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1
Chalmers, Peter, Rocco Bassora, Chris Inzerillo, Andrew Beharrie, Anthony Romeo, and Brandon Erickson. "Training with Lighter Baseballs Increases Velocity Without Increasing Injury Risk." Orthopaedic Journal of Sports Medicine 8, no. 7_suppl6 (2020): 2325967120S0034. http://dx.doi.org/10.1177/2325967120s00341.
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Objectives: Pitch velocity has become an increasingly popular metric by which pitchers are graded and compared. Training programs that utilize weighted balls have been effective in increasing velocity but at the cost of increased injury risk. The purpose of this study was to determine if a baseball pitcher-training program utilizing lighter baseballs could increase fastball velocity without increasing injury risk. The author’s hypothesized that the training program with lighter baseballs would increase fastball velocity without causing injuries during the training program to the participants Methods: All baseball pitchers who participated in a 15-week pitching mechanic and velocity training program were included. Training program was broken down into three phases, and each participant went through the same program. Lighter balls (4oz and 3oz) and standard baseballs (5oz) were utilized as part of the training program. Weighted (heavier) balls were not used. Velocity was measured at four time points throughout the program. Injury rates for all players were recorded throughout the entire program. Results: 48 male pitchers aged 10-17 (average age: 14.7 +/- 1.8) years started the program and 44 had complete data and were included in the analysis. No pitcher sustained a baseball-related injury while participating in the training program (one player broke his ankle playing basketball, one player moved, one did not have baseline velocity data, and one experienced biceps soreness after participating in back to back showcases against recommendations). Fastball velocity increased by an average of 4.8mph (95% confidence intervals 4.1 - 5.5mph). Overall 43/44 players (98%) had an increase in fastball velocity over the course of the program. Conclusions: A 15-week baseball pitcher-training program with lighter baseballs significantly improved pitching velocity without significantly increasing injuries. Lighter baseballs should be considered instead of weighted baseballs when attempting to increase a pitcher’s velocity.
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Erickson, Brandon J., Peter N. Chalmers, Michael J. Axe, and Anthony A. Romeo. "Exceeding Pitch Count Recommendations in Little League Baseball Increases the Chance of Requiring Tommy John Surgery as a Professional Baseball Pitcher." Orthopaedic Journal of Sports Medicine 5, no. 3 (2017): 232596711769508. http://dx.doi.org/10.1177/2325967117695085.
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Background: Empirical evidence has suggested a connection between youth pitch counts and subsequent elbow injury. For players within the Little League World Series (LLWS), detailed historical player data are available. Some of these players progress to both professional play and require an ulnar collateral ligament reconstruction (UCLR). Purpose: To determine the percentage of LLWS pitchers who proceed to play professional (major or minor league) baseball, the rate of UCLR in former LLWS pitchers who played professional baseball, and the risk to those who exceeded current pitch count recommendations while playing in the LLWS. Study Design: Cohort study; Level of evidence, 3. Methods: All LLWS pitchers from 2001 through 2009 from all teams and countries were identified, and all performance data were extracted. A professional (major and minor league) baseball database was then searched to determine whether each former LLWS pitcher played professional baseball. These professional players were then searched for using publicly available databases to determine whether they underwent UCLR. Results: Overall, 638 adolescents pitched in the LLWS between 2001 and 2009; 62 (10%) progressed to professional play. Of the 56 minor league players, 25 (45%) pitched. Of the 6 Major League Baseball players, 3 (50%) pitched. Three former LLWS pitchers (5%) who played professionally underwent UCLR. In former LLWS pitchers who exceeded pitch counts and played professionally, 50% (2/4) required UCLR, while only 1.7% (1/58) of those who did not exceed pitch count recommendations required UCLR ( P = .009). Similarly, among former LLWS pitchers who subsequently played professionally, 23.1% of those who played as a pitcher required UCLR while 0% of those who also played other positions required UCLR ( P = .008). Conclusion: Progression from LLWS pitching to professional baseball is uncommon. Among youth players, both diversification (playing other positions besides pitcher) as well as following current pitch limit regulations may protect against UCLR.
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Greiner, Justin J., Geoffrey S. Baer, and Timothy A. McGuine. "PITCH COUNTS IN YOUTH BASEBALL PLAYERS: A COMPARISON TO PITCH SMART GUIDELINES." Orthopaedic Journal of Sports Medicine 8, no. 4_suppl3 (2020): 2325967120S0023. http://dx.doi.org/10.1177/2325967120s00234.
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Background: Overthrowing injuries in youth baseball players have been linked with pitching behaviors such as as high pitch counts, inadequate rest, and participating in throwing activities throughout the year. Pitch Smart guidelines were developed as an initiative between Major League Baseball and USA Baseball to provide recommendations for youth baseball athletes to help decrease the risk of injuries from overthrowing. Purpose: The purpose of this study was to perform a quantitative analysis of pitch counts in youth baseball players and evaluate compliance with Pitch Smart guidelines. Methods: Local youth baseball teams competing in nine and under (9U) to fourteen and under (14U) age brackets were recruited to track pitches during the summer baseball season. A tablet with a pitch counting application was used to record pitches for each pitcher of the study team and their opponents. Days of rest between games was calculated for the study teams only and not opponents. Pitch counts and days of rest for each pitcher were compared to the recommended Pitch Smart guidelines. Continued prospective collection of data is ongoing through the 2019 summer. Results: Interim review of 23 youth baseball teams using a tablet allowed analysis of 181 pitchers of the 23 study teams using tablets and 285 pitchers of 98 opponent teams. Violation of Pitch Smart guidelines occurred in 14 (60.9%) study teams and 29 (16.0%) pitchers. Of these violations, 27 (93%) pitchers had insufficient rest between games while 2 (7%) pitchers exceeded daily maximum pitches. Further, 8 (35%) teams had more than one player violate guidelines. Pitch smart daily maximum pitch counts were violated in 2 of 98 (2.0%) opponent teams and 2 of 285 (0.7%) of opponent pitchers Conclusion: A total of 61% of youth baseball teams and 16% of pitchers in this study violated Pitch Smart guidelines at interim analysis. The vast majority of guideline violations were due to inadequate rest between games. The high rate of Pitch Smart violations suggests that further education of coaches, parents, and athletes regarding these guidelines, with emphasis on rest recommendations, is necessary to prevent overthrowing injuries in youth baseball players. [Table: see text]
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Trotter, Cameron A., Justin J. Greiner, Tim McGuine, and Geoffrey S. Baer. "PITCHING IN YOUTH SOFTBALL: HOW MUCH ARE PITCHERS THROWING?" Orthopaedic Journal of Sports Medicine 9, no. 7_suppl3 (2021): 2325967121S0004. http://dx.doi.org/10.1177/2325967121s00049.
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Background: Softball is a popular sport among youth female athletes. While multiple youth baseball studies have evaluated the relationship of injury to pitch counts, there is a paucity of literature for youth softball. In contrast to the numerous youth baseball leagues adhering to pitching guidelines, pitch counts are frequently not enforced in youth softball which results in pitchers with exceedingly high volumes. Purpose: The purpose of this study was to perform a quantitative analysis of pitching volume in youth softball players. We hypothesized that the majority of pitches would be thrown by a small proportion of pitchers on each team. Methods: Seventy youth softball teams including 538 pitchers competing in age brackets eight and under (8U) to fourteen and under (14U) between Spring 2017 and Fall 2019. Game dates and pitch counts were collected for each player using an electronic application. Games played on two or more consecutive days were defined as a tournament. The three highest-volume pitchers from each team defined by total season pitches were analyzed for comparison to the average pitcher. Results: 538 pitchers on 70 teams were included. The average pitcher threw 813 pitches per year and appeared in 20.0% of games and the average high-volume pitcher threw 2500 pitches per year and appeared in 54.5% of games. The highest-volume pitcher from each team threw 40% of all recorded pitches, the second highest 27.2%, and the third highest 15.2%, totaling 82.4% of all team pitches. Single day pitch counts of >100 and >200 occurred in 17.7%, and 1.1% of same day games with the average pitcher and in 31.2%, and 2.4% of same day games with the average highest-volume pitcher. Tournament pitch counts of >100 and >200 occurred in 51.0% and 13.8% of tournaments with the average pitcher and in 81.4% and 30.8% of tournaments with the average highest-volume pitcher. The average and highest-volume pitcher threw pitches in two or more games on the same day in 37.5% and 48.6% of possible games while pitching two or more consecutive days in 64.0% and 79.6% of possible games, respectively. Conclusion: Softball pitchers throw high volumes of pitches while also pitching multiple days consecutively. A disparity among pitchers on softball teams exists as 82.4% of team pitches are thrown by three pitchers. These high-volume pitchers may be engaging in unsustainable pitching practices that could predispose to injury. Tables: [Table: see text]
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Okoroha, Kelechi R., Jason E. Meldau, Vincent A. Lizzio, et al. "Effect of Fatigue on Medial Elbow Torque in Baseball Pitchers: A Simulated Game Analysis." American Journal of Sports Medicine 46, no. 10 (2018): 2509–13. http://dx.doi.org/10.1177/0363546518782451.
