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How Foot Posture Contributes to Baseball Pitching Injuries

As spring approaches, we anticipate the next baseball season.  Whether you are a little league pitcher or a major league star, we all must be cognisant of factors contributing to injury and time away from your favourite past time.

According to the April 2014 Lower Extremity review in the college ranks, there is an incidence of 5.8 injuries per 1000 game exposures and 1.9 injuries per 1000 athletic practices. The time loss due to injury is much higher for pitchers than position players. In major league baseball, pitchers constituted an average of 48.4% of the disabled list and 56.9% of the total disabled days. Yes, some of these injuries are located in the upper extremity, but the cause of these injuries are no longer believed to be solely  upper body mechanics. The medical community is now looking southward to the lower extremity as the possible root of the problem.

It is known that variations in foot posture can influence lower extremity movement and therefore influence a pitcher’s predisposition to overuse injuries. Recent studies have correlated elite level baseball pitcher’s shoulder and elbow injuries to abnormal foot posture.

Pitching can be described as a balanced, controlled fall. Proper balance requires the ability to maintain a proper center of gravity position and coordination of the eyes(visual system), ears(vestibular system) and sense of position(proprioception). If the pitcher has a tendency for the arches of the foot to be lower(pes planus) or higher(pes cavus) than normal;  weight passing through the foot will rotate the lower leg  inwards or outwards through the pitching motion, requiring a compensatory reaction from above to perform the pitch. As this compensation continues, so too does the likelihood of a chronic injury.  This is only one example.

The earlier the athlete is assessed, the sooner the abnormal lower limb biomechanics can be corrected.  Sometimes with a series of exercises and arch supports, abnormal motion will improve, resulting in better form and increased performance.  Warning………Don’t always assume the cause of the injury is from the pain location.  


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Greg Lawrence DCh,
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