Publications

Background: The flexor-pronator muscles (FPM) and their common tendon (CT) are essential in protecting the medial ulnar collateral ligament against elbow valgus stress during pitching. This study aimed to investigate the effect of repetitive pitching on FPM strength and CT stiffness.

Methods: Fifteen healthy males (mean age: 21.8 ± 1.3-years-old) with over 5 years of baseball experience performed a series of 100 full-effort fastball pitches. We measured grip and isolated digital flexion strength of the second, third, and fourth digits before and after the pitching task. The decline in muscle strength was determined using the rate of change in muscle strength after pitching relative to that before. CT stiffness was measured using a hand-held myotonometer device at rest and during grip motion at 50% maximum voluntary contraction. The increase in CT stiffness during grip motion relative to rest was calculated as the augmentation rate of CT stiffness. Statistical analyses were performed to compare the changes in grip strength, digital flexion strength, and CT stiffness due to pitching. Additionally, the reduction rate of muscle strength was compared among various strength variables. Correlation coefficients were used to evaluate the relationships between the augmentation rate of CT stiffness after pitching and the reduction rate in any muscle strength.

Results: Grip and isolated digital flexion strengths decreased significantly after pitching (P < 0.01). The decline in muscle strength was significantly higher for all isolated digital strengths than that for grip strength (P < 0.05). CT stiffness was augmented with grip motion compared to that at rest pre- and post-pitching (P < 0.001). However, no change in CT stiffness due to pitching was observed, regardless of the grip motion (P > 0.05). Additionally, a lower augmentation rate of CT stiffness after pitching was moderately associated with the greater reduction rate of the second digital flexion strength (r = 0.607, P = 0.016) without other relationships.

Conclusion: This study found reduced grip and digital flexion strength after pitching; with no change in CT stiffness. However, given the consequences of correlation analyses, individuals with a more prominent reduction in second digital flexion strength due to pitching were impaired in CT stiffness augmentation after pitching. Digital flexion strength represents the strength of the flexor digitorum superficial; therefore, this study suggests that forearm FPM, particularly the second digit of the flexor digitorum superficial, is an important factor for enhancing CT stiffness.

Keywords: baseball, ulnar collateral ligament, flexor-pronator muscles, flexor digitorum superficial, common tendon

The current study investigated the acute effects of repetitive pitching on grip strength, isolated digital flexion strength, and CT stiffness. A single bout of repetitive pitching induced muscle fatigue in dynamic medial elbow stabilizers, especially in digital flexors. Despite these, no statistically significant changes were observed in CT stiffness. However, a greater reduction rate of the second digital flexor strength exhibited a moderate correlation with a lower augmentation rate of the CT stiffness after pitching. This indicates that individuals exhibiting severe fatigue of the second digital flexion strength cannot augment CT stiffness during grip motion. Therefore, the second digit of the FDS may play a vital role in increasing CT stiffness to resist elbow valgus stress during pitching.