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Background: The incidence of overuse injury to the elbow among baseball pitchers continues to rise, despite extensive efforts at pitch count regulations and emphasis on proper throwing mechanics. Purpose: To determine if the medial elbow experiences increased torque levels as a baseball pitcher fatigues through the course of a simulated game. Study Design: Descriptive laboratory study. Methods: High school and collegiate baseball pitchers were recruited for this simulated game study. Each pitcher completed a simulated game consisting of 6 innings and a standardized pitching scheme of fastballs, curveballs, and changeups. In total, each pitcher threw 90 pitches. Fatigue was reported per inning with a visual analog scale, and pitch velocity was captured per pitch with a radar gun. Outcome measures were assessed with a validated mobile sensor and included medial elbow torque, arm speed, arm rotation, and arm slot. Linear and quadratic regression modeling was used to evaluate the relationship between pitcher fatigue and pitching kinematics. Results: A total of 11 pitchers (mean age, 17.6 years; range, 15-20 years) completed the study. Visual analog scale fatigue scores increased 0.72 points per inning pitched ( P < .01, effect size = 0.64). Medial elbow torque also increased beyond inning 3, with an increase of 0.84 N·m each inning ( P < .01, effect size = 0.08), while pitch velocity decreased (0.28 mph per inning, P < .01, effect size = 0.27). Fastballs generated the greatest amount of medial elbow torque (49.3 ± 1.4 N·m, P < .01, effect size = 0.24). There were no differences in arm rotation ( P = .42) or arm speed ( P = .80) as the game progressed. However, arm slot decreased with each successive inning (0.73° on average per inning, P = .03, effect size = 0.12). No adverse outcomes were noted with use of the mobile sensor. Conclusion: In this simulated game analysis, pitchers experienced increased fatigue after each successive inning. While the average pitch velocity declined with each successive inning, the torque on the medial elbow increased after inning 3. These findings signify a possible relationship between fatigue and injury risk.
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Whiteside, David, Douglas N. Martini, Ronald F. Zernicke, and Grant C. Goulet. "Changes in a Starting Pitcher’s Performance Characteristics Across the Duration of a Major League Baseball Game." International Journal of Sports Physiology and Performance 11, no. 2 (2016): 247–54. http://dx.doi.org/10.1123/ijspp.2015-0121.
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Purpose:With a view to informing in-game decision making as it relates to strategy and pitcher health, this study examined changes in pitching-performance characteristics across 9 innings of Major League Baseball (MLB) games.Methods:129 starting MLB pitchers met the inclusion criteria for this study. Pitch type, speed, ball movement, release location, and strike-zone data—collected using the MLB’s ball-tracking system, PITCHf/x—were obtained for 1,514,304 pitches thrown from 2008 to 2014.Results:Compared with the 1st inning, the proportion of hard pitches thrown decreased significantly until the 7th inning, while the proportions of breaking and off-speed pitches increased. Significant decreases in pitch speed, increases in vertical movement, and decreases in release height emerged no later than the 5th inning, and the largest differences in all variables were generally recorded between the 1st inning and the late innings (7–9). Pitchers were most effective during the 2nd inning and significantly worse in innings 4 and 6.Conclusion:These data revealed that several aspects of a starting pitcher’s pitching characteristics exhibited changes from baseline as early as the 2nd or 3rd inning of an MLB game, but this pattern did not reflect the changes in his effectiveness. Therefore, these alterations do not appear to provide reasonable justification for relieving a starting pitcher, although future work must address their relevance to injury. From an offensive standpoint, batters in the MLB should anticipate significantly more hard pitches during the early innings but more breaking and off-speed pitches, with decreasing speed, as the game progresses.
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Irawan, Fajar Awang, and Chuang Long-Ren. "Baseball and biomechanics: Injury prevention for baseball pitcher." Jurnal Keolahragaan 7, no. 1 (2019): 57–64. http://dx.doi.org/10.21831/jk.v7i1.24636.
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Pitching was the fastest motion in baseball. Upper extremity has important roles especially in shoulder, elbow, wrist, and fingers. The purpose of this study was to integrate the information in a resume of biomechanical pitching and baseball pitcher’s injuries. The data base used refers to PubMed, SAGE, and Elsevier and several relevance journals related to baseball and injuries. Source refers to the data since December 2017 to the oldest 2000 to get data source in baseball pitcher injuries. Upper arm has the prominent role when pitching to get maximum motion and joints stabilize. Rotator cuff muscle generate rotation in the shoulder while pitching and control shoulder joints in the lower arm’s muscles and joints. Baseball pitcher has a special skill in the strength, speed, and endurance. They had to keep their performance to avoid from injury especially shoulder and elbow injuries. Biomechanical analysis can help to evaluated performance in monitoring dan give recommendation to elevate skills and prevent injury. Knowledge and understanding about basic of pitching have to mastering before elevate to the next level. Further study can focus on the time for the pitcher to improve the skills and maximizing the pitch type to avoid from injuries.
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Makhni, Eric C., Jason E. Meldau, Jeff Stephens, et al. "Relationship Between Pitcher Fatigue and Medial Elbow Torque in Baseball Pitchers: A Simulated Game Analysis." Orthopaedic Journal of Sports Medicine 6, no. 7_suppl4 (2018): 2325967118S0007. http://dx.doi.org/10.1177/2325967118s00073.
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Objectives: The incidence of overuse injury to the elbow in baseball pitchers continues to rise, despite exhaustive efforts at pitch count regulations and emphasis on proper throwing mechanics. The goal of this study was to determine if the medial elbow experiences increased torque levels as the pitcher fatigues through the course of a simulated game. Methods: Competitive baseball pitchers were recruited for this simulated game study. Medial elbow torque was assessed using a validated mobile sensor that recorded medial elbow torque during the throwing motion. A radar gun was used to capture pitch velocity for each recorded pitch. Each pitcher completed a simulated game consisting of 6 innings and a standardized pitching scheme of fastballs, curveballs, and change-ups. Visual analog scores (VAS) measuring fatigue were recorded in between each inning. In total, each pitcher threw 90 pitches. Data was recorded every pitch to include ball velocity, medial elbow torque, arm speed, arm rotation, and arm slot. Results: A total of 11 pitchers (average age 17.6 years; range 15-20 years) completed the study. No adverse outcomes were noted with use of the mobile sensor. VAS scores increased 0.716 points per inning pitched (p<0.001). Medial elbow torque also was found to increase with successive innings, with an increase of 0.836 Nm each inning (p<0.001), while average pitch velocity was found to decrease as the game progressed (0.28 mile per hour decrease per inning; p<0.001). Fastballs generated the highest amount of medial elbow torque. There were no differences found in arm rotation or arm speed as the game progressed. However, the arm slot was found to decrease with each successive inning (0.731 degree decrease per inning; p<0.001). Conclusion: In this simulated game analysis, pitchers were noted to experience increase fatigue after each successive inning. While the average fastball velocity decreased from inning-to-inning, the medial elbow torque was found to increase, signifying a possible risk factor for overuse injury to the medial elbow.
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Tajika, Tsuyoshi, Noboru Oya, Tsuyoshi Ichinose, et al. "Relation between grip and pinch strength and pitch type in high school pitchers with and without elbow symptoms." Journal of Orthopaedic Surgery 28, no. 1 (2020): 230949901989074. http://dx.doi.org/10.1177/2309499019890743.
