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New Study Examines Effects of Mound vs. Flat Ground Pitching in High School Pitchers

In a new study, researchers found that there are no statistically significant effects of using a mound, flat ground or distance variation on arm speed or shoulder rotation in high school pitchers.

The results were published in the Orthopaedic Journal of Sports Medicine on December 10, 2020.

“This is an important topic as we continuously look to refine and develop evidence-based injury-prevention and recovery guidelines for baseball pitchers,” said Joshua S. Dines, MD, sports medicine surgeon at HSS and senior author. “Creating data-driven programs requires us to have a better understanding of the kinetic and kinematic implications of a variety of throwing programs.”

Both elbow and shoulder injuries such as ulnar collateral ligament (UCL) tears continue to be on the rise in all baseball players but especially those at the high school level. UCL treatment (also known as Tommy John surgery) has increased sixfold over the last 20 years among this age group. To try to combat this, coaches and clinicians monitor workload, making constant adjustments to keep players healthy.

While workload has been a highly researched topic, the effects of mound height and distance to home plate have not been studied.

“As we’re monitoring pitchers’ workloads, we need to be aware of the stress being placed on the throwing arm elbow during training and rehabilitation in order to make the right adjustments to that individual pitcher’s training regimen,” added Dr. Dines.

Twenty-one healthy high school pitchers wore a sensor arm sleeve while pitching from four different conditions. The sensor and a radar gun were used to record data such as arm speed, arm slot, shoulder rotation, elbow varus torque and ball velocity. The results showed that there is no statistically significant difference between these variations.

“In the past, it has been assumed that throwing from flat ground was safer than throwing off of a mound due to increased elbow torque,” said study co-author Kathryn D. McElheny, MD, primary sports medicine physician at HSS. “Our study findings did not support this notion. Furthermore, we saw that elbow stress and ball velocity may not have a perfect correlation.”

The researchers concluded that pitchers were using similar mechanics (arm speed, shoulder rotation, elbow varus torque) whether throwing from the mound or flat ground, so this knowledge can be factored into player workload calculations.

About HSS

HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 14th consecutive year), No. 2 in rheumatology by U.S. News & World Report (2023-2024), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2023-2024). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a fourth consecutive year (2023). Founded in 1863, the Hospital has the lowest readmission rates in the nation for orthopedics, and among the lowest infection and complication rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. In addition, more than 200 HSS clinical investigators are working to improve patient outcomes through better ways to prevent, diagnose, and treat orthopedic, rheumatic and musculoskeletal diseases. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 165 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally.