Deficits in passive range of motion (ROM) and strength of the lead hip during the pitch among professional baseball pitchers are associated with increased injury risk to the core, groin, and throwing shoulder.
Hypothesis:
A positive, linear relationship will link lead hip flexion at maximum shoulder external rotation (MER) with pitch velocity.
Study Design:
Descriptive laboratory study.
Level of Evidence:
Level 3.
Methods:
Professional pitchers were divided into Low (<85°, n = 122), Moderate (85-95°, n = 137), and High (>95°, n = 80) groups based on lead hip flexion at MER, and pitched fastballs while using 3-dimensional motion capture (480 Hz).
Results:
Pitchers in the Low, Moderate, and High groups did not significantly differ in age (P = 0.16), weight (P = 0.08), height (P = 0.36), or throwing hand (P = 0.54). Low pitchers had significantly less MER compared with High pitchers (P = 0.04); shorter stride length than Moderate and High pitchers (P < 0.001); greater lead knee extension velocity than High pitchers (P = 0.007); and less lead knee flexion at ball release than Moderate and High pitchers (P < 0.001). Low pitchers had greater shoulder anterior force, elbow anterior force, and elbow flexion torque compared with Moderate pitchers. Lead hip flexion at MER was not predictive in group (P = 0.89) or univariate analysis (P = 0.43) for ball velocity.
Conclusion:
This study provides normative values for lead hip flexion angles throughout the pitch. Pitchers with moderate lead hip flexion at MER demonstrated significantly less shoulder anterior force, elbow anterior force, and elbow flexion torque compared with other groups, with no significant relationship with biomechanical efficiency or ball velocity.
Clinical Relevance:
Pitchers appear to benefit from maintaining lead hip flexion within an appropriate range at MER, near 90°, as either too much or too little can be disadventagous.
AguinaldoALChambersH.Correlation of throwing mechanics with elbow valgus load in adult baseball pitchers. Am J Sports Med. 2009;37(10):2043-2048. doi:10.1177/0363546509336721
2.
AlbieroMLKokottWDziukCCrossJA.Hip flexibility and pitching biomechanics in adolescent baseball pitchers. J Athl Train. 2022;57(7):704-710. doi:10.4085/1062-6050-0103.21
3.
AlbieroMLKokottWDziukCCrossJA.Hip strength and pitching biomechanics in adolescent baseball pitchers. J Athl Train. 2023;58(3):271. doi:10.4085/1062-6050-0074.22
4.
AnzAWBushnellBDGriffinLPNoonanTJTorryMRHawkinsRJ.Correlation of torque and elbow injury in professional baseball pitchers. Am J Sports Med. 2010;38(7):1368-1374. doi:10.1177/0363546510363402
5.
BirferRSonneMWHolmesMW.Manifestations of muscle fatigue in baseball pitchers: a systematic review. PeerJ. 2019;2019(7):e7390. doi:10.7717/peerj.7390
6.
BradburyJCFormanSL.The impact of pitch counts and days of rest on performance among major-league baseball pitchers. J Strength Cond Res. 2012;26(5):1181-1187. doi:10.1519/JSC.0b013e31824e16fe
7.
DowlingBLaughlinWAGurchiekRD, et al. Kinematic and kinetic comparison between American and Japanese collegiate pitchers. J Sci Med Sport. 2020;23(12):1202-1207. doi:10.1016/j.jsams.2020.04.013
8.
DowlingBManziJERaabGColadonatoCDinesJSFleisigGS.The relationship among lead knee extension, fastball velocity and elbow torque in professional baseball pitchers. Sports Biomech. 2024;23(12):2664-2674. doi:10.1080/14763141.2022.2050801
9.
DowlingBHodakowskiABrusalisCM, et al. Influence of lead knee extension on ball velocity and elbow varus torque in professional and high school baseball pitchers. Orthop J Sports Med. 2024;12(8):23259671241257540. doi:10.1177/23259671241257539
10.
FleisigGSSlowikJSKutzCBEscamillaRF.Comparison of windup and stretch pitching biomechanics in baseball with implications for safety and performance. Am J Sports Med. 2024;52(7):1671-1675. doi:10.1177/03635465241247543
11.
HodakowskiADowlingBBrusalisCM, et al. Professional baseball pitchers produce similar ball velocity and kinematics when pitching from the wind-up and stretch deliveries: a biomechanical analysis. Sports Biomech. 2024;23(12):3680-3692. doi:10.1080/14763141.2024.2398507
12.
HoltTOliverGD.Hip and upper extremity kinematics in youth baseball pitchers. J Sports Sci. 2016;34(9):856-861. doi:10.1080/02640414.2015.1076163
13.
KeeleyDWOliverGDTorryMRWickeJ.Validity of pitch velocity and strike percentage to assess fatigue in young baseball pitchers. Int J Perform Anal Sport. 2014;14(2):355-366. doi:10.1080/24748668.2014.11868727
14.
LueraMJDowlingBMagriniMAMuddleTWDColquhounRJJenkinsNDM. Role of rotational kinematics in minimizing elbow varus torques for professional versus high school pitchers. Orthop J Sports Med. 2018;6(3):232596711876078. doi:10.1177/2325967118760780
15.
LueraMJDowlingBMuddleTWDJenkinsNDM. Differences in rotational kinetics and kinematics for professional baseball pitchers with higher versus lower pitch velocities. J Appl Biomech. 2020;36(2):68-75. doi:10.1123/JAB.2019-0235
16.
