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Computing Muscle, Ligament, and Osseous Contributions to the Elbow Varus Moment During Baseball Pitching

Abstract

Baseball pitching imposes a dangerous valgus load on the elbow that puts the joint at severe risk for injury. The goal of this study was to develop a musculoskeletal modeling approach to enable evaluation of muscle–tendon contributions to mitigating elbow injury risk in pitching. We implemented a forward dynamic simulation framework that used a scaled biomechanical model to reproduce a pitching motion recorded from a high school pitcher. The medial elbow muscles generated substantial, protective, varus elbow moments in our simulations. For our subject, the triceps generated large varus moments at the time of peak valgus loading; varus moments generated by the flexor digitorum superficialis were larger, but occurred later in the motion. Increasing muscle–tendon force output, either by augmenting parameters associated with strength and power or by increasing activation levels, decreased the load on the ulnar collateral ligament. Published methods have not previously quantified the biomechanics of elbow muscles during pitching. This simulation study represents a critical advancement in the study of baseball pitching and highlights the utility of simulation techniques in the study of this difficult problem.

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Acknowledgments

This work was funded by NIH Grant: EB011615 and the Searle Funds of the Chicago Community Trust.

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Correspondence to Wendy M. Murray.

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Associate Editor Amit Gefen oversaw the review of this article.

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Buffi, J.H., Werner, K., Kepple, T. et al. Computing Muscle, Ligament, and Osseous Contributions to the Elbow Varus Moment During Baseball Pitching. Ann Biomed Eng 43, 404–415 (2015). https://doi.org/10.1007/s10439-014-1144-z

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  • DOI: https://doi.org/10.1007/s10439-014-1144-z

Keywords

  • Ulnar collateral ligament
  • Musculoskeletal model
  • Valgus torque
  • Dynamic simulation