What are the biomechanical stages of throwing a baseball that can lead to rotator cuff injuries?

Updated: Oct 25, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Craig C Young, MD  more...
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Answer

A similar type of motion is involved in a number of overhead sports activities (eg, serving in tennis, spiking in volleyball, throwing a football or baseball). The baseball throwing motion has been studied in detail and can be divided into 5 stages.

  • Stage 1 is the wind-up phase. EMG studies have determined that the rotator cuff muscles are inactive during this initial stage.

  • Stage 2 is the early cocking stage and involves shoulder external rotation and abduction supplied primarily by the deltoid.

  • Stage 3 is the late cocking stage, which continues until maximal external rotation is achieved. The rotator cuff muscles are very active during this stage, especially the subscapularis, which eccentrically contracts and acts as a dynamic stabilizer.

  • Stage 4 is the acceleration stage, which begins with internal rotation of the humerus and ends with release of the baseball. During this phase, the pectoralis major and the latissimus dorsi are very active, whereas the muscles of the rotator cuff are inactive.

  • Stage 5 is the follow-through of the baseball pitch, where deceleration takes place. During this phase, the rotator cuff muscles and the posterior deltoid are most active. The supraspinatus eccentrically contracts to decelerate internal rotation of the limb.

Proper balance between the concentrically contracting muscles that generate force and the eccentrically contracting muscles that control movement is important. Imbalance between these opposing muscle groups results in overuse of muscles and, ultimately, overuse injuries of the shoulder. Note that a great deal of the force generated in overhead sports occurs in the trunk and lower extremity, and these areas should be targeted in any conditioning program for athletes who throw.


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