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Objective: Gripping and pinching a ball is a fundamentally important part of the kinetic chain for throwing baseball pitches of various types. This study of high school pitchers was conducted to assess the association between grip and pinch strength, the pitch type, and the history of elbow symptoms. Methods: We examined 133 high school baseball pitchers, all of whom had completed a self-administered questionnaire including items related to pitch type throwing ratios, the age at starting each pitch type, and throwing-related elbow joint pain sustained during the prior 3 years. We measured grip strength and the bilateral side tip, key, and palmar pinch strengths. Comparisons were made between the participants with and without an elbow symptom history to assess the grip and each pinch strength, throwing ratio of pitch type, and the age at starting to throw each pitch type. Results: Pitchers with an elbow symptom history exhibited less difference between the grip strength on the throwing side than those with no elbow symptom history ( p = 0.04). No difference was found between participants with and without an elbow symptom history in terms of pinch strength, the throwing ratios of pitch types, or the age at starting to throw pitches of each type. Positive significant association was found between pinch strength on the pitching side and the forkball and screwball throwing ratio ( r = 0.27, p = 0.002). Conclusion: Grip strength might influence high school baseball pitcher elbow conditions. The frequency of certain pitch types might develop pinch strength in high school baseball pitchers.
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Pareek, Ayoosh, Chad W. Parkes, Alexey A. Leontovich, et al. "Are Baseball Statistics an Appropriate Tool for Assessing Return to Play in Injured Players: An Analysis of Statistically Variability in Healthy Players Using a Machine Learning Approach." Orthopaedic Journal of Sports Medicine 7, no. 7_suppl5 (2019): 2325967119S0039. http://dx.doi.org/10.1177/2325967119s00397.
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Objectives: Traditional pitching statistics (ERA, WHIP, etc) have been used as surrogates for pitcher performance without being validated. Even amongst healthy pitchers, the normal variability of these parameters has not yet been established. The purpose of this study was to determine the normal variability of basic and advanced pitching statistics in non-injured Major League Baseball (MLB) pitchers. It is our hope that this work will serve as the foundation for the identification and implementation of validated, pitcher dependent statistical measures that can be used to assess return to play performance following injury. Methods: Publicly available data from MLB Statcast and Pitch/Fx databases was used to analyze all non-injured MLB pitchers during 2015 and 2016 seasons who pitcher greater than 100 innings each season without injury. Traditional and advanced baseball pitching statistics were analyzed. The variability of each parameter was assessed by computing coefficient of variation (CV) between individual pitchers and across all pitchers. A CV below 10 is typically indicative of a relatively constant parameter, and parameters with a CV > 10 are generally considered inconsistent and unreliable. Results: A total of 118 pitchers met all inclusion criteria. For each of these healthy pitchers, 38 basic/traditional parameters and 17 advanced parameters were analyzed. Of the traditional pitcher statistics, only 1 (3%) demonstrated a CV value < 10 (average fastball velocity [FBv]; CV 1.5) (Figure 1). In advanced statistics, 9 of 17 (53%) variables demonstrated acceptable consistency as evidenced by a CV value < 10 (Figure 2). Release position from plate (release_pos_y) along with velocity from the plate (vy0) where the two most constant advanced parameters. When separated by pitch type, these two parameters were the most constant (lowest CV) in every pitch type. Conclusion: The validity and variability of baseball statistics as surrogate markers for performance after injury/surgery have not yet been evaluated. It is critical that baseball statistics undergo proper vetting prior to being used to assess recovery. This study reveals average fastball velocity and release position from the plate to be the least variable basic and advanced baseball statistics in MLB pitchers. In total, only 10 of the 55 statistics analyzed demonstrated acceptable consistency and reliability. This study can be further used to determine the minimum time that each of these variables needs to be followed to ensure an appropriate sample size is obtained to detect significant differences in pre- and post- injury performance. [Figure: see text][Figure: see text]
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Chang, Shun-Chuan. "Can pitcher performance reveal game fixing in baseball? Developing a forensic analysis detection procedure." Social Behavior and Personality: an international journal 46, no. 2 (2018): 259–71. http://dx.doi.org/10.2224/sbp.6549.
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Gambling and game-fixing scandals have loomed over the international baseball world and a lack of sports ethics in baseball may lead to many problems. In this study I conducted a textual analysis of reports by prosecutors regarding a pitcher who was investigated but not indicted in 2009 after allegations of game fixing. Drawing upon the statistical records of the season's games for the pitcher that were contained in the prosecutor's reports and game-by-game records for each Chinese Professional Baseball League pitcher in the 2009 regular season, I used the change-point test and difference-in-differences techniques to identify anomalies in the pitcher's play. The results I obtained support information contained in the prosecutors' reports regarding the pitcher's actions. My model is confirmed as an appropriate method of applied behavior analysis for detecting corruption in baseball pitching performance.
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McGraw, Michael H., Michael Vrla, Dean Wang, et al. "Shoulder and Elbow Range of Motion Can Be Maintained in Major League Baseball Pitchers Over the Course of the Season, Regardless of Pitching Workload." Orthopaedic Journal of Sports Medicine 7, no. 2 (2019): 232596711882506. http://dx.doi.org/10.1177/2325967118825066.
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Background: Studies examining the evolution of shoulder and elbow range of motion (ROM) in baseball pitchers over a single season have yielded inconsistent results. Purpose: To evaluate shoulder and elbow ROM in Major League Baseball (MLB) pitchers over a single season and to assess for correlations between these changes and measures of a pitcher’s workload. Study Design: Case-control study; Level of evidence, 3. Methods: Bilateral shoulder ROM (internal rotation [IR], external rotation [ER], and total range of motion [TROM]) was assessed in 92 MLB pitchers pre- and postseason. Shoulder forward flexion (FF) was measured in 64 pitchers, horizontal adduction (HA) was measured in 87 pitchers, and elbow ROM was measured in 86 pitchers. Data collected included demographics (age, height, weight, and body mass index) and measures of workload for pitchers (pitches thrown, innings pitched, and mean fastball velocity). Pitchers were not specifically excluded if they had an injury during the season but had recovered and were actively pitching at the time of postseason measurements. The change in motion from pre- to postseason was measured and the associations with player demographics and workload were calculated by use of the Pearson correlation coefficient. Results: On average, pitchers demonstrated an increase in dominant shoulder ER from 118.8° to 125.4° ( P < .001) and TROM from 173.1° to 181.7° ( P < .001). HA was increased by an average of 15.7° ( P < .001). The average shoulder IR ( P = .189), FF ( P = .432), and elbow ROM (flexion, P = .549; extension, P = .185) remained similar over the span of the season. Average glenohumeral IR deficit did not increase. Pitcher demographics and measures of throwing workload (total pitches thrown, innings pitched, mean fastball velocity) were not significantly correlated with changes in shoulder or elbow ROM. Conclusion: Significant increases in dominant shoulder ER, TROM, and HA were identified in MLB pitchers over the course of a single baseball season. These ROM changes were not correlated with measures of pitching workload.
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Chu, Yungchien, Glenn S. Fleisig, Kathy J. Simpson, and James R. Andrews. "Biomechanical Comparison between Elite Female and Male Baseball Pitchers." Journal of Applied Biomechanics 25, no. 1 (2009): 22–31. http://dx.doi.org/10.1123/jab.25.1.22.
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The purpose of the current study was to identify the biomechanical features of elite female baseball pitching. Kinematics and kinetics of eleven elite female baseball pitchers were reported and compared with eleven elite male pitchers. Results suggested that females share many similarities with males in pitching kinematics, with a few significant differences. Specifically, at the instant of stride foot contact, a female pitcher had a shorter and more open stride and less separation between pelvis orientation and upper torso orientation. From foot contact to ball release, a female pitcher produced lower peak angular velocity for throwing elbow extension and stride knee extension. Ball velocity was lower for the female. Foot contact to ball release took more time for a female pitcher. Maximal proximal forces at the shoulder and elbow joints were less for a female pitcher.
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Sasanuma, Hideyuki, Yuki Iijima, Tomohiro Saito, et al. "Satisfaction With Elbow Function and Return Status After Autologous Osteochondral Transplant for Capitellar Osteochondritis Dissecans in High School Baseball Players." American Journal of Sports Medicine 48, no. 12 (2020): 3057–65. http://dx.doi.org/10.1177/0363546520952782.
