The Baseball Swing And Force At The Elbow: Entering Uncharted Territory Through

Advanced Motion Capture

Patrick C. McCulloch, M.D.1; Jordan P. Ankersen1,2; Harvey Oliver, M.D.1; Corbin Hedt, DPT1; Joshua R. Daum1; Aaron Henry2; Robert A. Jack, M.D.1; Bradley S. Lambert, Ph.D.1
1Department of Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston TX; 2Department of Engineering, Texas A&M University, College Station, TX

ABSTRACT METHODS (Motion Capture) RESULTS

INTRODUCTION: Little data exists on the difference between various progressive hitting phases that
may be involved with return to baseball after elbow injury. The purpose of this study was to critically
analyze and report the kinetic force of the medial elbow during various phases and intensities of hitting
in Division I collegiate baseball athletes.

METHODS: Sixteen position players of a Division I collegiate baseball team were included in the study.
Each performed 15 swings [light (25-50% effort), 5 swings moderate (50-75% effort), and 5 swings
high intensity (75-100% effort)] in the following conditions: dry swings with reduced weight (wiffleball
bat), dry swings with regulation bat, live hitting from a tee, soft toss, and a pitching machine. 3D Motion
capture (Vicon® 20-camera system; force plates) data was recorded for each swing whereby medial
force (Newtons/body mass; N/kg) was measured for each elbow: top hand (cranial most hand position
on the bat) and bottom hand (caudal hand position on the bat) (Fig.1). A mixed model ANOVA followed
by a Tukey’s post-hoc test was used for comparison of force on each elbow for each intensity level and
to compare force on each elbow between swing types within each intensity. Type I error was set at
alpha=0.05.

RESULTS: In the bottom hand, there was a statistically significant increase in force at the medial elbow
with increasing intensity of dry swings (whiffle bat, regulation bat)(p<0.05) with similar forces across all
swing intensities during live swinging at a ball (tee, soft toss, pitching machine). Dry swings with a
• 78 Markers per Subject
regulation bat yielded the highest medial force on the bottom hand elbow at all intensities (p<0.05). • VICON’s Plug in Gait
For the top hand, force was similar and significantly lower compared to the bottom hand for all swing • 3 markers per segment
types and intensities (p<0.05).

DISCUSSION AND CONCLUSION: We conclude that the bottom hand experiences the greatest medial
stress and that that force at the elbow is similar when any contact with the ball is made, irrespective of
hitting type or effort (tee vs. soft toss vs pitching machine). In live swinging scenarios, players are often
unable to physically differentiate swing intensity when coached to do so. Although often utilized in
swinging progressions when returning from injury, dry swings with a regulation bat should not be
considered benign. These data will aid physicians, physical therapists, and coaches in decision making
for progressive return to batting following elbow injuries.

BACKGROUND
Within the sport of baseball, a majority of injuries occur in the upper extremity1-4 and can include:
ulnar collateral ligament tears, glenoid labrum injury, rotator cuff tears/sprains, and various other
musculoskeletal pathologies.3,4
• Vicon Motion Capture System
In a sport with such high-velocity movements and repetitive nature, special caution should be provided
when returning from injury.4,7-12 Rehabilitation programs incorporate carefully-specified interval hitting • 18 Vantage V16 Cameras

• 2 Bonita Video Cameras

and throwing programs to ensure a progressive return, reduce potential for re-injury, and maximize
return to sport efficacy.10-12 Baseball hitting, in particular, has been widely studied and kinetic models of
• 8 AMTI Force Platforms
the swing motion are well-understood.4,7,13-16 Emphasis on optimizing mechanics is often suggested as
well as a gradual return to swing intensities through graduated phases of hitting.4,7 Data are presented as means ± SEM for %Maximal elbow force calculates as force / peak force measured across
either limb across all trials.
Many studies outline a preferred approach to increasing volume and load with the baseball swing
involving a progression from dry swings at low intensities to full intensity hitting with a pitching • Medial Elbow Force (MEF) Reported
machine. However, little data exists on the differences between hitting phases and the load on the
upper extremities. • Plug in Gait Model Export
DISCUSSION / CONCLUSIONS
This is important for returning from elbow injury where the mechanical parameters of throwing are well
characterized but data are lacking for batting. This is of particular clinical relevance for two-way players
• Statistics: 5 (Swing Type) x 3 (Swing
who are subjected to the forces of both hitting and batting. Intensity) Mixed Model ANOVA followed by • During all phases and swing intensities, the bottom hand arm experiences greater MEF
a Tukey’s post hoc test for pairwise than the top hand arm.
To address the paucity in the literature, the purpose of this study was to use 3D motion capture in
tandem with force plate technology to assess medial forces on the elbow (related to elbow injury risk) comparisons (p<0.05).
during swing types used during progressive return to hitting following injury. • During dry swings, subjects were better able to differentiate between intensity. However,
among all swing types involving ball contact, almost no difference was observed in MEF
METHODS RESULTS regardless of voluntary increases in swing intensity. Therefore, regardless of player
reported effort, care should be exercised for the bottom hand arm.
• The study was approved by the Institutional Review Board (IRB) prior to subject enrollment. All
participants provided informed consent prior to participation. Included study participants were • No evidence of expected linear increase in MEF with progression of swing type.
Division I collegiate level baseball players from the local area (n=16). Subjects were excluded
from participation if they have a previous history of upper extremity injury, current painful
dysfunction resulting in exercise or study participation limitation, any health-related exercise • With the highest MEF measures, dry swings with a regulation bat should not be
limitation as ordered by a physician, inability to comply with all provisions of the study, and considered benign despite often being used in the early phases of return to hitting.
inexperience with baseball hitting.

• Once participants have undergone the appropriate device calibration processes (Methods To
• These findings may aid clinicians, athletic trainers, and physical therapists in making
Follow), they performed swing progressions in the following sequence: educated decisions regarding progressive return to hitting in a manner that is specific to
the injured upper extremity.
Dry Swings
with
Dry Swings
with Live Hitting
Live Hitting
from Soft
Live Hitting
from Pitching
• Further modeling will be required to incorporate the mass and dimensions of the specific
Reduced-
Weight Bat
Regulation
Bat
from Tee
Toss Machine bats used in this investigation for further refinement of MEF measures. Such information
will also assist in characterizing the biomechanical forces on other major joints of interest
as well.
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