Establishing the Role of Elbow Muscles by Evaluating Muscle Activation and Co-contraction Levels at Maximal External Rotation in Fastball Pitching

Background: Baseball pitching is associated with a high prevalence of ulnar collateral ligament injuries, potentially due to the high external valgus load on the medial side of the elbow at the instant of maximal shoulder external rotation (MER). In-vitro studies show that external valgus torque is...

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Autores principales:	Bart van Trigt, Eva Galjee, Marco J. M. Hoozemans, Frans C. T. van der Helm, DirkJan H. E. J. Veeger
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	electromyography musculoskeletal injuries Tommy John surgery overhead sports ulnar collateral ligament (UCL) injury prevention Sports GV557-1198.995
Acceso en línea:	https://doaj.org/article/40bb02097b9342b4a2d1f512d31fc845
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spelling	oai:doaj.org-article:40bb02097b9342b4a2d1f512d31fc8452021-12-01T16:36:40ZEstablishing the Role of Elbow Muscles by Evaluating Muscle Activation and Co-contraction Levels at Maximal External Rotation in Fastball Pitching2624-936710.3389/fspor.2021.698592https://doaj.org/article/40bb02097b9342b4a2d1f512d31fc8452021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fspor.2021.698592/fullhttps://doaj.org/toc/2624-9367Background: Baseball pitching is associated with a high prevalence of ulnar collateral ligament injuries, potentially due to the high external valgus load on the medial side of the elbow at the instant of maximal shoulder external rotation (MER). In-vitro studies show that external valgus torque is resisted by the ulnar collateral ligament but could also be compensated by elbow muscles. As the potential active contribution of these muscles in counteracting external valgus load during baseball pitching is unknown, the aim of this study is to determine whether and to what extent the elbow muscles are active at and around MER during a fastball pitch in baseball.Methods: Eleven uninjured pitchers threw 15 fastball pitches. Surface electromyography of six muscles crossing the elbow were measured at 2000 Hz. Electromyography signals were normalized to maximal activity values. Co-contraction index (CCI) was calculated between two pairs of the flexor and extensor elbow muscles. Confidence intervals were calculated at the instant of MER. Four ranges of muscle activity were considered; 0–20% was considered low; 21–40% moderate; 41–60% high and over 60% as very high. To determine MER, the pitching motion was captured with a highspeed camera at 240 Hz.Results: The flexor pronator mass, pronator teres, triceps brachii, biceps brachii, extensor supinator mass and anconeus show moderate activity at MER. Considerable variation between participants was found in all muscles. The CCI revealed co-contraction of the two flexor-extensor muscle pairs at MER.Interpretation: The muscle activation of the flexor and pronator muscles at MER indicates a direct contribution of forearm muscles crossing the medial side of the elbow in counteracting the external valgus load during fastball pitching. The activation of both flexor and extensor muscles indicates an in-direct contributory effect as the combined activity of these muscles counteract opening of the humeroulnar joint space. We believe that active muscular contributions counteracting the elbow valgus torque can be presumed to relieve the ulnar collateral ligament from maximal stress and are thus of importance in injury risk assessment in fastball pitching in baseball.Bart van TrigtEva GaljeeMarco J. M. HoozemansFrans C. T. van der HelmDirkJan H. E. J. VeegerFrontiers Media S.A.articleelectromyographymusculoskeletal injuriesTommy John surgeryoverhead sportsulnar collateral ligament (UCL)injury preventionSportsGV557-1198.995ENFrontiers in Sports and Active Living, Vol 3 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	electromyography musculoskeletal injuries Tommy John surgery overhead sports ulnar collateral ligament (UCL) injury prevention Sports GV557-1198.995
spellingShingle	electromyography musculoskeletal injuries Tommy John surgery overhead sports ulnar collateral ligament (UCL) injury prevention Sports GV557-1198.995 Bart van Trigt Eva Galjee Marco J. M. Hoozemans Frans C. T. van der Helm DirkJan H. E. J. Veeger Establishing the Role of Elbow Muscles by Evaluating Muscle Activation and Co-contraction Levels at Maximal External Rotation in Fastball Pitching
description	Background: Baseball pitching is associated with a high prevalence of ulnar collateral ligament injuries, potentially due to the high external valgus load on the medial side of the elbow at the instant of maximal shoulder external rotation (MER). In-vitro studies show that external valgus torque is resisted by the ulnar collateral ligament but could also be compensated by elbow muscles. As the potential active contribution of these muscles in counteracting external valgus load during baseball pitching is unknown, the aim of this study is to determine whether and to what extent the elbow muscles are active at and around MER during a fastball pitch in baseball.Methods: Eleven uninjured pitchers threw 15 fastball pitches. Surface electromyography of six muscles crossing the elbow were measured at 2000 Hz. Electromyography signals were normalized to maximal activity values. Co-contraction index (CCI) was calculated between two pairs of the flexor and extensor elbow muscles. Confidence intervals were calculated at the instant of MER. Four ranges of muscle activity were considered; 0–20% was considered low; 21–40% moderate; 41–60% high and over 60% as very high. To determine MER, the pitching motion was captured with a highspeed camera at 240 Hz.Results: The flexor pronator mass, pronator teres, triceps brachii, biceps brachii, extensor supinator mass and anconeus show moderate activity at MER. Considerable variation between participants was found in all muscles. The CCI revealed co-contraction of the two flexor-extensor muscle pairs at MER.Interpretation: The muscle activation of the flexor and pronator muscles at MER indicates a direct contribution of forearm muscles crossing the medial side of the elbow in counteracting the external valgus load during fastball pitching. The activation of both flexor and extensor muscles indicates an in-direct contributory effect as the combined activity of these muscles counteract opening of the humeroulnar joint space. We believe that active muscular contributions counteracting the elbow valgus torque can be presumed to relieve the ulnar collateral ligament from maximal stress and are thus of importance in injury risk assessment in fastball pitching in baseball.
format	article
author	Bart van Trigt Eva Galjee Marco J. M. Hoozemans Frans C. T. van der Helm DirkJan H. E. J. Veeger
author_facet	Bart van Trigt Eva Galjee Marco J. M. Hoozemans Frans C. T. van der Helm DirkJan H. E. J. Veeger
author_sort	Bart van Trigt
title	Establishing the Role of Elbow Muscles by Evaluating Muscle Activation and Co-contraction Levels at Maximal External Rotation in Fastball Pitching
title_short	Establishing the Role of Elbow Muscles by Evaluating Muscle Activation and Co-contraction Levels at Maximal External Rotation in Fastball Pitching
title_full	Establishing the Role of Elbow Muscles by Evaluating Muscle Activation and Co-contraction Levels at Maximal External Rotation in Fastball Pitching
title_fullStr	Establishing the Role of Elbow Muscles by Evaluating Muscle Activation and Co-contraction Levels at Maximal External Rotation in Fastball Pitching
title_full_unstemmed	Establishing the Role of Elbow Muscles by Evaluating Muscle Activation and Co-contraction Levels at Maximal External Rotation in Fastball Pitching
title_sort	establishing the role of elbow muscles by evaluating muscle activation and co-contraction levels at maximal external rotation in fastball pitching
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/40bb02097b9342b4a2d1f512d31fc845
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Establishing the Role of Elbow Muscles by Evaluating Muscle Activation and Co-contraction Levels at Maximal External Rotation in Fastball Pitching

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