PhysicalTherapy.com Phone: 866-782-6258


Phases of Pitching Cycle Related to Potential Injury

Ryan Bitzel, MPT

January 1, 2024

Share:

Question

What are the five phases of a pitching cycle, and which two phases are identified as critical in terms of potential injury to the UCL (ulnar collateral ligament)?

Answer

The five phases of the pitching cycle are as follows:

1. Windup: Initiates with the pitcher's initial movement, going into a single-leg stance, and ends when the pitcher's hands break apart.

2. Early Cocking: Begins when the pitcher's hands break apart and the ball is removed from the glove. The shoulder goes into abduction and external rotation, ending when the pitcher's foot hits the ground.

3. Late Cocking: Starts when the pitcher's foot hits the ground, with the shoulder continuing into abduction and external rotation, and the elbow flexing between 90 and 120 degrees. This phase concludes at max external rotation.

4. Acceleration: Begins when max external rotation is achieved, and the shoulder starts to come forward. The shoulder goes into abduction and internal rotation, while the elbow starts to go into extension. This phase ends at ball release.

5. Deceleration or Follow-Through: Begins at ball release, and the shoulder completes its move, going through abduction and internal rotation. The key here is the elbow's rapid extension, terminating with the termination of movement.

The two critical phases identified for potential UCL (ulnar collateral ligament) injury are:

1. Late Cocking Phase: Large valgus forces are experienced on the UCL during this phase, especially when the shoulders are at max external rotation, and the elbow is flexed between 90 and 120 degrees.

2. Deceleration Phase: High forces on the elbow, particularly compression forces on the medial elbow, occur during rapid extension of the elbow. This phase is crucial and can lead to valgus extension overload.

Despite the protection provided by the flexor-pronator mass, which absorbs about half of the forces, the UCL still bears a significant load, and cumulative microtrauma during repetitive pitching can lead to UCL injuries, including insufficiency, partial tearing, or complete tearing. The mechanism of injury differs between adults and adolescents, with adolescents more prone to avulsion injuries due to the weaker growth plates compared to the UCL. In adults, the UCL is weaker than mature bone, so you will see more mid-substance UCL tears.  


ryan bitzel

Ryan Bitzel, MPT

Ryan is an adjunct professor in the physical therapy department at Walsh University (North Canton, OH). Previously, he served as the Major League Physical Therapist for the Seattle Mariners baseball team (2018- 2022) and as the Minor League Rehabilitation Coordinator for the San Diego Padres Organization (2010-2017). He also completed a minor league internship program with the Houston Astros minor league affiliate Salem Avalanche in 2003. He began his career as a staff physical therapist for Proaxis Therapy at the Steadman-Hawkins Clinic of the Carolinas (Spartanburg, SC) from 2006-2010. He also served as a consultant PT for the Greenville Drive minor league baseball team. He graduated with his Master’s degree in Physical Therapy from Walsh University in 2006 and currently resides in Massillon, OH.


Related Courses

The Management of Ulnar Collateral Ligament (UCL) Injuries in Baseball Athletes
Presented by Ryan Bitzel, MPT
Recorded Webinar

Presenter

Ryan Bitzel, MPT
Course: #4521Level: Intermediate2 Hours
  'Thank you for a wonderful course'   Read Reviews
This course discusses risk factors associated with ulnar collateral ligament (UCL) injuries spanning from youth baseball to the professional level. Current concepts of both conservative and surgical management of UCL injuries, as well as injury prevention methods for adolescent/high school baseball pitchers, will also be discussed.

Clinical Use of the Reformer for the Lower Body
Presented by Rhondi Miller, PT, MS, SCS, ATC
Recorded Webinar

Presenter

Rhondi Miller, PT, MS, SCS, ATC
Course: #3329Level: Intermediate2 Hours
  'Challenges the brain to see all that is going on in the body'   Read Reviews
The reformer is an effective tool for rehabilitating the lower body. This course will provide exercises appropriate for progressing lower extremity rehab from ankle injury, to post-op knees, to hip pain. Exercises focus on the concepts of motor control, stability/mobility system balance, movement competency and training functional movement patterning. This course is part three of our four part series on Pilates. This course is directly related to the practice of physical therapy and athletic training and therefore appropriate for the PT/PTA and AT.

Complex and Chronic Impairment in Concussion
Presented by Laura Morris, PT, NCS
Recorded Webinar

Presenter

Laura Morris, PT, NCS
Course: #4353Level: Intermediate2 Hours
  'Nice common sense approach'   Read Reviews
This webinar will include an exploration of the various etiologies of dysfunction following mTBI, including, headache, visual/oculomotor impairment, chronic dizziness, and pain. The challenging issue of prioritizing intervention and appropriate referral to other medical practitioners will be discussed. This course is directly related to the practice of physical therapy and athletic training and is therefore appropriate for the PT/PTA and AT.

Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for .5 hour of general and 1.5 hour of Direct Access CE credit.

Clinical Use of the Reformer for the Upper Body
Presented by Rhondi Miller, PT, MS, SCS, ATC
Recorded Webinar

Presenter

Rhondi Miller, PT, MS, SCS, ATC
Course: #3330Level: Intermediate2 Hours
  'I liked the videos demonstrating the various exercises'   Read Reviews
A reformer is an effective tool for rehabilitating the upper body. This course will provide exercises appropriate for progressing upper extremity rehab from scapular control to glenohumeral stability, to fully-integrated shoulder girdle training. Exercises focus on the concepts of motor control, stability/mobility system balance, movement competency and training functional movement patterning. This is part four of our four-part series on Pilates. This course is directly related to the practice of physical therapy and athletic training and is therefore appropriate for the PT/PTA and AT.

Cultivating a Sustainable Core, Part II: Therapeutic Interventions from Yoga, Physical Therapy, and Sports Medicine in Rehabilitation
Presented by Liz Gillem Duncanson, PT, MPT, ATC, CSCS, PYT, RYT-200, C-IAYT
Recorded Webinar

Presenter

Liz Gillem Duncanson, PT, MPT, ATC, CSCS, PYT, RYT-200, C-IAYT
Course: #3332Level: Intermediate2 Hours
  'Thorough - nice explanations, videos'   Read Reviews
This course is a continuation of the course titled, "Yoga Therapeutics to Cultivate A Sustainable Core" We build on the evidence-based and anatomical foundation of the dynamic core and apply the clinical reasoning of progressing patients and athletes through therapeutic exercises. This course is directly related to the practice of physical therapy and athletic training and is appropriate for the PT,PTA and AT.

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.