Baseball pitching biomechanics in relation to pain, injury, and surgery: A systematic review

ObjectivesTo investigate the relationship between baseball pitching biomechanics and pain, injury, or surgery, in pitchers of all ages competition levels.DesignSystematic review.MethodsThis study was registered on Prospero (CRD42019137462). Four online databases (MEDLINE, SPORTDiscus, CINAHL, Embase) from inception to June 13, 2019 were systematically searched. Risk bias assessed through modified Downs Black.Results967 titles/abstracts screened with 11 studies (1376 pitchers) included. used 3D biomechanical analyses, five video analysis, two evaluated EMG activity. Level 1b evidence suggests that injured had greater elbow valgus torque at late arm cocking (injured: 91.6 N m, non-injured: 74.7 p = 0.013) early trunk rotation predictive increased upper extremity surgical risk (Hazard Ratio: 1.69 (95% CI 1.02–2.80)). 3b observed history lateral tilt release (surgery: 29.3°, controls: 23.4°, 0.035), flexor carpi ulnaris activity decreased 68% MMT, 103% MMT) injury.ConclusionsIncreased injury factors, displayed diminished forearm muscle Due low power many these studies, lack prospective other variables cannot be ascertained as factors. Future are needed prospectively assess methods.