[PDF]

Professional Baseball Pitchers Use of Weighted Ball Training, Injury Incidence, and Time Loss: A Preliminary Study PDF Free Download

1 / 11
0 views•11 pages

Professional Baseball Pitchers Use of Weighted Ball Training, Injury Incidence, and Time Loss: A Preliminary Study PDF Free Download

Professional Baseball Pitchers Use of Weighted Ball Training, Injury Incidence, and Time Loss: A Preliminary Study PDF free Download. Think more deeply and widely.

&C:8:?2= (6D62C49
Professional Baseball Pitchers Use of Weighted Ball Training, Injury
Incidence, and Time Loss: A Preliminary Study
Ellen Shanley, PT, PhD, OCS1a, Thomas J. Noonan, MD2,3, Michael J. Kissenberth, MD4, Daniel Kline, PT, DPT, SCS1,
Charles A. Thigpen, PT, ATC, PhD1, Garrett S. Bullock, PT, DPT, DPhil5,6
1 ATI Physical Therapy, 2 Department of Orthopaedic Surgery, University of Colorado School of Medicine, 3 University of Colorado Health, Steadman
Hawkins Clinic, 4 Steadman Hawkins Clinic of the Carolinas, 5 Department of Orthopaedic Surgery, Wake Forest University School of Medicine,
6 Department of Biostatistics and Data Science, Wake Forest University School of Medicine
Keywords: plyometric balls, plyo balls, injuries, kinetic chain
https://doi.org/10.26603/001c.140886
?E6C?2E:@?2= !@FC?2= @7 )A@CED '9JD:42= *96C2AJ
,@=  DDF6 
Background
#:EE=6 :D <?@H? 23@FE E96 :?;FCJ C:D< 2DD@4:2E65 H:E9 H6:89E65 32== FD6 3J AC@76DD:@?2=
32D632== A:E496CD *96 AFCA@D6 @7 E9:D DEF5J H2D E@ 56D4C:36 H6:89E65 32== EC2:?:?8 2?5
:?;FC:6D 2?5 4@>A2C6 :?;FCJ C2E6D 36EH66? E9@D6 AC@76DD:@?2= A:E496CD FD:?8 H6:89E65 32==
EC2:?:?8 2?5 E9@D6 E92E 5:5 ?@E FD6 H6:89E65 32== EC2:?:?8 5FC:?8 E96  AC6 2?5
C68F=2C D62D@?
Methods
*9:D DEF5J :?E6?565 2D 2 >F=E:J62C AC@;64E D6CG6D 2D 2? :?E6C:> D276EJ 2?2=JD:D 27E6C @?6
J62C @7 7@==@H FA ':E496CD F?56CH6?E C@FE:?6 A9JD:42= 6I2>:?2E:@? 2?5 :?;FCJ D4C66?:?8
2?5 H6C6 DFCG6J65 23@FE E96:C FD6 @7 H6:89E65 32D632== EC2:?:?8 *9C@F89@FE DAC:?8
EC2:?:?8 2?5 E96 $:?@C #628F6 2D632== $:# D62D@? 2== A:E496CD H6C6 >@?:E@C65 52:=J
