Baseball pitchers elbows may be connected to their thigh bone—at least where injuries are concerned. Research by Kevin W. Farmer, M.D., of the University of Florida Department of Orthopaedics and Rehabilitation, indicates that a limited range of motion in a pitcher’s hips could be a risk factor for injury to their elbows.
Pitchers’ Hip Motion Key to Elbow Injury
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As Farmer explained, when a pitcher throws, he lifts one knee—the leg opposite his throwing arm—so his thigh is parallel with the ground. Simultaneously, he brings the ball behind his shoulder and begins the pitch, bringing his throwing hand over his shoulder at the same time his raised knee is coming down. That step forward helps power the pitch.
When the pitcher throws a pitch, much of the stress is focused on a single ligament, the ulnar collateral ligament of the elbow joint. About 1, 000 pounds of pressure per square inch is often placed on that ligament, Farmer said. The mechanics of the throw affect what Farmer and his colleagues call the “elbow valgus torque.”
“Most studies have looked at shoulders and elbows. While very few studies have looked at lower extremities, some have done early work looking at range of motion, but no one has really correlated hips with the risk of injury to the elbow, ” Farmer said.
To test how a pitcher’s hip range of motion affected his elbow, Farmer and his fellow researchers tested the pitching style of seven college Division 1 athletes in a biomechanical throwing analysis. They correlated the hip range of motion to what they already knew could risk injury, and found that the tighter the range of motion that pitchers had in their hips, the greater the injury risk to their arms. They found that pitchers unknowingly compensate for limited range of motion in their hips, which places more torque on their elbows.
Farmer said that coaches and athletic trainers could easily help athletes improve the flexibility in their hips. He plans to follow pitchers over a period of time to determine whether there are changes in their ranges of motion over their careers, and whether a stretching program can improve range of motion and reduce the risk of injury.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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