Elbow below the shoulder. Good advice? Not re: ASMI


#1

We all have seen Chris O’Leary speak at length about his advice of getting the elbow slightly below the shoulder line when pitching. ASMI has this to say about it.

The synopsis of the “biomechanics study” Fleisig references is:

[quote]Shoulder Abduction and Lateral Trunk Tilt Influence the Peak Elbow Varus Torque During Pitching

Matsuo T, Fleisig GS, Zheng N, Andrews JR. Simulated influence of shoulder abduction and lateral trunk tilt on peak elbow varus torque for college baseball pitchers. Journal of Applied Biomechanics 22:93-102, 2006

Methods

Varus torque is a primary factor in the risk of elbow injury during pitching and it was hypothesized that varus torque may be affected by shoulder abduction angle and lateral trunk tilt angle. Motion data of 33 healthy, college baseball pitchers were collected at ASMI and used for computer simulation in which shoulder abduction and lateral trunk tilt angles were systematically altered from the actual movement. For each pitcher, 42 simulated motions were generated and the peak elbow varus torque for each motion was calculated.

Results

The main effect of shoulder abduction angle on peak elbow varus torque was found to be significant (p<0.0001). The results showed minimum peak elbow varus torque at 90º and 100º of shoulder abduction. The main effect of lateral trunk tilt was also found to be significant (p<0.0001). The minimum in peak elbow varus torque was found to be at 0º of lateral trunk tilt. Finally, the interaction of shoulder abduction angle and lateral trunk tilt was also significant. The combination of 10º of lateral trunk tilt and 100º of shoulder abduction produced the minimum peak varus torque among all conditions in the study. Thus, the results of this simulation study clearly show that shoulder abduction angle and lateral trunk tilt have an affect on elbow varus torque and thus can be helpful in reducing stressful forces on the shoulder and elbow during pitching.
[/quote]


#2

I’ve got to go back and find the presentation by Dr. Andrews where he stated that pitcher’s built up their UCLs over time. Chris claimed that the idea that UCLs could be strengthened was a fringe concept and not something accepted by the mainstream medical community.

http://www.littleleague.org/pitchcount/pc/sect3/Little%20League%20-%20Andrews%20and%20FleisigSECTION3.swf


#3

There may be a limit as to how low. Mark Mulder and Jason Schmidt are 2 pitchers I notice that get their elbows well below the shoulder at foot plant. But they both have had shoulder injuries though, not elbow injuries. Mulder had rotator cuff surgery, while Schmidt had a torn labrum, inflamed bursa, and a frayed biceps tendon.


Althought at release, they both do get their elbows back up to level with the shoulders.


Is the 100 degrees stated in relation to the trunk or the ground? Is it only at release? Or during shoulder rotation?


#4

I would say the 100 deg. is relative to the trunk (they reference abduction) but the 10 deg. is for the trunk and relative to the ground (or a vertical line). With respect to when, I’d say it’s from high cocked through to release.

Yes, there are those who start around high cocked with the elbow somewhat lower than 90 deg. but that doesn’t negate their findings about the amount of torque being at it’s minimum within the parameters they identified. The other thing is that, of course, nothing is absolute and it’s a matter of identifying the magnitude of the risk.


#5

This statement is an absolute! :wink:


#6

This statement is an absolute! [/quote]No it’s not. I NEVER use absolutes. NEVER. 8)


#7

[quote=“xv84”]There may be a limit as to how low. Mark Mulder and Jason Schmidt are 2 pitchers I notice that get their elbows well below the shoulder at foot plant. But they both have had shoulder injuries though, not elbow injuries. Mulder had rotator cuff surgery, while Schmidt had a torn labrum, inflamed bursa, and a frayed biceps tendon.


Althought at release, they both do get their elbows back up to level with the shoulders.


Is the 100 degrees stated in relation to the trunk or the ground? Is it only at release? Or during shoulder rotation?[/quote]
That only tires a little muscle in your rotator cuff which loses control.


#8

I’m sorry, Annarborkid, but I don’t understand what you mean. Can you elaborate on that please.? Thanks.


#9

Im glad you started this thread, i first started one like this and not much response.


#10

Thanks. It’s just that I came across this info, after seeing it before, but thought it might be a good time to bring it up because Chris has been on the mission he has. I think that this requires some actual science be out there instead of just theory.


#11

As a physical therapist I certainly appreciate the value of “studies” but also realize that you must take them with a grain of salt.

This study for instance uses an extremely small sample size and based on individual mechanics, has a computer create the deviations and then attempt to calculate the varus torques based on those models or simuations. Hardly real world with a multitude of factors not taken into consideration. Basically fuel to create an even more meaningful study. :shock:

It also is not a predictor of injury but more a predictor of risk for those pitchers only . Work ethic, conditioning, gross strength, flexibility and body type also play a factor. A mesomorph would have an inherently larger muscle and ligament structure than an ectomorph and yes, ligament structures can increase load tolerances based on repetetive stress (ie Wolf’s Law).

As far as Chris O’leary, I have spoken with him on the subject and believe that he is making observations only…based on commonalities between injured pitchers. That database continues to grow and could take several years to actually proclaim an official correlation.

Arm path that would take the elbow above the shoulder plane in an inverted “W” as Chris calls it, certainly places the shoulder at risk (labrum and secondary impingement) due to the excessive forceful external rotation that movement creates upon launch. Also, elbow flexion angle influences hand path which can lead to a multitude of elbow issues based on timing, pronation, pitch type, etc (ala Marshall). But that is a subject for another post.