Youth Baseball Pitching Mechanics

Youth Baseball Pitching Mechanics:
A Systematic Review

As athletes continue to become younger and younger when they begin their athletic journeys, injuries remain increasingly common. Shoulder and elbow pain remain staple gripes in baseball and other throwing sports. Even with a decrease in youth baseball participation, throwing injuries are increasing in youth pitching. The causes of these injuries can be contributed to playing year round as well as ‘a lack of basic bio-mechanical understanding of the normal pitching motion. ‘ This study dissected 10 separate studies that related to bio-mechanical parameters of the normal youth pitching motion or compared mechanics of pitch type.

We must first recognize fundamental movements within the pitching motion to gain a full understanding of this review. ‘The windup and the stretch are the traditional starting positions used during the thrower’s ball release. The nuts and bolts of these positions collide when the lead hip and knee are flexed. The lead leg should then extend toward home plate, all the while the pitcher’s upper trunk rotates to face the target.’ The arm deceleration phase begins when the ball is released and ends with maximum shoulder internal rotation. Once the ball is released, the young pitchers had ‘challenges controlling throwing arm deceleration as a result of underdeveloped rotator cuff musculature; this showed to increase horizontal flexion across the torso in an attempt to decelerate the throwing arm.’

Little League Baseball recommends that breaking pitches not be thrown until 14 years old because of shoulder pain Youth pitchers showed that elbow valgus torque was a cause in several types of elbow injuries.

Joint torque was measured through out the throwing process of these 10 biomedical studies with athletes that ranged from 10-15 years old. The weight of the pitcher showed to be the bio-mechanical factor that paralleled with the significance of valgus torque and also connects with elbow injuries. Furthermore, several of the studies used showed that maximum elbow valgus torque occurs just prior to maximum shoulder external rotation. Forces on the elbow and shoulder are greater for the fastball than the curve. This article did bring up that there are not enough studies being done on the lower body of the adolescent pitcher since ‘the young pitcher will attempt to compensate lower body mechanics will subject the upper body to added stress and increased risk of injury.’ Further studies must be done on the lower body so that a complete understanding of adolescent pitchers so that a reduce in injury can truly be seen.

Sports Health A Multidisciplinary Approach
Youth Baseball Pitching Mechanics: A Systematic Review
Samuel F. Thompson, MD, Trent M. Guess PhD. , Andreas C Plackis, MD,
Seth L Sherman, MD, and Aaron D. Gray, MD
March-April 2018
Volume 10 Number 2

Shoulder Dislocations

Shoulder Dislocations

Shoulder dislocations are a relatively common injury in young athletes and occasionally weekend warriors. They most often occur due to a traumatic mechanism of injury where the shoulder is forcible pulled upward and outward (abducted and externally rotated). This disrupts the normal relationship between the ball and socket (glenohumeral joint) forcing the ball out of the socket. Contact sports including football, hockey, and wrestling are associated with shoulder dislocations.

Symptoms and signs include immediate shoulder pain, limited range of motion, and weakness. Shoulder deformity may be present as well. Occasionally the sensation of numbness and tingling occur in the shoulder or arm. Most often athletes complain that the shoulder feels out of place.

Initial management includes sling immobilization and documentation of the patient’s neurovascular status (pulses are checked and nerve function assessed). X-rays confirm a dislocation and any associated fractures about the shoulder. Subsequently, an attempt to reduce (put back in place) the glenohumeral joint is typically performed in the Emergency Room under sedation or local anesthetic, but can be performed on the athletic field by a Sports Medicine physician in certain circumstances. An x-ray is always taken to confirm that the shoulder is back in place after the reduction is performed.

Most injuries can be treated non-operatively with a brief period of immobilization in a sling. Once pain and swelling subside, a graduated physical therapy program is initiated focusing on range of motion and gentle strengthening. Many patients are able to return to sports without surgery, however, recurrent dislocations can occur and require further evaluation.

Recurrent shoulder dislocations or subluxations are best managed by an Orthopaedic Surgeon who can determine the reason for the continued symptoms and to formulate an appropriate treatment plan. Often times a magnetic resonance imaging (MRI) test is obtained to evaluate the anatomic structures injured. Bracing is an option that can be considered in appropriate patients. Surgery is also an option for some patients with good outcomes reported in most studies. However, patients considering surgery need to understand the risks of surgery, benefits, and alternative treatments prior to deciding their treatment course.

For more information on shoulder dislocations, please visit the AAOS website listed below.

