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Document Title: Mullaney-AJSM-Jan05.shtml
Article Title: Upper and Lower Extremity Muscle Fatigue After a Baseball Pitching Performance
Authors: Michael J. Mullaney, MPT, Malachy P. McHugh, PhD, Tom M. Donofrio, MSPT and Stephen J. Nicholas, MD
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date: January 2005
Volume 33, page 108-113
Keywords: performance demands, pitching fatigue, empty can test, shoulder strength, implications for lower-body fatigue, legs, knee.
(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form. This article contains tables, but no figures.)
Comments: This study looked at repeated baseball pitching (which involves the entire body, not just the pitching arm) and the fatigue resulting therefrom. Although much of the study focuses on shoulder musculature, the authors note that fatigue in the leg muscles is correlated with reduced knee flexion, among other kinematic indicators. Since reduced knee flexion is correlated with increased risk of knee injury (especially in sports rich in running, jumping, and pivoting), and because fatigue-related concerns arises from any vigorous and potentially fatiguing activity (not just ball-throwing), it follows that endurance-training should be pursued as part of any rehabilitation or sports-training regimen.
ABSTRACT
Background: Previous studies have estimated joint torques and electromyogram activity associated with the pitching motion. Although previous studies have investigated the influence of extended pitching (fatigue) on kinematic and kinetic parameters, no attempts have been made to quantify the fatigue associated with a pitching performance.
Purpose: Considering previous investigations on muscle activity during pitching, this study investigated muscle fatigue in upper and lower extremity muscle groups after a pitching performance.
Study Design: Descriptive laboratory study.
Methods: Thirteen baseball pitchers from 4 universities and 1 independent minor league team were tested before and after 19 games. Pitchers threw an average of 99 pitches during an average of 7 innings. Shoulder, scapular, and lower extremity muscle strengths were assessed using a handheld dynamometer before and after the pitching performances.
Results: Baseline strength tests revealed that the pitching arm was 12% weaker (P = .02) in the empty can test (supraspinatus) compared to the contralateral side. Postgame shoulder strength tests revealed selective fatigue of 15% in shoulder flexion (P = .02), 18% fatigue in internal rotation (P = .03), and 11% fatigue in shoulder adduction (P = .01). Minimal fatigue was noted in the empty can test, scapular stabilizers, and hip musculature.
Conclusions: A trend toward significant baseline strength in internal rotation together with significant selective postgame fatigue on internal rotation of the dominant upper extremity indicate that the internal rotators experience a high performance demand during pitching. Weakness in the empty can test on the dominant arm combined with minimal postgame fatigue was surprising given that studies and injury patterns have indicated a high performance demand on the supraspinatus during pitching.
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