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Background: Osteochondral autograft transplant (OAT), a surgical treatment for capitellar osteochondritis dissecans (OCD), has favorable rates of elbow recovery and return to sports in adolescents. However, few reports have investigated how long patients continue to play baseball after OAT and their satisfaction with their treatment outcome. Purpose: To evaluate the rate of boys who played baseball and received OAT for OCD in junior high school or earlier (age <15 years) and continued to play baseball in high school and the players’ satisfaction with their elbow function during play. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 32 elbows of boys who played baseball and received OAT at age ≤15 years (mean, 14.1 years) were examined and divided into pitcher (n = 11) and nonpitcher (n = 21) groups according to their player position before surgery. The clinical Timmerman-Andrews score at the end of their high school baseball, participation percentage of players who continued to play baseball, and satisfaction level during play (on a scale of 0-10 during pitching and batting and in a 4-choice format) were compared between the 2 groups. Results: The Timmerman-Andrews scores significantly improved after surgery in both groups, with no significant difference between the groups. Of the 32 players, 30 (93.8%) continued to play baseball throughout high school, including all players in the pitcher group and 19 (90.5%) of those in the nonpitcher group. The percentage of players who continued to pitch was 55.6% (6/11) in the pitcher group. Satisfaction with elbow joint function at the time of pitching was significantly lower in the pitcher group. Further, 5 players reported being “a little unsatisfied” because of elbow pain during pitching. All of the players indicated satisfaction with elbow function during batting. Conclusion: The percentage of players who received OAT for OCD in junior high school and continued to play baseball in high school was favorable. However, satisfaction with elbow function during throwing was lower in pitchers than in nonpitchers. Clinical Relevance: Before surgery, consent should be obtained from patients who are pitchers after it is explained that satisfaction with elbow joint function during pitching could be decreased after OAT.
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Erickson, Brandon J., Thomas R. Atlee, Peter N. Chalmers, et al. "Training With Lighter Baseballs Increases Velocity Without Increasing the Injury Risk." Orthopaedic Journal of Sports Medicine 8, no. 3 (2020): 232596712091050. http://dx.doi.org/10.1177/2325967120910503.
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Background: Pitch velocity has become an increasingly popular metric by which pitchers are graded and compared. Training programs that utilize weighted balls have been effective in increasing velocity but at the cost of an increased injury risk. No studies have evaluated training with lighter baseballs with regard to increasing pitch velocity and the injury risk. Purpose/Hypothesis: The purpose of this study was to determine whether a training program utilizing lighter baseballs could increase fastball velocity without increasing the injury risk to participants. We hypothesized that a training program with lighter baseballs would increase fastball velocity but not increase the injury risk. Study Design: Case series; Level of evidence, 4. Methods: All baseball pitchers who participated in a 15-week program at a single location, with the same coaches, and aimed to improve pitching mechanics and increase velocity were included. The training program was broken down into 3 phases, and each participant went through the same program. Lighter baseballs (3 and 4 oz) and standard baseballs (5 oz) were utilized as part of the training program. Weighted (heavier) balls were not used. Velocity was measured at 4 time points throughout the program with the pitcher throwing 5 fastballs using a standard 5-oz ball at maximum velocity (sessions 3, 10, 17, and 25). Injuries for all players were recorded throughout the entire program. Results: A total of 44 male pitchers aged 10 to 17 years (mean age, 14.7 ± 1.8 years) completed the training program and were available for analysis. No pitcher sustained a shoulder or elbow injury during the course of the training program. Fastball velocity increased by a mean of 4.8 mph (95% CI, 4.0-5.6 mph) ( P < .001). Overall, 43 of 44 players (98%) had an increase in fastball velocity over the course of the program. Conclusion: A 15-week pitching training program with lighter baseballs significantly improved pitching velocity without causing any injuries, specifically to the shoulder or elbow. Lighter baseballs should be considered as an alternative to weighted baseballs when attempting to increase a pitcher’s velocity.
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Zaremski, Jason L., Giorgio Zeppieri, Deborah L. Jones, et al. "Unaccounted Workload Factor: Game-Day Pitch Counts in High School Baseball Pitchers—An Observational Study." Orthopaedic Journal of Sports Medicine 6, no. 4 (2018): 232596711876525. http://dx.doi.org/10.1177/2325967118765255.
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Background: Throwing injuries are common in high school baseball. Known risk factors include excessive pitch counts, year-round pitching, and pitching with arm pain and fatigue. Despite the evidence, the prevalence of pitching injuries among high school players has not decreased. One possibility to explain this pattern is that players accumulate unaccounted pitch volume during warm-up and bullpen activity, but this has not yet been examined. Hypotheses: Our primary hypothesis was that approximately 30% to 40% of pitches thrown off a mound by high school pitchers during a game-day outing are unaccounted for in current data but will be revealed when bullpen sessions and warm-up pitches are included. Our secondary hypothesis was that there is wide variability among players in the number of bullpen pitches thrown per outing. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Researchers counted all pitches thrown off a mound during varsity high school baseball games played by 34 high schools in North Central Florida during the 2017 season. Results: We recorded 13,769 total pitches during 115 varsity high school baseball starting pitcher outings. The mean ± SD pitch numbers per game were calculated for bullpen activity (27.2 ± 9.4), warm-up (23.6 ±8.0), live games (68.9 ±19.7), and total pitches per game (119.7 ± 27.8). Thus, 42.4% of the pitches performed were not accounted for in the pitch count monitoring of these players. The number of bullpen pitches thrown varied widely among players, with 25% of participants in our data set throwing fewer than 22 pitches and 25% throwing more than 33 pitches per outing. Conclusion: In high school baseball players, pitch count monitoring does not account for the substantial volume of pitching that occurs during warm-up and bullpen activity during the playing season. These extra pitches should be closely monitored to help mitigate the risk of overuse injury.
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Williams, B. D., and M. R. Safran. "HIP PAIN - BASEBALL PITCHER." Medicine & Science in Sports & Exercise 35, Supplement 1 (2003): S104. http://dx.doi.org/10.1097/00005768-200305001-00572.
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Pesigan, Ramon Julian M., Wazim Buksh, Moneef Hauter, Dean Padavan, and Damion Martins. "Wrist Pain- Baseball Pitcher." Medicine & Science in Sports & Exercise 47 (May 2015): 564–65. http://dx.doi.org/10.1249/01.mss.0000478251.76258.e2.
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Scarborough, Donna Moxley, Shannon E. Linderman, Javier E. Sanchez, and Eric M. Berkson. "Baseball Pitchers’ Kinematic Sequences and Their Relationship to Elbow and Shoulder Torque Production." Orthopaedic Journal of Sports Medicine 7, no. 7_suppl5 (2019): 2325967119S0042. http://dx.doi.org/10.1177/2325967119s00429.
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Objectives: Ball velocity is generated during the overhead baseball pitch via efficient force transmission up the kinetic chain, from the lower body up and outward to the throwing hand. The kinematic sequence, or the sequential timing pattern of peak angular velocities of body segments during a pitch, provides insight to segment position and motion control that drives the kinetic chain (Putnam CA, 1993). Previous publications report an ideal kinematic sequence (KS) where the timing of each body segment’s peak angular velocity occurs in a proximal-to-distal (PDS) pattern resulting in greater ball velocity and reduction in throwing arm injury risk (Fortenbaugh D, et.al, 2009). A recent study revealed that baseball pitchers perform a variety of KSs (Scarborough DM et.al, 2018). There is no known investigation of the relationship of kinematic sequences and throwing arm joint torques. The purpose of this study was to 1) identify the number of different KSs performed by each pitcher and 2) compare elbow valgus and shoulder external rotation (ER) and extension (Ext) torques between the 3 primary KSs performed during the fastball pitch. Methods: Fourteen collegiate baseball pitchers (20.57 ± 1.91 yr) underwent 3D biomechanical pitch analysis using 20 motion-capture Vicon MX™ cameras (360 Hz). A total of 119 fastball pitches with an average of 8.5 ± 2.71 pitches per player were analyzed. Elbow valgus and shoulder external rotation and extension torques were calculated. The timing of peak angular velocities for the pelvis, trunk, arm, forearm and hand body segments were recorded to generate each pitch’s KS. KSs were then divided into groups based on similarities to the ideal PDS pattern. ANCOVA statistical analyses were performed to compare joint torques across these KS groups with ball velocity as a covariate. Results: A total of 13 different KSs were observed across the 14 pitchers resulting in an average of 3 ± 1.41 different KSs per pitcher. Three different primary KS groups were identified: (1) PDS group: with a KS closest to the ideal PDS pattern (2) the Altered Distal Upper Extremity segment: with the forearm peaking after the hand (the most common group) and (3) Altered Proximal Upper Extremity segment order with the arm segment peaking after the hand (2nd most common). Across these three primary KS patterns, statistically significant differences were noted for elbow valgus torque [F(62,2) = 8.785, ɳ2 = .221, p < 0.00], shoulder external rotation (ER) torque [F(62,2) = 14.127, ɳ2 = .313, p < 0.00] and shoulder extension (Ext) torque [F(62,2) = 13.237, ɳ2 = .299, p < 0.00] (Figure 1). Conclusion: Our findings demonstrate that collegiate baseball pitchers performed an average of 3 different kinematic sequence patterns during fastball pitching. This is the first study to demonstrate a relationship between KSs and elbow and shoulder torque production. As anticipated, the PDS KSs produced the least torque across the elbow and shoulder joints. Alterations in Distal Upper Extremity KS was most common and generated the greatest shoulder Ext torques. Alterations in the Proximal Upper Extremity KS demonstrated the greatest elbow valgus and shoulder ER. Further study of the influence of kinematic sequence on joint torques in the baseball pitch may provide insight into pitching injuries and injury avoidance programs.