7@C 2E9=6E:4 6IA@DFC6D 2?5 :?;FC:6D *96 @FE4@>6 @7 :?E6C6DE H2D ?@?EC2F>2E:4 32D632==
:?;FC:6D E@ 2?J E6?5@? =:82>6?E ?6CG6 >FD4=6 @C 3@?6 E92E @44FCD 5FC:?8 2?J 32D632==
E62> DA@?D@C65 24E:G:EJ @C 6G6?E E92E H2D 4@?PC>65 3J E96 E62> 2E9=6E:4 EC2:?6C ?;FCJ
C2E6D A6C  82>6 6IA@DFC6D  H2D 42=4F=2E65 3J H6:89E65 32== FD6 2?5 8C@FA65 3J
3@5J A2CE
Results
:89EJ6:89E A:E496CD H6C6 :?4=F565 -6:89E65 2== ?  %@ -6:89E65 2== ? 
E@E2= @7  :?;FC:6D H6C6 C6A@CE65 +AA6C 6IEC6>:EJ )9@F=56C ?;FCJ =3@H ?;FCJ
 *CF?<@C6 #@H6C IEC6>:EJ ':E496CD E92E FD65 H6:89E65 32== EC2:?:?8
DF776C65 6:89E >@C6 :?;FC:6D 2E 2  8C62E6C :?;FCJ C2E6 A6C  2E9=6E6 6IA@DFC6 52JD
4@>A2C65 E@ A:E496CD E92E 5:5 ?@E FD6 H6:89E65 32== EC2:?:?8 -6:89E65 32== A:E496CD 2C>
:?;FCJ C2E6 H2D  A6C   2?5 ?@ H6:89E65 32== 2C> :?;FCJ C2E6 H2D  A6C 
 -6:89E65 32== A:E496C ECF?< :?;FCJ C2E6 H2D  A6C   2?5 ?@ H6:89E65 32==
ECF?< :?;FCJ C2E6 H2D  A6C  
Conclusions
? E9:D :?E6C:> D276EJ 2?2=JD:D AC@76DD:@?2= A:E496CD E92E A6C7@C>65 H6:89E65 32==
EC2:?:?8 DF776C65 7C@> 8C62E6C 2C> 2?5 4@C6ECF?< :?;FC:6D 4@>A2C65 E@ AC@76DD:@?2=
A:E496CD E92E 5:5 ?@E A6C7@C> H6:89E65 32== EC2:?:?8
Corresponding Author
Ellen Shanley
ATI Physical Therapy
200 Patewood Dr.
Greenville, SC 29615
ellen.shanley@atipt.com
a
Shanley E, Noonan TJ, Kissenberth MJ, Kline D, Thigpen CA, Bullock GS. Professional
Baseball Pitchers Use of Weighted Ball Training, Injury Incidence, and Time Loss: A
Preliminary Study. IJSPT. 2025;20(7):995-1005. doi:10.26603/001c.140886
Level of Evidence
%*(&+* &%
'=2J:?8 32D632== 2E E96 9:896DE =6G6=D :D 2 8@2= @7 >2?J
J@F?8 32D632== A=2J6CD &?=J  @7 2== :?5:G:5F2=D E92E A=2J
@C82?:K65 32D632== A2CE:4:A2E6 2E E96 4@==68:2E6 @C AC@76D
D:@?2= =6G6=
*96 8@2= @7 A=2J:?8 32D632== AC@76DD:@?2==J 92D 6?4@FC
2865 2E9=6E6D E@ 2=E6C EC2:?:?8 2?5 A2CE:4:A2E:@? 5G2?465
EC2:?:?8 2?5 A2CE:4:A2E:@? :?4=F5:?8 A=2J:?8 32D632== @?
>F=E:A=6 E62>D A6C D62D@? A:E49:?8 :? >F=E:A=6 82>6D 5FC
:?8 2 D:?8=6 E@FC?2>6?E 6I4665:?8 A:E49 D>2CE 8F:56=:?6D
$2;@C #628F6 2D632== 0$#1 AF3=:D965 8F:56=:?6D 7@C
