Elbow stress in youth softball windmill pitchers: predictors of increased torque

Purpose: To assess torque at the elbow in the underhand throwing motion utilizing wearable sensor technology and discover the predictors of medial elbow toque in young female softball pitchers. Methods: Female softball players 12 to 18 years old whose primary position was pitcher and actively participating in sport were studied. Players experiencing throwing arm pain, lower extremity injury hindering pitching motion, or prior surgery were excluded. Age, handedness, height, weight, and throwing arm dimensions were measured and recorded. Pitchers threw 15 pitches, max effort from 43 feet and were given 30 to 60 second rest between pitches. A wearable sensor was placed inside an athletic compression sleeve which recorded data. Measurements included medial elbow torque (Newton-meters; NM), arm speed (peak rotational velocity of the forearm; in rotations per minute; RPM), arm slot (forearm angle in relation to the ground at release; in degrees), and shoulder rotation (maximum forearm angle during the 12 o’clock phase; in degrees). Peak ball velocity in miles per hour (MPH) was measured by a radar gun. Results: Twenty females mean age 15.2 years (range, 12.6-16.9 years) achieved an average elbow stress of 35.5 NM (14-78 NM). Average arm speed measured 583.8 RPM (3502.8 deg/sec) and ball speed ranged from 33-56 mph with an average of 44.1 mph. Multivariate analysis demonstrated arm stress significantly associated with increasing age (P-value 0.00003), arm length (P-value 0.000006); however, increased forearm length measured a decreased arm stress (P-value 0.00007). Conclusions: There was significant stress measured across the medial elbow in young softball pitchers. Elbow torque was associated with increasing age and total arm length; however, increased forearm length was associated with decreased elbow torque.