The trend of association between lateral trunk tilt angle and peak elbow valgus moment has also been reported in a study by Aguinaldo et al.26 Supporting these finding, Huang et al.52 demonstrated that youth pitchers

with a history of elbow pain exhibited greater trunk lateral tilt compared to pitchers without history of injuries. However, the mechanism by which GSK J4 research buy the trunk movement influences upper extremity joint loading is not well understood, and warrants further investigation. Most of the studies discussed thus far are conducted in a laboratory setting using motion capture systems, which are useful in describing three-dimensional joint kinematics and kinetics. However, the motion capture systems are rarely available to baseball pitchers, coaches, and parents. Therefore, Davis et al.33 took a

unique approach that is more relevant to baseball coaches and parents by investigating the effects of observable technical errors on joint loading. The study demonstrated that having an “open shoulder” at stride foot contact and having a hand under the ball (i.e., forearm in supination) during stride were associated with greater elbow valgus and shoulder Nintedanib mw internal rotation moments.33 This finding is meaningful in that baseball coaches or sports medicine professionals can use this information to identify pitchers who may be at higher risks of injuries. Biomechanical studies discussed here provide evidence that pitching technique affects the magnitude of stress experienced at the shoulder and elbow joints and risk of injury, which suggests that instruction of proper pitching technique that minimize stress on upper extremity joints may lead

to prevention of injury. Most of the studies investigating pitching technique associated with increased joint loading conclude that their findings should be used to design instructional programs to decrease joint loading and thus prevent injuries. However, there has been no study that attempted to implement such a program. The goal of the second part of this review is to discuss consideration and potential barriers in first utilizing instructional programming on pitching technique to prevent pitching-related upper extremity injuries. From observation of pitchers playing in Major League Baseball, it is clear that no two elite pitchers perform pitches in an identical manner. It needs to be noted that being a successful professional pitcher has to do with more than just pitching technique. Therefore, it would be a mistake to believe that technique used by elite professional baseball pitchers is always “proper”. In fact, many of the conventional wisdom on pitching technique prevailing in baseball community today are not supported by scientific evidence.