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Stodden, David F., Glenn S. Fleisig, Scott P. McLean, Stephen L. Lyman, and James R. Andrews. "Relationship of Pelvis and Upper Torso Kinematics to Pitched Baseball Velocity." Journal of Applied Biomechanics 17, no. 2 (2001): 164–72. http://dx.doi.org/10.1123/jab.17.2.164.
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Generating consistent maximum ball velocity is an important factor for a baseball pitcher’s success. While previous investigations have focused on the role of the upper and lower extremities, little attention has been given to the trunk. In this study it was hypothesized that variations in pelvis and upper torso kinematics within individual pitchers would be significantly associated with variations in pitched ball velocity. Nineteen elite baseball pitchers were analyzed using 3-D high-speed motion analysis. For inclusion in this study, each pitcher demonstrated a variation in ball velocity of at least 1.8 m/s (range: 1.8–3.5 m/s) during his 10 fastball pitch trials. A mixed-model analysis was used to determine the relationship between 12 pelvis and upper torso kinematic variables and pitched ball velocity. Results indicated that five variables were associated with variations in ball velocity within individual pitchers: pelvis orientation at maximum external rotation of the throwing shoulder (p= .026), pelvis orientation at ball release (p= .044), upper torso orientation at maximum external rotation of the throwing shoulder (p= .007), average pelvis velocity during arm cocking (p= .024), and average upper torso velocity during arm acceleration (p= .035). As ball velocity increased, pitchers showed an increase in pelvis orientation and upper torso orientation at the instant of maximal external rotation of the throwing shoulder. In addition, average pelvis velocity during arm cocking and average upper torso velocity during arm acceleration increased as ball velocity increased. From a practical perspective, the athlete should be coached to strive for proper trunk rotation during arm cocking as well as strength and flexibility in order to generate angular velocity within the trunk for maximum ball velocity.
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Gutman, Brian, Christopher Hadley, Jacob Kirsch, Christopher Joyce, Surena Namdari, and Michael Gutman. "Performance in Major League Baseball Pitchers After Surgical Treatment of Thoracic Outlet Syndrome." Orthopaedic Journal of Sports Medicine 9, no. 7_suppl4 (2021): 2325967121S0022. http://dx.doi.org/10.1177/2325967121s00221.
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Objectives: Thoracic outlet syndrome (TOS) can be a career threatening injury for baseball pitchers. The purpose of this study is to determine the efficacy of surgical management for TOS as a function of return to play and quantitative pitching metrics. Methods: Twenty-seven major league baseball pitchers underwent surgical treatment for TOS between January 2001 and December 2017. Analysis of pre and postoperative pitching metrics were used to assess the effect of surgery on 20 pitchers who returned to pitch in Major League Baseball (MLB). All pitching metrics were compared via assessing performance two years prior to surgery and two years after surgery. For 20 pitchers who returned to pitch, MLB pitching metrics of earned run average (ERA), walks plus hits per innings pitched (WHIP), wins above replacement (WAR), strikeouts per nine innings (K/9), average fastball velocity, and strike percentage, were used to assess a pitcher’s ability to return to preoperative performance level. Results: Of the 27 pitchers, 20 pitchers were diagnosed with neurogenic thoracic outlet syndrome (NTOS) and seven with venous thoracic outlet syndrome (VTOS). The average age of onset of TOS was 28.6 years. There was no significant difference between the age of onset between the NTOS and VTOS populations (p=0.272). Of the 27 pitchers, 20 (74.1%) were able to return to MLB play at a mean of 297 days (range, 105-638 days) after surgery. Pitching metrics demonstrated that pitcher ERA remained inferior postoperatively compared to baseline preoperative performance (3.66 vs 4.50, p=0.03). Fastball velocity (p=0.94), strike percentage (p=0.50), and K/9 (p=0.878) were equivalent to pre-injury performance. There was no difference in preoperative pitching metrics between pitchers who were able to return and pitchers who were unable to return to the MLB. Conclusions: About 3/4 of professional pitchers who undergo surgical intervention for TOS are able to return to play at the MLB level. With regards to performance, the majority of metrics were unchanged from prior to surgery, indicating return at a similar functional level.
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Escamilla, Rafael F., Glenn S. Fleisig, Steven W. Barrentine, Naiquan Zheng, and James R. Andrews. "Kinematic Comparisons of Throwing Different Types of Baseball Pitches." Journal of Applied Biomechanics 14, no. 1 (1998): 1–23. http://dx.doi.org/10.1123/jab.14.1.1.
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The purpose of this study was to establish and compare kinematic data among four groups of collegiate pitchers who threw the fastball (FA), change-up (CH), curveball (CU), and slider (SL). Twenty-six kinematic parameters at lead foot contact, during the arm-cocking and arm acceleration phases, and at ball release were measured for 16 collegiate baseball pitchers. Approximately 60% of these parameters showed significant differences among the four pitch variations. The greatest number of differences (14 of 26) occurred between the FA and CH groups, while the fewest differences (2 of 26) occurred between the FA and SL groups. The CH group had the smallest knee and elbow flexion at lead foot contact and the greatest knee and elbow flexion at ball release. During the arm-cocking and arm acceleration phases, peak shoulder, elbow, and trunk angular velocities were generally greatest in the FA and SL groups and smallest in the CH group. At ball release the CH group had the most upright trunk and the greatest horizontal shoulder adduction, while the CU group had the most lateral trunk tilt. Understanding kinematic differences can help a pitcher select and learn different pitches and can help a batter learn how to identify different pitches.
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Burris, Kyle, and Jacob Coleman. "Out of gas: quantifying fatigue in MLB relievers." Journal of Quantitative Analysis in Sports 14, no. 2 (2018): 57–64. http://dx.doi.org/10.1515/jqas-2018-0007.
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Abstract As relief pitcher usage in Major League Baseball has spiked in recent years, optimal bullpen decision-making has become increasingly vital for team managers. Throughout the season, managers must be mindful to avoid overusing their most talented relievers, due to the risks of injury and ineffectiveness. Despite the substantial amount of attention given to pitcher arm health and injury prevention, the effect of workload on pitcher fatigue is poorly understood. As a result, many of these overuse decisions are driven by feel and intuition. In this paper, we borrow ideas from toxicology to provide a framework for estimating the effect of recent workload on short-term reliever effectiveness, as measured by fastball velocity. Treating a thrown pitch as a fatigue-inducing “toxin” administered to a player’s arm, we develop a Bayesian hierarchical model to estimate the pitcher-level dose-response relationship, the rate of recovery, and the relationship between pitch count and fatigue. Based on the model, we find that the rate of reliever fatigue rises with increasing pitch count. When relief pitchers throw more than 15 pitches in an appearance, they are expected to suffer small, short-term velocity decreases in future games; upon crossing the 20 pitch threshold, this dip is further amplified. For each day that passes after the appearance, we estimate that the effect on a player’s velocity is cut roughly in half. Finally, we identify the relievers most affected by fatigue, along with those most resilient to its effects.
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Portney, Daniel Aaron, Lucas T. Buchler, Jake Michael Lazaroff, Stephen Gryzlo, and Matthew Saltzman. "Release Location in a Risk Factor for Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers." Orthopaedic Journal of Sports Medicine 6, no. 7_suppl4 (2018): 2325967118S0016. http://dx.doi.org/10.1177/2325967118s00164.
