Pathomechanics are changes in the normal biomechanical function of a joint, an extremity, or the torso as the result of trauma or disease. The majority of injury comes from these pathomechanics as defined here in this article.Injury is a major factor in baseball, especially as pitching velocity has skyrocketed in this game as illustrated in the chart here. The only way baseball will be able to survive the injury epidemic, is if they begin to program the proper training, to remedy the pathomechanics that are causing the injuries, into player development. The problem is baseball's thick skin is working hard to stay ignorant of the science as opposed to embracing it as quickly as possible.
In this article, I will use the 6 basic components of 3X Pitching to define the most efficient and effective biomechanics to developing healthy elite movements in the pitching delivery, along with the pathomechanics that leads to most of the pitching injuries. I will also list how the 3X Pitching Velocity Program was built as much for injury prevention as performance enhancement.
Pathomechanics and the Kinetic Chain
Most of the information in this article comes from an incredible document called, The Kinetic Chain Revisited: New Concepts on Throwing Mechanics and Injury by Samuel K. Chu, MD, Prakash Jayabalan, MD, PhD, W. Ben Kibler, MD, Joel Press, MD published in the Advanced Sports Medicine Concepts and Controversies.
The document starts by defining how the kinetic chain is used most efficiently and effectively during the throwing motion. The kinetic chain is simply defined as a linked system of joints in the body. The document gives us a more complex understanding of the kinetic chain as well.
The kinetic chain temporarily links multiple body segments during the phases of throwing motion, including the feet, which provide contact with the ground, maximize the ground reaction force, and create a stable proximal base for distal arm mobility [3]. In addition, maximizing force development in the large muscles of the core and legs produces more than 51%-55% of the kinetic energy that is transferred to the hand.
An efficient kinetic chain requires optimal anatomy, physiology (that includes muscle flexibility, strength,
and task-specific motor patterns), and mechanics throughout all of the body segments involved [2]. Breakdown in the kinetic chain from factors such as variation in motor control, inadequate muscle strength, flexibility and endurance, joint injury, and improper muscle activation patterns can lead to impaired function, performance, and injury [4,5]. A “catch-up” phenomenon has been described in which breaks in the kinetic chain alter forces in distal segments, leading to pain and possible injury [2,11].
Here is a simply visual to help you truly understand how to best define and use the kinetic chain as a pitcher.
Legs and core are mass for stable base and engine for largest amount of force generation. Shoulder is funnel for force regulation. #pitching pic.twitter.com/knPPMCJZvy
— Brent Pourciau (@TopVelocity) December 15, 2016
3X Pitching Mechanics VS Pathomechanics and Injury
The pitching delivery can best be segmented into these 6 mechanical components. You will first learn each components normal mechanics followed by its pathomechanics. The 3X Pitching Velocity Program will help you improve or eliminate these pathomechanics.
Lift Leg Momentum
Normal Mechanics
The focus of this moment in the pitching delivery is to start building momentum towards the target. More momentum potentially can equal less work for the arm if energy is transferred efficiently and effectively. It is best to lead with the hip as momentum is being developed to help delay the trunk during this movement. The 3X Pitching Velocity Program will go into more depth about this critical component.
Pathomechanics
Weakness of the stance leg hip abductors and knee extensors produces an unstable base of support for the
thrower during this phase and can lead to pain or injury in the distal segments through the previously mentioned “catch-up” phenomenon [1].
Poor hip abduction, adduction and glute strength and mobility will prevent the drive leg from loading properly.
Load Position
Normal Mechanics
This is the most poorly coached pitching component in the pitching delivery. You can compare this component to the importance of the sprinter to fire off the block. If a sprinter fails to fire quickly off of the block it is detrimental to his overall performance. The purpose of the block for the sprinter is to load the legs into flexion to create power in extension and to also align the force vector (ankle to knee) in a more parallel position with the ground to help accelerate the linear movement. Pitchers must also get on the block or load their drive leg into a similar position to produce linear power. More linear power from the lower half reduces work for the arm. The 3X Pitching Velocity Program will go into more depth about this critical component.
