There has been an explosion of interest in fast-pitch softball. This certainly has some of its roots due to the amazing performance of the American team in the last Olympics. Both the numbers of girls and women and the level of play have increased dramatically. Unfortunately, little is known regarding the biomechanics and types of injuries patterns seen in players, particularly pitchers. Recently, research interest has produced two studies which help begin the process of better understanding and preventing and rehabilitating common injuries.
A study by Lossli et al.1 was a retrospective search for the types of injuries seen in collegiate softball pitchers as observed by their trainers. The incidence of time-loss injury was 45%; of these, 27% were due to overuse injury at the shoulder.
A more recent study performed by researchers at the Biomechanics Laboratory in Inglewood, California, used electromyographic (EMG) recording of shoulder muscle activity in fast-pitch softball pitchers.2 Previously, this same group has measured the shoulder muscle activity in tennis, baseball, swimming, and golf. This current study used 10 collegiate-level pitchers. Fine-wire intramuscular electrodes were implanted into six shoulder muscles of each pitcher. The pitchers were videotaped and underwent motion analysis to define the different phases of the softball pitching activity. This also provides a frame of reference for statements regarding peak muscle activity.
The frame of reference is a side view of the body. If the pitching arm can be viewed as the hand on a clock with full circumduction moving from 12 o'clock through 3, 6, 9, and back to 12, the 12 o'clock position is full elevation, 90 degrees of shoulder flexion would be considered the 3 o'clock position, and the arm by the side as the 6 o'clock position. Two almost complete revolutions are performed prior to ball release. The phases based on this system are:
A review of muscle activity during softball pitching should aid attempts at prevention and rehabilitation of soft-tissue and biomechanical injury about the shoulder. Observation of pitching may reveal flaws or weaknesses in a specific phase that may be corrected through appropriate myofascial release or exercise. Although this study focused on the shoulder's contribution to pitching, the reader must be reminded that much of the stress on the shoulder is reduced by the contribution and synchrony of trunk and lower body participation. Attention to these areas must not be ignored.
References
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
