Effects of Repetitive Pitching on Trunk Muscle Endurance and Thoracic and Shoulder Kinematics.

Background: Baseball players are aware of the potential of shoulder problems due to repetitive throwing. However, few studies have examined how pitching repeatedly affects the thoracic spine and shoulder. Purpose: This study aimed to determine the effects of pitching repeatedly on the endurance of trunk muscles and kinematics of the thoracic spine and shoulder. Study design: Cohort study. Methods: Trunk muscle endurance was assessed in flexion, extension, and lateral flexion positions in 12 healthy amateur baseball players. The positions of stride foot contact (SFC) during the early cocking phase and maximal shoulder external rotation (MER) during the late cocking phase were used to compute the thoracic and shoulder kinematics in degrees. Participants were then asked to throw 135 fastballs (~9 innings with 15 throws per inning). Throwing motions were monitored throughout the first, seventh, eighth, and nine innings, whereas trunk muscular endurance was assessed before and after the repetitive throwing activity. Ball speed during pitching was measured using a radar gun. All outcome measures were statistically compared to examine differences over time. Results: The trunk muscle endurance declined after the throwing task. In the eighth inning, compared with the first inning, the thoracic rotation angle at the SFC increased toward the throwing side. In contrast, the shoulder horizontal adduction angle at MER decreased in the seventh and ninth innings. Conclusion: With repeated pitching, trunk muscle endurance gradually declines, and repetitive throwing significantly altered kinematics of the thoracic rotation at SFC and shoulder horizontal plane at MER. Level of Evidence: 2a.