Pathomechanics
Decreased hip abduction strength has been associated with increased shoulder workload and posterior superior labral tears in overhead throwing athletes [2,7]. Furthermore, overhead throwing athletes with inadequate knee flexion have been reported to have higher loads in shoulder horizontal adduction and rotation and valgus load at the elbow [2]. Poor single-leg balance on the stance leg, impaired trunk control, and premature forward movement also can disrupt the kinetic chain and lead to increased forces on the distal kinetic chain, promoting further risk of injury [5,8].
It is critical the pitcher has good strength in the posterior chain to load the glutes and all the external rotators instead of moving prematurely into the quads and calves muscles. The pitcher also needs the mobility necessary to prevent the anterior chain, of the lower half, firing early. The 3X Pitching Mobility Course defines the exact measurement of these mobility ranges.
Triple Extension & Separation
Normal Mechanics
During the initial part of this phase, the thrower’s center of gravity is lowered with contraction of the stance leg hip flexors [1]. The stride leg also extends toward the target. Hip abduction of the stance leg helps initiate forward motion, followed by knee and hip extension of the stance leg [1]. Contraction of the stance leg gluteus maximus provides stability of the pelvis and trunk [5]. The stride leg hip externally rotates while the stance leg hip internally rotates [1].
This is the bread an butter of 3X Pitching. Triple Extension (3X), is the extension of the ankle, knee and hip flexor. This movement is the engine and hip to shoulder separation is the transmission in the pitching delivery. Not every pitcher will 3X, you can learn the other two drive leg styles in this video.
Pathomechanics
During the this phase, hip internal rotation of the stance leg is important for transfer of energy to the distal segments of the kinetic chain. If restrictions or deficits are present in hip internal rotation in the stance leg, this may lead to early forward rotation of the pelvis and subsequent increased stress on the distal kinetic chain such as the shoulder and elbow [1,6]. Early trunk rotation has been shown to increased valgus torque on the throwing elbow [1,2].
Hyperangulation of the humerus in relation to the glenoid can cause an increased load to be placed on the anterior shoulder with resultant internal impingement [2]. Alterations in positioning or dynamic motion of the scapula, known as scapular dyskinesis, can be due to muscle weakness, inflexibility, or imbalance and has been associated with 67%-100% of shoulder injuries.
The ultimate challenge with this phase is preventing an early transfer of energy. This early transfer can come as an early transfer of trunk tilt which is the trunk moving forward toward the target or early trunk rotation which is the glove side pulling the trunk early into rotation. Hyperangulation or arm drag of the throwing arm can occur during these early movements which puts the shoulder in a extremely vulnerable position to protect itself from injury. It can also force the throwing arm into excessive horizontal adduction into pitch release which then puts the elbow in a very vulnerable position to protect itself.
The key to avoid the stress of the arm is preventing the early transfer of energy which is best done with optimal hip to shoulder separation following an optimal leg drive. The 3X Pitching Velocity Program will go into more depth about this critical component and how to develop it.
You can also watch episode #231 of the @TopVelocity #PitchingTips Show to Learn more about Hyperangulation. Please subscribe if you enjoy the show!
Chest Thrust External Rotation
Normal Mechanics
The pelvis and trunk then rotate toward the target with subsequent lumbar spine hyperextension and rotation of the upper torso [1]. Eccentric contraction of the abdominal obliques prevent excess hyperextension of the lumbar spine [5]. Stability of the pelvis and hip is controlled by contraction of the gluteal muscles [8].
In the upper extremities, the throwing arm is externally rotating at the shoulder and flexing at the elbow. The throwing shoulder progresses toward maximal external rotation as the shoulder reaches 90 of abduction [1]. The elbow and hand lag behind the trunk and shoulder during this phase. When the shoulder is at maximal abduction and external rotation, the scapula is positioned in maximal retraction, lateral rotation, and posterior tilt [1]. This positioning of the scapula is important to maintain the subacromial space and prevent impingement during the throwing motion [1].
Glenohumeral internal rotation deficit greater than 18-20 increases the risk of injury at the shoulder and the elbow [1,2]. Increased glenohumeral external rotation has also been associated with superior labrum anterior to posterior tears, rotator cuff impingement, and tears and increased valgus stress on the elbow [1].
