Does High Medial Elbow Stress During Pitching Compromise the Dynamic Stabilizers of The Elbow?
Malachy P McHugh, Michael J Mullaney
PMID 37547846WHAT IT FOUND
Pitchers with high elbow stress showed significantly more fatigue in finger flexion strength than those with low stress.
Grip strength did not change. This suggests finger flexion tests detect specific muscle fatigue that general grip tests miss.
Key findings
01Middle and ring finger flexion strength showed greater fatigue in pitchers with high valgus elbow torque compared to those with low torque.
02Grip strength changes were not affected by elbow valgus torque levels.
03EMG testing confirmed that middle and ring finger flexion exercises preferentially activate the flexor digitorum superficialis and flexor carpi ulnaris muscles.
STILL TO COME
How it was doneWhat they found
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What it does not show
The sample size was very small (10 pitchers), and the study was underpowered to fully assess recovery the day after the game. Pitchers threw fewer pitches (58 on average) than in typical games because these were preseason scrimmages. The finger flexion test is not yet established as a reliable clinical measure for other therapists, as the primary tester had over 20 years of experience. Pitch velocity was measured at a different time than the games, which may affect the accuracy of torque-velocity relationships.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that grip strength is a valid proxy for medial elbow stability. This study found that while finger flexion strength declined in high-stress pitchers, grip strength remained unchanged, meaning a normal grip test could miss significant fatigue in the specific muscles stabilizing the elbow.