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Objectives: Medial ulnar collateral ligament reconstruction (UCLR) is a common procedure performed for Major League Baseball (MLB) pitchers. The etiology of UCL injury is complex and not entirely understood. The purpose of this study was to use publically available pitch tracking technology (PITCHf/x) to compare the pre-injury throwing mechanics of MLB pitchers who require UCL reconstructive surgery with those of pitchers who have never undergone UCL reconstruction. Methods: Pitch tracking and demographic data on MLB pitchers who had undergone UCL reconstruction between the 2010 and 2017 seasons was gathered. Pitchers were excluded if they did not throw 100 total pitches in each of the three years prior to surgery. Furthermore, only pitch types that a given pitcher utilized more than 25 times in each of the three years prior to surgery were included for individual analysis. Pitch type, release location, and velocity were compared between the UCL reconstructive surgery cohort and a matched-control cohort. Results: The average pitch release location for pitchers who required UCL reconstruction was more lateral in the two years immediately preceding surgery than the control cohort (p=0.001 and p=0.023). Furthermore, a time-based comparison between the year immediately preceding surgery and two years prior showed a more lateral release immediately prior to surgery (p=0.036). Pitchers who required UCL reconstruction throw similar rates of fastballs as the control cohort and the average pitch velocity and fastball velocity were similar between the UCL group and the control group. The control pitchers displayed a significant decrease in average pitch velocity (p=0.005) and average fastball velocity (p=0.012) over the period of the study. Conclusion: Pitch tracking indicates pitch selection and pitch velocity are similar before that the average release point is more lateral preceding UCL reconstruction as compared to the control cohort suggesting that pitch release location might be an independent risk factor for UCL injury and reconstruction. On the other hand, pitch selection and pitch velocity are similar between these cohorts. Powerful technology including PITCHf/x allows for accurate monitoring of factors such as arm position and could potentially be used to identify pitchers at risk for UCL rupture. [Figure: see text]
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Fudin, Robert, Lesley Renninger, and Jordon Hirshon. "Analysis of Data from Reichler's (1979) the Baseball Encyclopedia: Right-Handed Pitchers are Taller and Heavier than Left-Handed Pitchers." Perceptual and Motor Skills 78, no. 3 (1994): 1043–48. http://dx.doi.org/10.1177/003151259407800367.
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In 1989 Coren concluded right-handed Major League pitchers whose careers began up to 1975 are significantly taller and heavier than left-handed pitchers. His source of data, Reichler's 1979 edition of The Baseball Encyclopedia, however, lists heights and weights for pitchers whose careers began through 1978 and for individuals who pitched but who almost always appeared at a different position or positions. Coren did not indicate why he did not analyze all of the relevant data in Reichler nor did he explain how he decided that an individual's usual position was that of pitcher. Further, there is evidence from Topp which suggests that the era during which the pitchers began their careers should be considered when comparing their heights and weights because relatively recent rookies (from 1980 through 1986) are taller and heavier than rookies who began their careers 50 and 100 years prior to that era. Classifying an individual as a pitcher if he pitched in at least 50% of the games in which he played at a position, using all relevant data in Reichler, and considering the era during which dextral and sinistral pitchers began their careers, we found strong corroborative evidence for Coren's 1989 findings.
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Roebber, Paul J. "Does the principle of investment diversification apply to the starting pitching staffs of major league baseball teams?" PLOS ONE 16, no. 1 (2021): e0244941. http://dx.doi.org/10.1371/journal.pone.0244941.
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Financial advisors often emphasize asset diversification as a means of limiting losses from investments that perform unexpectedly poorly over a particular time period. One might expect that this perceived wisdom could apply in another high stakes arena–professional baseball–where player salaries comprise a substantial portion of a team’s operational costs, year-to-year player performance is highly variable, and injuries can occur at any time. These attributes are particularly true in the case of the starting pitching staffs of professional baseball teams. Accordingly, this study analyzes starting pitcher performance and financial data from all Major League Baseball teams for the period 1985–2016 to determine whether the standard investment advice is applicable in this context, understanding that the time horizon for success for an investor and a baseball team may be distinct. A multiple logistic regression model of playoff qualification probability, based on realized pitcher performance, measures of luck, and starting pitcher staff salary diversification is used to address this question. A further stratification is conducted to determine whether there are differences in strategy for teams with allocated financial resources that are above or below league average. We find that teams with above average resources increase their post-season qualification probability by focusing their salary funds on a relative few starting pitchers rather than diversifying that investment across the staff. Second, we find that pitcher performance must align with that investment in order for the team to have a high qualification probability. Third, the influence of luck is not negligible, but those teams that allocate more overall funds to their pitching are more resilient to bad luck. Thus, poorly resourced teams, who are generally unable to bid for pitchers at the highest salary levels, must adopt alternative strategies to maintain their competitiveness.
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Herickoff, Paul K., Charles Silberstein, Ritchie Bancells, Brian Ebel, and Edward G. McFarland. "Shoulder Pain Professional Baseball Pitcher." Medicine & Science in Sports & Exercise 37, Supplement (2005): S59. http://dx.doi.org/10.1249/00005768-200505001-00315.
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Herickoff, Paul K., Charles Silberstein, Ritchie Bancells, Brian Ebel, and Edward G. McFarland. "Shoulder Pain Professional Baseball Pitcher." Medicine & Science in Sports & Exercise 37, Supplement (2005): S59. http://dx.doi.org/10.1097/00005768-200505001-00315.
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Pelkowski, T. D., and G. W. Coppola. "UNILATERAL ARM SWELLING - BASEBALL PITCHER." Medicine & Science in Sports & Exercise 33, no. 5 (2001): S103. http://dx.doi.org/10.1097/00005768-200105001-00579.
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Calabrese, Gary J., P. T. William, and H. Seltz. "SHOULDER PAIN - COLLEGE BASEBALL PITCHER." Medicine & Science in Sports & Exercise 24, Supplement (1992): S39. http://dx.doi.org/10.1249/00005768-199205001-00231.
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Sanchez, Luis A., Juan C. Galloza, and William Micheo. "Elbow Pain-Young Baseball Pitcher." Medicine & Science in Sports & Exercise 49, no. 5S (2017): 503. http://dx.doi.org/10.1249/01.mss.0000518280.63577.a6.
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Lynch, Mary, Jacob Sellon, and Marc Gruner. "Posterior Shoulder Pain - Baseball Pitcher." Medicine & Science in Sports & Exercise 52, no. 7S (2020): 539. http://dx.doi.org/10.1249/01.mss.0000680060.76384.53.
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Matsuura, Tetsuya, Toshiyuki Iwame, and Koichi Sairyo. "Exceeding Pitch Count Recommendations In Youth Baseball Increases The Elbow Injuries." Orthopaedic Journal of Sports Medicine 6, no. 7_suppl4 (2018): 2325967118S0012. http://dx.doi.org/10.1177/2325967118s00126.
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Objectives: With the incidence of Little League elbow increasing, pitch limit recommendations for preventing throwing injuries have been developed in the United States and Japan. In 1995, the Japanese Society of Clinical Sports Medicine announced limits of 50 pitches per day and 200 pitches per week to prevent throwing injuries in younger than 12 years old. However the relationship between pitch limit recommendation and elbow injuries among pitchers has not been adequately studied. The aim of our study was to evaluate the association between pitch counts and elbow injuries in youth pitchers. Methods: A total of 149 pitchers without prior elbow pain were observed prospectively for 1 season to study injury incidence in relation to specific risk factors. Average age was 10.1 years (range, 7-11 years). One year later, all pitchers were examined by questionnaire. Subjects were asked whether they had experienced any episodes of elbow pain during the season. The questionnaire was also used to gather data on pitch counts per day and per week, age, number of training days per week, and number of games per year. We investigated the following risk factors for elbow injury: pitch counts, age, position, number of training days per week, and number of games per year. Data were analyzed by multivariate logistic regression models and presented as odds ratio (OR) and profile likelihood 95% confidence interval (CI) values. The likelihood-ratio test was also performed. A two-tailed P value of less than .05 was considered significant. All analysis was done in the SAS software package (version 8.2). Results: Of the 149 subjects, 66 (44.3%) reported episodes of pain in the throwing elbow during the season. 1. Analysis for pitch count per day Univariate analysis showed that elbow pain was significantly associated with more than 50 pitches per day. Multivariate analysis showed that more than 50 pitches per day (OR, 2.44; 95% CI, 1.22-4.94), and more than 70 games per year (OR, 2.47; 95% CI, 1.24-5.02) were risk factors significantly associated with elbow pain. Age and number of training days per week were not significantly associated with elbow pain. 1. Analysis for pitch count per week Univariate analysis showed that elbow pain was significantly associated with more than 200 pitches per week. Multivariate analysis showed that more than 200 pitches per week (OR, 2.04; 95% CI, 1.03-4.10), and more than 70 games per year (OR, 2.41; 95% CI, 1.22-4.87) were risk factors significantly associated with elbow pain. Age was not significantly associated with elbow pain. Conclusion: A total of 44.3% of youth baseball pitchers had elbow pain during the season. Multivariable logistic regression revealed that elbow pain was associated with more than 50 pitches per day, more than 200 pitches per week, and more than 70 games per year. Previous studies have revealed the risk factor with the strongest association to injury is pitcher. Our data suggest that compliance with pitch limit recommendations including limits of 50 pitches per day and 200 pitches per week may be protective against elbow injuries. Those who played more than 70 games per year had a notably increased risk of injury. With increasing demand on youth pitchers to play more, there is less time for repair of bony and soft tissues in the elbow. In conclusion, among youth pitchers, limits of 50 pitches per day, 200 pitches per week, and limits of 70 games per year may protect elbow injuries.