Following optimal hip to shoulder separation the spine and throwing shoulder will continue to transfer energy and load to continue to multiple forces before funneling the energy. The 3X Pitching Velocity Program will go into more depth about this critical component.
Pathomechanics
Scapular dyskinesis can lead to external impingement, internal impingement, decreased rotator cuff strength, and increased anterior capsular strain [2]. In terms of hand positioning, if the hand is under or on the side of the ball, an increased valgus strain can be placed on the elbow [2].
Hyperlordosis or back extension places increased load on the abdominals and creates a “slow arm” in which the arm is behind the body with increased abduction and external rotation at the shoulder, which results in increased compression loads at the shoulder [7]. Hyperlordosis also loads the posterior elements of the spine. If this load is excessive, the player is at risk for the development of spondylolysis [9]. If the throwing elbow is dropped below 90 of abduction, this position can place an increased valgus load on the elbow [2].
Pitchers who struggle to create optimize hip to shoulder separation will overload thoracic extension to delay the release point. This can be the result of poor hip and spinal mobility and strength. Developing optimal core and leg strength and mobility is the key to reducing the risk of injury to the arm.
Elbow Extension Internal Rotation
Normal Mechanics
During this phase, the trunk continues to rotate and tilt, acting to transfer energy through the upper extremity [5]. The trunk moves from a hyperextended position to a forward flexed position, and there should be a controlled lordosis [1,2].
The abdominal obliques, rectus abdominis, and lumbar paraspinal musculature of the nonthrowing side appear to have greater activity compared with the throwing side during acceleration and are important in accentuating pelvic and truncal rotation [5].
In addition, contraction of the rectus femoris contributes to hip flexion of the stride leg and knee extension, which provides a stable anterior base [5]. An increase in forward truncal tilt allows the throwing upper extremity to accelerate through a larger distance, increasing the force that is transferred through the ball [5].
The serratus anterior contributes to scapular protraction and helps provide a stable base for horizontal adduction and internal rotation of the humerus [5]. The subscapularis, pectoralis major, and latissimus dorsi reach maximal activity during this phase, causing the large amount of internal rotation of the humerus [5]. At the start of this phase, the elbow initially flexes from 90-120 and then rapidly extends to just prior to release of the ball [5]. The elbow extension results from a combination of the force generated by rotation of the trunk and contraction of the triceps [5]. A short delay between elbow extension and the start of shoulder internal rotation decreases rotational resistance of the arm and helps increase ball velocity [1,4,6]. The optimal position of the throwing arm is with a high elbow, at 90 of shoulder abduction, to minimize impingement and maximize strength [1,2]. Wrist flexion to neutral and radioulnar pronation assist in release of the ball [5].
After the ball release, the arm continues to extend at the elbow and internally rotate at the shoulder, and the arm adducts across the body to 35 [5]. This phase causes the greatest amount of glenohumeral joint loading during throwing, with inferior shear forces, increased compressive forces, and adduction torques [1,5]. These large forces are dissipated by the posterior shoulder soft tissue musculature, including the teres minor, infraspinatus, and posterior deltoid [5]. Rotator cuff contraction and the posterior capsule help limit excessive anterior translation of the humerus [1]. After release of the ball, the throwing arm is directed toward home plate, the elbow is flexed to 25, and the arm is abducted an average of 93 while horizontally adducted [5]. Eccentric contraction of the elbow flexors, the biceps, and the brachialis muscles decelerate the rapidly extending elbow and pronating forearm [1,5]. In addition, the trapezius, serratus anterior, and rhomboids help decelerate the shoulder girdle and stabilize the scapula as it returns from an upward position to an anteriorly tilted position [1,5].
The final movement of the pitching delivery once the trunk has transferred energy to the arm is the arm path to funnel that energy to the ball. Here is a complete walk through of the most effeicent and effective arm path to funnel the energy.
Pathomechanics
The large eccentric contractile needs of the musculature of the posterior shoulder are likely the cause of the posterior capsule and soft tissue reaction seen in pitchers with glenohumeral internal rotation deficit [5]. Pathologic conditions that are associated with this phase include tears of the superior labrum (ie, superior labrum anterior to posterior tears), along with biceps, brachialis, and teres minor injuries [10].
