Relationship of Forearm-Hand Inertia With Throwing Motion Patterns and Elbow Valgus Load in Adolescent Baseball Players

• Published in: Orthopaedic journal of sports medicine 2024-10, Vol.12 (10), p.23259671241272488
• Main Authors: Tsutsui, Toshiharu, Sakamaki, Wataru, Maemichi, Toshihiro, Torii, Suguru
• Format: Article
• Language: English
• Subjects: Baseball; Efficiency; Elbow; Inertia; Load; Original Research
• ISSN: 2325-9671; 2325-9671
• DOI: 10.1177/23259671241272488

Background: Growth-specific physical characteristics in adolescence may mediate throwing-related loads and movement patterns associated with elbow injuries. In a previous study, the authors calculated the forearm-hand inertia, which is the moment of inertia centered at the elbow joint. Purpose: To determine the relationship of forearm-hand inertia values with throwing motion patterns and elbow valgus load in adolescent baseball players. Study Design: Descriptive laboratory study. Methods: A total of 35 adolescent baseball players underwent measurements by dual-energy x-ray absorptiometry (DXA) scans and a throwing trial. Forearm-hand inertia was determined as the joint moment around the elbow using the subregion analysis mode of DXA. Elbow valgus torque and ball speed during throwing were measured using a dedicated sensor and speed gun, and throwing efficiency was calculated by dividing the elbow valgus load by the ball speed. Players were divided according to the throwing motion pattern in which maximum acceleration occurred: pelvis–upper arm–forearm (proximal-to-distal sequencing [PDS] group; n = 19) or pelvis-forearm–upper arm (proximal upper extremity [PUE] group; n = 16). The groups were compared in terms of ball speed, elbow valgus torque, throwing efficiency, and forearm-hand inertia using t tests and analysis of covariance, with forearm-hand inertia as covariates. The chi-square test was used to examine the relationship between throwing motion patterns and forearm-hand inertia. Results: The PUE group had a higher elbow valgus load (effect size [ES] = 0.65; P = .03), throwing efficiency (ES = 0.63; P = .02), and forearm-hand inertia values (ES = 0.64; P = .04) than the PDS group. In addition, a significant relationship was observed with throwing patterns when forearm-hand inertia values were 350 kg·m2 (OR, 2.36; 95% CI, 1.09-5.12; P = .012) and 400 kg·m2 (OR, 1.68; 95% CI, 0.99-2.85; P = .037). Conclusion: Study results indicated that growth-specific physical characteristics in adolescent baseball players exhibited in forearm-hand inertia mediated the relationship between high elbow valgus and poor throwing efficiency caused by poor throwing motion patterns. Clinical Relevance: A better understanding of the details in muscle function with throwing mechanics may prevent future injuries.