Clinical and Biomechanical Evaluation of the Softball Pitcher: A Review of Current Concepts and Clinical Commentary

Background: The windmill softball pitch (WSP) is a vastly understudied human motion relative to its counterpart the overhand baseball pitch (OBP). A large body of research has been conducted to understand the kinematics and kinetics of the OBP. Better understanding of the kinematics and kinetics of the WSP may help provide better pitch volume guidelines, physical performance preparation, and injury prevention programs. EvidenceAcquisition: A comprehensive review of the literature was performed to gain a full understanding of all currently available biomechanical and clinical evidence surrounding the WSP and related softball injuries. Study Design: Clinical Review. Level of Evidence: Level 5. Results: The softball pitch is a highly complex series of coordinated movements, in which the force generated by the large muscles of the lower extremity and trunk during the wind-up and stride phases are transferred to the ball through the shoulder and arm. Biomechanical evidence has demonstrated relatively equivocal distraction forces at the shoulder for both the softball pitch and baseball pitch. Conclusions: Altered pitching biomechanics, high pitch velocity, elevated pitch counts, decreased rest between outings, and increased pitcher fatigue may increase tissue stress on the upper extremity of a softball pitcher. There is convincing evidence that each of these variables have a compounding effect on injury risk for a softball pitcher. Therefore, coaches and clinicians need more research to promote upper extremity health in the softball pitcher at all levels of competition including pitch volume guidelines and injury prevention strategies.