamic Stabilizers of The Elbow? |
| title_sort | does high medial elbow stress during pitching compromise the dynamic stabilizers of the elbow |
| url | https://doi.org/10.26603/001c.81596 |
| work_keys_str_mv | AT malachypmchugh doeshighmedialelbowstressduringpitchingcompromisethedynamicstabilizersoftheelbow AT michaeljmullaney doeshighmedialelbowstressduringpitchingcompromisethedynamicstabilizersoftheelbow |