Rarely is the injury that occurs in this component, caused by this component. The links are downstream in the kinetic chain.
Stabilization
Normal Mechanics
This is the last component listed but it already occurred at front foot strike.
The landing foot should be positioned toward the target, and the stride leg, stance leg, and target should all be in line [1,2].
The quadriceps in the stride leg contract to decelerate the flexed knee, stabilize the stride leg, and provide a stable base [1].
It is critical to prevent any lead knee flexion at front foot strike. This quickly dumps valued energy from moving up the body.
Pathomechanics
Restrictions in stride leg hip external rotation may also influence the kinetic chain because of the influence on stride foot placement [8]. Stride foot positions that close the body cause the athlete to throw across the body and can affect performance and accuracy. Increased stress is also placed on hip and oblique musculature [2,8]. Stride foot positions that open the body can also cause the athlete to throw outside of the target area, which increases the load on abdominal and anterior shoulder muscles and valgus stress on the throwing elbow [2,8].
Weakness or tightness of the stride leg knee extensors can alter knee motion and produce an unstable base of support [1,2], which can result in decreased throwing performance, impaired force generation, and overuse injuries in the distal segments of the kinetic chain, particularly the shoulder and elbow [1].
Weakness of the abdominal oblique muscles can lead to hyperextension of the lumbar spine.
The #1 Training Program To Develop the Healthy Pitcher
Now that you have a full list of pathomechanics and how critical to your health that you must remedy these major issues, you will need a program that gives you the roadmap to health through enhanced performance. This is why I developed the 3X Extreme Pitching Velocity Program. It first took me from rotator cuff surgery back to health and into pro ball.
The reason the 3X Extreme Pitching Velocity Program works is because it is based off of science and it has been proven to develop the healthy 90+mph fastball on thousands of pitchers. It isn't rocket science or voodoo, it is the real deal! The program comes with a high level workload of drills, lifts and exercises scientifically programmed to enhance throwing speed on the mound while developing an efficient healthy pitching delivery. The format of the 3X Pitching Velocity Program is similar to the same approach Olympic throwers have been using for decades to increase throwing velocity and reduce wear and tear. This approach isn't new to the sports world but it is new to baseball.
If you are serious about your career and are insanely driven to put yourself into an extremely small percentage of pitchers who are potential D1 prospects, top level draft picks or you just want to reach your potential on the mound then this program is the best chance you have to making your dreams come true.
Learn more about the 3X Extreme Pitching Velocity Program or get started TODAY adding 5-10+mph!
References
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- Sciascia A, Thigpen C, Namdari S, Baldwin K. Kinetic chain abnormalities in the athletic shoulder. Sports Med Arthrosc 2012;20: 16-21.
- Lintner D, Noonan TJ, Kibler WB. Injury patterns and biomechanics of the athlete’s shoulder. Clin Sports Med 2008;27:527-551.
- Seroyer ST, Nho SJ, Bach BR Jr, Bush-Joseph CA, Nicholson GP, Romeo AA. Shoulder pain in the overhead throwing athlete. Sports Health 2009;1:108-120.
- Dillman CJ, Fleisig GS, Andrews JR. Biomechanics of pitching with emphasis upon shoulder kinematics. J Orthop Sports Phys Ther 1993;18:402-408.
- Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: Spectrum of pathology. Part III: The SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy 2003; 19:641-661.
- Calabrese GJ. Pitching mechanics, revisited. Int J Sports Phys Ther 2013;8:652-660.
- McCleary MD, Congeni JA. Current concepts in the diagnosis and treatment of spondylolysis in young athletes. Curr Sports Med Rep 2007;6:62-66.
- Wilk KE, Macrina LC, Cain EL, Dugas JR, Andrews JR. The recognition and treatment of superior labral (slap) lesions in the overhead athlete. Int J Sports Phys Ther 2013;8:579-600.
- van der Hoeven H, Kibler WB. Shoulder injuries in tennis players. Br J Sports Med 2006;40:435-440.
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