Chris Pokabla, MD–conditions/dislocated-shoulder/

Shin Splints Blog by Robert Dunaway

Shin Splints

Shin splints are a common cause of leg pain in athletes. When an athlete has pain along the inner aspect of the shinbone, this can be due to shin splints. There are several medical conditions that can cause leg pain. Ranging from overuse in running, having arch problems, or exercising in shoes that are worn.
You can help prevent shin splints by wearing proper fitting athletic shoes, slowly increase your exercise routine, and cross training. For example you can alternate training from running to biking or swimming.
If you are having shin pain there are a few thing you can do to help alleviate the pain. Rest can be good. Ice your shins for 20 minutes at a time 2-3 times a day, take some type of NSAID medicine, compression, and orthotics can offer pain relief.
If these measures do not help and you are still having pain, an Orthopaedic evaluation can help establish a definitive diagnosis.

Bob Dunaway A.T.,C.


My name is Shawn Matsunaga. As an athlete, wouldn’t you want to 1) Improve your reaction time 2) Reduce your injury rate and improve overall health 3) Prolong your playing career 4) Increase your accuracy and faster sprint times 5) Commit fewer mental errors? If your answer is yes, one of the first things to come to mind might be some sort of supplement or performance enhancing drugs (PED’s). If that crossed your mind, think again. It’s free and most of us don’t get enough of it. This wonder drug is SLEEP.

Sleep deprivation is known to reduce reaction time significantly. A single all-nighter can reduce reaction time greater than 300%! A study conducted at the University of California concluded that injury rates in youth athletes increased during games where athletes slept fewer than 6 hours. Lack of sleep impairs performance. Sleep is vital to restore your muscle and brain cells. Sleep loss impairs judgment, and has a negative effect on decision making, risk taking, moral reasoning and inhibitions.

In closing, sleep is needed not only for optimal performance, but optimal health. Contrary to popular belief, you can’t catch up on your sleep. Your best ergogenic aid is sleep. So, if you want to perform better and increase your overall health get your ZZZZZZZZ’s!

For details and references go to ways sleep impacts peak athletic performance.

Dr. Jean Simard Discusses Mako Total Knee Replacements on ‘Local Memphis Live’

If you are a candidate for a total knee replacement and want to feel better, recover faster, and have your replacement last longer, call Memphis Orthopaedic Group at 901-381-4664 to make an appointment with Dr. Jean Simard.

Physiatrist Joins MOG – Jonathan Stuart, D.O.

Dr. Stuart

We are pleased to announce a new physiatrist, Jonathan Stuart, D.O. recently joined our team here at Memphis Orthopaedic Group.  Dr. Stuart provides a prodigious blend of clinical education and knowledge with a strong passion for providing community-based care and excellent customer service.  Dr. Stuart will be an active member of the community which will be evident over the course of the months and years to come.

Jonathan Stuart, D.O. grew up in the Bartlett, Tennessee area, and received his undergraduate degree from the University of Memphis.  He later earned his Doctor of Osteopathic Medicine degree.  Dr. Stuart completed his residency in Physical Medicine and Rehabilitation while attending the University of Arkansas for Medical Sciences in Little Rock, Arkansas.  Additionally, Dr. Stuart reported to Naval Medical Center Portsmouth in Portsmouth, Virginia and served as the Division Officer of the Wounded Warrior Division.  Jonathan Stuart, D.O. is a fellow of the American Academy of Physical Medicine and Rehabilitation.

Jonathan Stuart, D.O. began seeing patients in all three of our locations July 18th.  His specialties include non-operative regenerative medicine, sports medicine, interventional pain management, and electro diagnostics.  He will be offering the following services:

  • EMGs
  • Orthobiologics
  • Epidural Steroid Injections
  • Osteopathic Manipulative Treatments
  • Fluoroscopic Guided Injections
  • Ultrasound Guided Injections
  • Prolotherapy

Please contact our scheduling desk at (901) 381-4664 to make an appointment.

Congratulations to Dr. Jean Simard for being the FIRST in Memphis to perform a successful Total Knee Replacement using the Mako Robotic-Arm Assisted Surgery System this morning at St. Francis Hospital-Memphis.

Biomarker for Concussions

I am Jessillyn Howard, one of MOG’s athletic trainers.  Driving down the road one day, I heard two radio hosts discuss a blood test that is able to identify a concussion. “That’s awesome!” I thought, “A test to identify concussion would eliminate any guess work and be proof to athletes, coaches, and parents when return to play is questioned.” My hopes, however, were crushed when I read the article published by NATA named “How to Address the New Blood Biomarker Test.”

In this article, the author disproves these claims made about this test. This biomarker can be used to detect intracranial hemorrhage, or bleeding between the brain and the skull, without use of a CT scan. This is helpful in limiting x-ray exposure to patients in which intracranial hemorrhage is suspected. This test, along with any other test or imaging, cannot diagnose concussion. The article states, “concussion remains a clinical diagnosis determined by the mechanism of injury, on-field signs and patient-reported symptoms.” This only solidifies the need for athletic trainers not only in schools, but anywhere sports-related concussion may be possible.

You can read NATA’s article “How to Address the New Blood Biomarker Test” HERE.