Oliver et al. (2021) studied 37 NCAA Division I softball pitchers to see whether having lower-extremity pain affected pitching mechanics or shoulder forces. Each pitcher completed a questionnaire asking if they currently experienced pain in the lower body (foot, ankle, leg, or thigh). Based on their answers, pitchers were placed into a pain group (5 athletes) or a pain-free group (32 athletes). All pitchers threw three rise-ball pitches for strikes while wearing electromagnetic motion-capture sensors that recorded body movement at 100 Hz. The researchers measured lower-body mechanics (stride knee flexion, stride length), trunk mechanics (flexion, rotation, lateral flexion), center-of-mass position, and shoulder forces during four phases of the pitch: top of backswing, foot contact, ball release, and follow-through. Statistical tests were used to compare the two groups and to examine whether pain was related to any of the measured mechanics or forces.
They found:
- No significant differences in pitching kinematics or kinetics between pitchers with lower-extremity pain and those without
- No significant relationships between lower-extremity pain and:
- Stride knee flexion
- Stride length
- Trunk flexion, rotation, or lateral flexion
- Center-of-mass position
- Shoulder distraction, compression, or shear forces
- Pitchers with knee pain still showed similar mechanics and shoulder loading compared to pain-free pitchers
- Effect sizes were small, indicating very little biomechanical separation between groups
Implications: The authors expected that pitchers with lower-extremity pain would show altered mechanics and increased shoulder stress, but this was not supported by the results. Instead, pitchers with pain were able to maintain similar pitching mechanics and forces as pain-free pitchers, possibly by compensating in subtle ways not detected in this study. One explanation is that the pain may have been mild or short-term, which may not be enough to change how an athlete moves. The authors also note that pitchers often continue throwing despite pain, which could mask underlying issues. Even though no differences were found, this does not mean pain is harmless—persistent or worsening lower-body pain may eventually lead to mechanical breakdown and increased injury risk. The authors emphasize that coaches and clinicians should not rely only on visual mechanics to identify pain or injury risk and should also consider athlete-reported pain. Future research should study pain severity and duration, as well as long-term changes in mechanics, to better understand how lower-extremity pain affects the pitching motion.
Also…
I love to listen to podcasts, and the Tim Ferriss Show is always in my feed. This week, Tim released an interview with Steve Young, former quarterback/MVP/ESPN Analyst. It was an incredible episode with a lot of real-life application to us and our athletes. Check it out!