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Lyman, Stephen, Glenn S. Fleisig, James R. Andrews, and E. David Osinski. "Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball Pitchers." American Journal of Sports Medicine 30, no. 4 (2002): 463–68. http://dx.doi.org/10.1177/03635465020300040201.
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Background Joint pain is thought to be an early sign of injury to a pitcher. Objective To evaluate the association between pitch counts, pitch types, and pitching mechanics and shoulder and elbow pain in young pitchers. Study Design Prospective cohort study. Methods Four hundred and seventy-six young (ages 9 to 14 years) baseball pitchers were followed for one season. Data were collected from pre- and postseason questionnaires, injury and performance interviews after each game, pitch count logs, and video analysis of pitching mechanics. Generalized estimating equations and logistic regression analysis were used. Results Half of the subjects experienced elbow or shoulder pain during the season. The curveball was associated with a 52% increased risk of shoulder pain and the slider was associated with an 86% increased risk of elbow pain. There was a significant association between the number of pitches thrown in a game and during the season and the rate of elbow pain and shoulder pain. Conclusions Pitchers in this age group should be cautioned about throwing breaking pitches (curveballs and sliders) because of the increased risk of elbow and shoulder pain. Limitations on pitches thrown in a game and in a season can also reduce the risk of pain. Further evaluation of pain and pitching mechanics is necessary.
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Stodden, David F., Glenn S. Fleisig, Scott P. McLean, and James R. Andrews. "Relationship of Biomechanical Factors to Baseball Pitching Velocity: Within Pitcher Variation." Journal of Applied Biomechanics 21, no. 1 (2005): 44–56. http://dx.doi.org/10.1123/jab.21.1.44.
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To reach the level of elite, most baseball pitchers need to consistently produce high ball velocity but avoid high joint loads at the shoulder and elbow that may lead to injury. This study examined the relationship between fastball velocity and variations in throwing mechanics within 19 baseball pitchers who were analyzed via 3-D high-speed motion analysis. Inclusion in the study required each one to demonstrate a variation in velocity of at least 1.8 m/s (range 1.8–3.5 m/s) during 6 to 10 fastball pitch trials. Three mixed model analyses were performed to assess the independent effects of 7 kinetic, 11 temporal, and 12 kinematic parameters on pitched ball velocity. Results indicated that elbow flexion torque, shoulder proximal force, and elbow proximal force were the only three kinetic parameters significantly associated with increased ball velocity. Two temporal parameters (increased time to max shoulder horizontal adduction and decreased time to max shoulder internal rotation) and three kinematic parameters (decreased shoulder horizontal adduction at foot contact, decreased shoulder abduction during acceleration, and increased trunk tilt forward at release) were significantly related to increased ball velocity. These results point to variations in an individual's throwing mechanics that relate to pitched ball velocity, and also suggest that pitchers should focus on consistent mechanics to produce consistently high fastball velocities. In addition, pitchers should strengthen shoulder and elbow musculature that resist distraction as well as improve trunk strength and flexibility to maximize pitching velocity and help prevent injury.
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Gmeiner, Michael William. "History-Dependent Mixed Strategies: Evidence From Major League Baseball." Journal of Sports Economics 20, no. 3 (2018): 371–98. http://dx.doi.org/10.1177/1527002518762554.
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This article analyzes to what extent baseball players adjust mixed strategies depending on the history by which the batting count is realized, then tests if these adjustments are aligned with best-response play. Two situations are examined: (1) pitches preceded by a borderline ball or strike at which the batter did not swing and (2) batters taking a strike as opposed to swinging and missing. Adjustments in batter and pitcher strategy on the following pitch are identified as statistically significant, however, of small magnitude. Analysis considers the effects of these adjustments on the expected runs scored during the plate appearance.
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Parsons, Christopher A., Johan Sulaeman, Michael C. Yates, and Daniel S. Hamermesh. "Strike Three: Discrimination, Incentives, and Evaluation." American Economic Review 101, no. 4 (2011): 1410–35. http://dx.doi.org/10.1257/aer.101.4.1410.
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Major League Baseball umpires express their racial/ethnic prefer ences when they evaluate pitchers. Strikes are called less often if the umpire and pitcher do not match race/ethnicity, but mainly where there is little scrutiny of umpires. Pitchers understand the incentives and throw pitches that allow umpires less subjective judgment (e.g., fastballs over home plate) when they anticipate bias. These direct and indirect effects bias performance measures of minorities downward. The results suggest how discrimination alters discriminated groups' behavior generally. They imply that biases in measured productivity must be accounted for in generating measures of wage discrimination. (JEL J15, J31, J44, J71, L83)
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Weinstein, L., G. A. Prather, and A. F. De Man. "College Baseball Pitchers' Throwing Velocities as a Function of Awareness of Being Clocked." Perceptual and Motor Skills 64, no. 3_suppl (1987): 1185–86. http://dx.doi.org/10.2466/pms.1987.64.3c.1185.
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The differences in velocity of fastballs thrown by 14 college pitchers with and without known presence of a “scout” (the experimenter) with speedgun was investigated. Each pitcher threw 40 fastballs in a game situation. The first 20 were measured with the pitchers seeing the experimenter measuring their velocity with a speed gun. The next 20 were measured without the pitchers seeing the speedgun or the experimenter. Analysis shows that with known presence of scout and speedgun, the average fastball among the 14 pitchers was clocked at 75.6 mph. Without known presence, the speed for the same 14 pitchers was measured at 79 mph. This finding questions the validity of a scout's or coach's measurements of a pitcher's true throwing velocity.
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Mayberry, John, Scott Mullen, and Scott Murayama. "What Can a Jump Tell Us About Elbow Injuries in Professional Baseball Pitchers?" American Journal of Sports Medicine 48, no. 5 (2020): 1220–25. http://dx.doi.org/10.1177/0363546520905543.
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Background: The incidence rate of elbow injuries has been rising in recent years among professional baseball pitchers. Determining valid screening procedures that allow practitioners to identify pitchers at an increased risk of such injuries is therefore of critical importance. Purpose: To validate the use of countermovement jump (CMJ) tests as a diagnostic tool for pitcher conditioning. Study Design: Case-control study; Level of evidence, 3. Methods: More than 500 pitchers at a single professional baseball organization performed preseason CMJ assessments on a force plate before the 2013 to 2018 seasons. Three measurements were extracted from ground-reaction force data during the test: eccentric rate of force development (ERFD), average vertical concentric force (AVCF), and concentric vertical impulse (CVI). Athletic trainers at the organization collected detailed information on elbow and shoulder injury rates as well as workload (pitch count) throughout the rest of the season. Poisson regression models were fit to investigate the dependency of injury rates on CMJ test performance. Results: ERFD, CVI, and AVCF were all significant predictors of elbow injury risk after accounting for pitcher age, weight, and workload. The analysis identified 3 specific indicators of heightened risk based on the results of a CMJ scan: low ERFD, a combination of low AVCF and high CVI, and a combination of high AVCF and low CVI. In contrast, shoulder injury risk was roughly independent of all 3 CMJ test measurements. Conclusion: This study supports the hypothesis of the entire kinetic chain’s involvement in pitching by establishing a link between CMJ test performance and elbow injury risk in professional baseball pitchers. CMJ assessment may be a powerful addition to injury risk alert and prevention protocols. Pitchers in high-risk groups can be prescribed specific exercise plans to improve movement imbalances.
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McGinnis, Ryan S., Noel C. Perkins, and Kevin King. "Pitcher training aided by instrumented baseball." Procedia Engineering 34 (2012): 580–85. http://dx.doi.org/10.1016/j.proeng.2012.04.099.
