Baseball pitching kinematics, joint loads, and injury prevention

There is a need for the prevention of upper extremity injuries that affect a large number of competitive baseball players. Currently available evidence alludes to three possible ways to prevent these injuries: 1) regulation of unsafe participation factors, 2) implementation of exercise intervention to modify suboptimal physical characteristics, and 3) instructional intervention to correct improper pitching techniques. Of these three strategies, instruction of proper pitching technique is under-explored as a method of injury prevention. Therefore, the purpose of this review was to explore the utility of pitching technique instruction in prevention of pitching-related upper extremity injuries by presenting evidence linking pitching technique and pitching-related upper extremity injuries, as well as identifying considerations and potential barriers in pursuing this approach to prevent injuries. Various kinematic parameters measured using laboratory-based motion capture system have been linked to excessive joint loading, and thus pitching-related upper extremity injuries. As we gain more knowledge about the influence of pitching kinematics on joint loading and injury risk, it is important to start exploring ways to modify pitching technique through instruction and feedback while considering the specific skill components to address, mode of instruction, target population, duration of program, and ways to effectively collaborate with coaches and parents.