Submarine Pitchers EXERCISES TAILORED TO MEET THE NEEDS OF SUBMARINE PITCHERS Independent Research Presented to The Faculty of the College of Health Professions and Social Work Florida Gulf Coast University In Partial Fulfillment Of the Requirement for the Degree of Doctorate of Physical Therapy By Kurtis Mullaney and Michael Klein 2015 Submarine Pitchers APPROVAL SHEET This independent research is submitted in partial fulfillment of the requirements for the degree of Doctorate of Physical Therapy ______________________________________ Kurtis Mullaney Michael Klein Approved: May 2015 ______________________________________ Dr. Shawn Felton, EdD, ATC, LAT Committee Chair ______________________________________ Professor Kelley Henderson, M.Ed., LAT, ATC Committee Member The final copy of this independent research has been examined by the signatories, and we find that both the content and the form meet acceptable presentation standards of scholarly work in the above mentioned discipline. Submarine Pitchers Acknowledgements Mike and I would like to thank several people for helping us to complete our independent research project. First of all, we would like to thank the overwhelming support we have always received from our families and loved ones, including Kelly, Michael, Kyle, Kameron, Karson, and Kolby Mullaney, and Candice, Hannah, and Eva Klein. Also, we would like to thank Dr. Shawn Felton and Professor Kelley Henderson for always rapidly responding, being attentive to detail, showing immense patience, and working tirelessly to help us with this research. We would also like to thank Dr. Arie van Duijn for his contributions in terms of helping us learn and utilize the equipment needed for this project. Other faculty that aided in completing this study included Dr. Mollie Venglar, Professor Tom Bevins, and Dr. Dennis Hunt. This project took a lot of time, effort, and patience from all of us involved and we are extremely grateful for the help. We would also like to thank all of the participants involved, who sacrificed their time to help make this research happen. Lastly we would like to thank our classmates, who were always there to support us and to keep us encouraged even when we hit major roadblocks along the way. This has been a difficult but rewarding journey, and we would not have been able to complete it without the support of all of those involved. Submarine Pitchers 4 Table of Contents Acknowledgements ................................................................................................................... 3 Abstract ..................................................................................................................................... 5 Introduction ............................................................................................................................... 6 Phases of Throwing ............................................................................................................... 9 Electromyography ............................................................................................................... 12 Motion Analysis .................................................................................................................. 14 Purpose .................................................................................................................................... 15 Research Question .................................................................................................................. 16 Hypothesis ............................................................................................................................... 16 Methods ................................................................................................................................... 16 Subjects ............................................................................................................................... 18 Instrumentation ................................................................................................................... 19 Procedure ............................................................................................................................ 20 Exercise Descriptions .......................................................................................................... 23 Data Analysis ...................................................................................................................... 26 Results ..................................................................................................................................... 26 Discussion ............................................................................................................................... 33 Limitations .......................................................................................................................... 35 Future Research .................................................................................................................. 36 Conclusion .............................................................................................................................. 37 References ............................................................................................................................... 39 Submarine Pitchers 5 Abstract Background: In order to remain healthy while performing at a high level, athletes must exercise in a manner that is functional and translatable to the movement being produced during sport. In order to accomplish this, exercises are often modified to meet the specific demands of different sporting activities. Purpose: Although many studies have been performed on several aspects of baseball pitching, few studies have focused on the submarine pitcher. This pilot study investigated the difference in the activation patterns of select muscles for subjects conducting two exercises: the cable retraction with external rotation exercise and the modified version of the same exercise, which had been tailored to the submarine pitcher. The following research was performed to advance the literature devoted to the specific needs of submarine pitchers, and to raise awareness on the lack of literature devoted to this style of throwing. Subjects: 16 healthy males ages 18-35 with previous high school, college, and/or professional baseball experience participated in this study. Methods: Each subject was observed performing five repetitions of the two exercises, while motion and muscle activation patterns of the posterior deltoid, the infraspinatus, the middle trapezius, and the lower trapezius were captured using the Qualisys Motion Capture System in conjunction with the Noraxon SEMG system. Results: No significant differences were found between the two exercises in terms of muscle activation patterns of the four muscles being studied. A positive correlation was found between the muscle activation patterns of the two exercises, indicating that both exercises may accomplish the same goal when it comes to strengthening the four targeted muscles. A significant difference was found in the angle of abduction in which peak muscle activation occurred for the posterior deltoid (13°), the middle trapezius (17°), and lower trapezius (14°). Submarine Pitchers 6 Introduction The motion of throwing a baseball is widely considered one of the most dynamic and demanding motions of the human body (Fleisig, Andrews, Dillman, & Escamilla, 1995). Overhead throwing places an extreme amount of stress on the structures of the shoulder at end ranges of motion. When pitching, the internal torque of the shoulder at the glenohumeral joint during arm acceleration has been reported to reach 10,000°/sec, and the distraction force placed on the glenohumeral joint during arm deceleration has been reported to reach 947 N (Pretz, 2004). As a result of the stresses that are placed on the glenohumeral joint, and the inherent instability of the glenohumeral joint, pitching accounts for 75% of all collegiate baseball injuries, with rotator cuff tendonitis being the leading injury (Scher, Anderson, Weber, Bajorek, Rand, & Bey, 2010). In order to pitch a baseball without causing injury to the upper extremity, the athlete must have adequate strength, endurance, power, and neuromuscular control of the involved musculature. A goal of sports medicine clinicians is to decrease the incidence of injury and maximize performance by prescribing exercises that maximize these attributes (Carter, Kaminski, Douex, Knight, & Richards, 2007). Therefore, it is imperative clinicians continue to conduct research and determine the most effective methods of developing the upper extremities of pitchers to prepare them to address the demands associated with throwing a baseball. It is also vital to acknowledge the current lack of literature regarding biomechanics and muscle activation of the unconventional baseball pitcher, specifically the underhand or submarine pitcher, and appropriate training methods for these athletes. Two factors determine an individual’s style of pitching. These include the lateral trunk flexion angle at ball release and the amount of shoulder abduction of the throwing Submarine Pitchers 7 arm at ball release (Truedson, Sexton, & Pettitt, 2012). There are four described styles of pitching, which are loosely defined based on the factors stated above. These include the overhand, sidearm, three-quarter, and submarine pitching styles (Figure 1). Pitchers are labeled as overhand style pitchers when there is significant