ManziJEDowlingBDinesJS, et al. The association of stride length to ball velocity and elbow varus torque in professional pitchers. J Sports Sci. 2021;39(23):2658-2664. doi:10.1080/02640414.2021.1949190
17.
ManziJEDowlingBTraugerNFuMCHansenBRDinesJS.The influence of shoulder abduction and external rotation on throwing arm kinetics in professional baseball pitchers. Shoulder Elbow. 2022;14(1 Suppl):90-98. doi:10.1177/17585732211010300
18.
ManziJEDowlingBWangZ, et al. Kinetic and kinematic comparisons in high school pitchers with low and high pitch location consistency. J Shoulder Elbow Surg. 2022;31(12):2620-2628. doi:10.1016/J.JSE.2022.06.011
19.
ManziJEEstradaJAQuanTRuzbarskyJJCiccottiMCDinesJS.The influence of excessive ipsilateral trunk tilt on upper extremity throwing mechanics: a newly characterized parameter for biomechanical evaluation in high school and professional pitchers. J Shoulder Elbow Surg. 2022;31(9):1909-1921. doi:10.1016/J.JSE.2022.01.153
20.
ManziJEFuryMDowlingB, et al. A comparison of throwing arm kinetics and ball velocity in professional baseball pitchers with the fastest maximum joint and segment velocities. J Shoulder Elbow Surg. 2025;34(7):1751-1761. doi:10.1016/J.JSE.2024.10.009
21.
MatsuoTEscamillaRFFleisigGSBarrentineSWAndrewsJR.Comparison of kinematic and temporal parameters between different pitch velocity groups. J Appl Biomech. 2001;17(1):1-13. doi:10.1123/jab.17.1.1
22.
MeluginHPLarsonDRFleisigGS, et al. Baseball pitchers’ perceived effort does not match actual measured effort during a structured long-toss throwing program. Am J Sports Med. 2019;47(8):1949-1954. doi:10.1177/0363546519850560
23.
PappasAMZawackiRMSullivanTJ.Biomechanics of baseball pitching. A preliminary report. Am J Sports Med. 1985;13(4):216-222. doi:10.1177/036354658501300402
24.
PutnamCA.A segment interaction analysis of proximal-to-distal sequential segment motion patterns. Med Sci Sports Exerc. 1991;23(1):130-144. doi:10.1249/00005768-199101000-00019
25.
PryhodaMKSabickMB.Lower body energy generation, absorption, and transfer in youth baseball pitchers. Front Sports Act Living. 2022;4:975107. doi:10.3389/FSPOR.2022.975107
26.
PutnamCA.Sequential motions of body segments in striking and throwing skills: descriptions and explanations. J Biomech. 1993;26(Suppl 1):125-135. doi:10.1016/0021-9290(93)90084-R
27.
RamseyDKCrotinRL.Effect of stride length on overarm throwing delivery: Part II: an angular momentum response. Hum Mov Sci. 2016;46:30-38. doi:10.1016/j.humov.2015.11.021
28.
RiffAJChalmersPNSgroiT, et al. Epidemiologic comparison of pitching mechanics, pitch type, and pitch counts among healthy pitchers at various levels of youth competition. Arthroscopy. 2016;32(8):1559-1568. doi:10.1016/j.arthro.2016.01.048
29.
RobbAJFleisigGWilkKMacRinaLBoltBPajaczkowskiJ.Passive ranges of motion of the hips and their relationship with pitching biomechanics and ball velocity in professional baseball pitchers. Am J Sports Med. 2010;38(12):2487-2493. doi:10.1177/0363546510375535
30.
SolomitoMJGaribayEJCohenANissenCW.Lead knee flexion angle is associated with both ball velocity and upper extremity joint moments in collegiate baseball pitchers. Sports Biomech. 2024;23(12):2626-2636. doi:10.1080/14763141.2022.2046143
31.
SolomitoMJGaribayEJCohenANissenCW.The role of the lead hip in collegiate baseball pitching: implications for ball velocity and upper-extremity joint moments. J Appl Biomech. 2024;40(5):399-405. doi:10.1123/JAB.2023-0277
32.
TanakaHHayashiTInuiH, et al. Estimation of shoulder behavior from the viewpoint of minimized shoulder joint load among adolescent baseball pitchers. Am J Sports Med. 2018;46(12):3007-3013. doi:10.1177/0363546518789626
33.
van TrigtBSchalligWvan der GraaffEHoozemansMVeegerD. Knee angle and stride length in association with ball speed in youth baseball pitchers. Sports. 2018;6(2):51. doi:10.3390/sports6020051
34.
WernerSLGillTJMurrayTACookTDHawkinsRJ.Relationships between throwing mechanics and shoulder distraction in professional baseball pitchers. Am J Sports Med. 2001;29(3):354-358. doi:10.1177/03635465010290031701
35.
WernerSLSuriMGuidoJAJrMeisterKJonesDG.Relationships between ball velocity and throwing mechanics in collegiate baseball pitchers. J Shoulder Elbow Surg. 2008;17(6):905-908. doi:10.1016/j.jse.2008.04.002
36.
YanagisawaOTaniguchiH.Relationship between stride length and maximal ball velocity in collegiate baseball pitchers. J Phys Ther Sci. 2020;32(9):578-583. doi:10.1589/jpts.32.578
37.
ZeppieriGJrBrunerMLMicheliniJPFarmerKW.The relationship between hip range of motion and pitching kinematics related to increased elbow valgus loads in collegiate baseball pitchers: a pilot study. Int J Sports Phys Ther. 2021;16(2):468-476. doi:10.26603/001C.21319
