More than the arm
Some great research on the importance of caring for the entire body of the throwing athlete has come out recently. (Gauthier et al, 2025)
We’ve linked the full article, but here are some important highlights to support coaches and parents as they advocate for their athletes.
What you need to know:
If your athlete experiences an injury, make sure your care team looks at their entire body.
Figure 1. Joint motion and muscle action during foot contact, acceleration, and deceleration phases of the throwing motion.
Artwork by Sam Bond
Link to Image Source
Findings:
High school pitchers experiencing an upper extremity injury were significantly more likely to present with decreased hip abduction strength off the drive leg. (Hamano et al, 2021)
Pitchers exhibited significantly decreased drive leg hip abductor strength compared to position players, requiring increased demand on the trunk and upper extremity to generate force. (Laudner et al., 2010)
Findings: Trunk rotation power played a significant role in the development of elbow valgus torque (inside part of the elbow associated with Tommy John) and ball speed. (Aguinaldo and Escamilla, 2019)
Findings: Throwing athletes demonstrating decreased lumbopelvic control in single leg stance were significantly more likely to miss over 30 days of a baseball season due to injury. (Chaudari et al., 2019)
Findings: Decreased lumbopelvic control on an athlete’s drive leg was correlated with increased torque at the anterior shoulder and medial elbow. (Laudner et al., 2010)
Roughly 86% of the total energy transferred through the elbow during the throwing motion was due to trunk motion. If you’re a visual person, this gives a great demonstration of the kinetic chain in motion. (Aguinaldo and Escamilla, 2019)
A classic example of the impact of the kinetic chain is the case of Dizzy Dean, a Hall of Fame pitcher from the 1930s. In 1937, Dean was struck in the foot by a line drive, fracturing his great toe. This injury and the subsequent impairments lead to an eventual career-altering arm injury.
Key Points
Take lower body pain and injury seriously for all athletes.
When seeking support care for an upper body injury, it is imperative the care team is looking at the lower body, as well.
Source:
Gauthier ML, Unverzagt CA, Davies GJ. Evaluation and Treatment of Baseball Pitchers: There's More to Assess than the Arm. Int J Sports Phys Ther. 2025 Jan 1;20(1):113-126. doi: 10.26603/001c.127461. PMID: 39758696; PMCID: PMC11698006.