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Gordon, Andrew H., and Arthur J. DeLuigi. "Medial Elbow Pain - Young Baseball Pitcher." Medicine & Science in Sports & Exercise 49, no. 5S (2017): 503–4. http://dx.doi.org/10.1249/01.mss.0000518281.01696.24.
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White, Brian F., and Gerard A. Malanga. "Shoulder pain in a baseball pitcher." Medicine & Science in Sports & Exercise 40, Supplement (2008): S128. http://dx.doi.org/10.1249/01.mss.0000322011.77279.61.
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Slowik, Jonathan S., Kyle T. Aune, Alek Z. Diffendaffer, E. Lyle Cain, Jeffrey R. Dugas, and Glenn S. Fleisig. "Fastball Velocity and Elbow-Varus Torque in Professional Baseball Pitchers." Journal of Athletic Training 54, no. 3 (2019): 296–301. http://dx.doi.org/10.4085/1062-6050-558-17.
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ContextHigh loads in the elbow during baseball pitching can lead to serious injuries, including injuries to the ulnar collateral ligament. These injuries have substantial implications for individual pitchers and their teams, especially at the professional level of competition. With a trend toward increased ball velocity in professional baseball, controversy still exists regarding the strength of the relationship between ball velocity and elbow-varus torque.ObjectiveTo examine the relationship between fastball velocity and elbow-varus torque in professional pitchers using between- and within-subjects statistical analyses.DesignCross-sectional study.SettingMotion-analysis laboratory.Patients or Other ParticipantsUsing the previously collected biomechanical data of 452 professional baseball pitchers, we performed a retrospective analysis of the 64 pitchers (52 right-hand dominant, 12 left-hand dominant; age = 21.8 ± 2.0 years, height = 1.90 ± 0.05 m, mass = 94.6 ± 7.8 kg) with fastball velocity distributions that enabled between- and within-subjects statistical analyses.Main Outcome Measure(s)We measured ball velocity using a radar gun and 3-dimensional motion data using a 12-camera automated motion-capture system sampling at 240 Hz. We calculated elbow-varus torque using inverse-dynamics techniques and then analyzed the relationship between ball velocity and elbow torque using both a simple linear regression model and a mixed linear model with random intercepts.ResultsThe between-subjects analyses displayed a weak positive association between ball velocity and elbow-varus torque (R2 = 0.076, P = .03). The within-subjects analyses showed a considerably stronger positive association (R2 = 0.957, P &lt; .001).ConclusionsWhen comparing 2 professional baseball pitchers, higher velocity may not necessarily indicate higher elbow-varus torque due to the confounding effects of pitcher-specific differences (eg, detailed anthropometrics and pitching mechanics). However, within an individual pitcher, higher ball velocity was strongly associated with higher elbow-varus torque.
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Johnson, Brett D., and Norris R. Johnson. "Stacking and “Stoppers”: A Test of the Outcome Control Hypothesis." Sociology of Sport Journal 12, no. 1 (1995): 105–12. http://dx.doi.org/10.1123/ssj.12.1.105.
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One explanation for stacking in sports is that minorities are excluded from positions with the greatest opportunity for determining the outcome of the competition, with the place kicker in football cited as an example. This paper postulated that the short relief pitcher in baseball also has high outcome control, and it hypothesized that minorities would be underrepresented in that position as well. We classified major league pitchers from the 1992 and 1993 seasons as starters, stoppers, or others and tested whether race or ethnicity was a factor in assignment to these positions. The hypothesis was not supported for either African American or Latin American pitchers. Minority group members were equally underrepresented in all categories of the pitcher position.
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Kato, Takaaki, and Tadahiko Fukuda. "Visual Search Strategies of Baseball Batters: Eye Movements during the Preparatory Phase of Batting." Perceptual and Motor Skills 94, no. 2 (2002): 380–86. http://dx.doi.org/10.2466/pms.2002.94.2.380.
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The aim of this study was to analyze visual search strategies of baseball batters during the viewing period of the pitcher's motion. The 18 subjects were 9 experts and 9 novices. While subjects viewed a videotape which, from a right-handed batter's perspective, showed a pitcher throwing a series of 10 types of pitches, their eye movements were measured and analyzed. Novices moved their eyes faster than experts, and the distribution area of viewing points was also wider than that of the experts. The viewing duration of experts of the pitching arm was longer than those of novices during the last two pitching phases. These results indicate that experts set their visual pivot on the pitcher's elbow and used peripheral vision properties to evaluate the pitcher's motion and the ball trajectory.
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Okoroha, Kelechi R., Vincent A. Lizzio, Fabien Meta, Christopher S. Ahmad, Vasilios Moutzouros, and Eric C. Makhni. "Predictors of Elbow Torque Among Youth and Adolescent Baseball Pitchers." American Journal of Sports Medicine 46, no. 9 (2018): 2148–53. http://dx.doi.org/10.1177/0363546518770619.
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Background: There has been an increasing incidence of overuse elbow injuries among youth and adolescent pitchers. Pitch type has been implicated as a risk factor for excess torque at the medial elbow; however, this has not been definitively demonstrated. Purpose: To assess predictors of torque across the medial elbow in youth and adolescent pitchers with a mobile sensor. In addition, the authors aimed to determine the differences in elbow torque produced according to pitch type (fastball, curveball, changeup) and pitcher demographics. Study Design: Descriptive laboratory study. Methods: Twenty youth and adolescent pitchers were instructed to throw 8 fastballs, 8 curveballs, and 8 changeups in a standardized but randomized sequence over a 25-minute period. Five pitchers were evaluated each day. A sensor placed at the medial elbow reported elbow torque, arm speed, arm slot, and shoulder rotation for each pitch, while a radar gun measured peak ball velocity. The primary outcome was a determination of thrower and pitch characteristics associated with elevated torque across the medial elbow. Secondary outcomes included the evaluation of differences in throwing biomechanics among different pitch types. Outcomes were assessed via a multivariable model, which controlled for possible covariates. Results: In total, 20 youth baseball pitchers with a mean age of 14.1 years (range, 12-17 years) were included in the study. On average, fastballs caused the greatest torque across the medial elbow (least squares mean ± SE, 47.3 ± 0.5 N·m) as compared with changeups (44.2 ± 0.5 N·m; P < .001) and curveballs (45.0 ± 0.5 N·m; P = .002). However, curveballs produced the greatest arm speed (917.8 rpm). Pitchers who started throwing curveballs at an older age experienced less elbow torque ( P < .001). A multivariable model demonstrated that increased ball velocity and body mass index and decreased arm slot were independent predictors of increased elbow torque. Conversely, increasing age, longer arm length, and greater elbow circumference were independent protectors against elbow torque. Conclusion: This study found that among youth and adolescent pitchers, fastballs generate the highest elbow torque while curveballs generated the greatest arm speed. Increased ball velocity and body mass index and decreased arm slot were predictors of elbow torque; however, increasing age and size of a pitcher’s arm were protectors against elbow torque. These findings are important to better understand risk factors for overuse injury in this at-risk athletic population. Clinical Relevance: These findings may inform future pitching recommendations with intentions of curtailing medial elbow injuries experienced by young pitchers, such as ulnar collateral ligament injuries.
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Yagi, Shusuke, Minoru Mitsugi, Teruaki Sangawa, Masashi Akaike, and Masataka Sata. "Paget-Schroetter Syndrome in a Baseball Pitcher." International Heart Journal 58, no. 4 (2017): 637–40. http://dx.doi.org/10.1536/ihj.16-447.
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Ku, Jung Hoei, Hyung Lae Cho, Tae Hyok Hwang, and Dong Hyun Lee. "Scapulothoracic Bursitis in a Amateur Baseball Pitcher." Korean Journal of Sports Medicine 33, no. 2 (2015): 134. http://dx.doi.org/10.5763/kjsm.2015.33.2.134.
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Ku, Jung Hoei, Hyung Lae Cho, and Jong Min Kim. "First-Rib Fracture in a Baseball Pitcher." Korean Journal of Sports Medicine 38, no. 2 (2020): 117–20. http://dx.doi.org/10.5763/kjsm.2020.38.2.117.
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Kleven, D. Keith, Susie Heins, and C. Janene Izatt. "Case study of a professional baseball pitcher." Journal of Hand Therapy 4, no. 2 (1991): 86–98. http://dx.doi.org/10.1016/s0894-1130(12)80109-8.
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