A:E49 4@F?E =:>:ED 2?5 C6BF:C65 C6DE 36EH66? A:E49:?8 4@>
A6E:E:@?D 3J 286 8C@FA 62C=J A2CE:4:A2E:@? :? D9@H42D6D
DA64:2=:K:?8 :? DA@CE 2?5 A@D:E:@? 2?5 E2<:?8 A2CE :? 32D6
32== DA64:P4 EC2:?:?8 92G6 366? E96@C:K65 E@ 6?92?46 A6C
7@C>2?46 3FE >2J 2=D@ :>A24E 2C> :?;FCJ C:D<M
'C@76DD:@?2= A:E496CD 56>@?DEC2E6 2? 2G6C286 72DE32==
G6=@4:EJ @7 2AAC@I:>2E6=J  >:=6D A6C 9@FC >A9
2DE32== A:E49 G6=@4:EJ :D 2 >6EC:4 FD65 E@ 56P?6 67764E:G6
A6C7@C>2?46 2?5 6G2=F2E6 A:E496CD 2D65 @? E96 A6C46:G65
:>A@CE2?46 @7 G6=@4:EJ 2D 2 >6EC:4 C6=2E65 E@ A:E49:?8 DF4
46DD 56G6=@A>6?E @7 G6=@4:EJ :D 2 7@4FD 7@C J@FE9 E9C@F89
25F=E A:E496CD :@>6492?:42= DEF5:6D 92G6 56>@?DEC2E65
E92E 9:896C G6=@4:EJ :?4C62D6D E96 =@25 @? E96 6=3@H 2?5
A@DD:3=J E96 :?;FCJ C:D< E@ E96 FAA6C 6IEC6>:EJ @7 A:E496CD
2== G6=@4:EJ 92D 366? 2DD@4:2E65 H:E9 >2?J :?EC:?D:4 2?5
6IEC:?D:4 724E@CD ? A:E496CD D@>6 @7 E96D6 724E@CD 42?
36 >@5:P65 :?4=F5:?8 E9C@H:?8 >6492?:4D <:?6E:4 492:?
DEC6?8E9 2?5 6?5FC2?46 *@ :?4C62D6 A6C7@C>2?46
2E9=6E6D A2CE:4:A2E6 :? DEC6?8E9 2?5 4@?5:E:@?:?8 AC@
8C2>D &G6C9625 2E9=6E6D 92G6 56>@?DEC2E65 :?4C62D65
E9C@H:?8 G6=@4:EJ :? >2?J DA@CED 27E6C 86?6C2= 2?5 DA@CE
DA64:P4 DEC6?8E9 EC2:?:?8 *C2:?:?8 E649?:BF6D 92G6 4@?
E:?F65 E@ 6G@=G6 3J :?4@CA@C2E:?8 DA@CE DA64:P4 >@G6>6?E
A2EE6C?D 2?5 E2D<D
&G6C E96 A2DE EH@ 564256D H6:89E6532== AC@8C2>D 92G6
82:?65 A@AF=2C:EJ :? 32D632== *96 EC2:?:?8 92D G2C:65 :?
4=F5:?8 FD6 @7 =:89E @C 962GJ H6:89E 32==D 7@C DA64:P4 EC2:?
:?8 AC@8C6DD:@?D H2C> FA @C 4@@= 5@H? @C 2D 2? 25;F?4E E@
EC2:?:?8 AC@8C2>D *96D6 EC2:?:?8 AC@8C2>D 92G6
366? 6BF:G@42==J 2DD@4:2E65 H:E9 :>AC@G65 G6=@4:EJ
(6:?@=5 6E 2= 2DD@4:2E65 H6:89E65 32== EC2:?:?8 H:E9 2=E6C
2E:@? :? D9@F=56C C2?86 @7 >@E:@? (&$ DEC6?8E9 2?5
A@DD:3=6 :?4C62D65 :?;FCJ C:D< #:EE=6 :D <?@H? 23@FE
E96 :?;FCJ C:D< 2DD@4:2E65 H:E9 H6:89E65 32== FD6 :? E96
J@FE9 E9C@F89 4@==68:2E6 A:E496CD =6DD :D <?@H? 23@FE E96
:?;FCJ C:D< E@ AC@76DD:@?2= 32D632== A:E496CD H96? FD:?8
H6:89E65 32== 2D 2? 25;F?4E E@ E96:C C68F=2C EC2:?:?8 AC@
8C2> *96 AFCA@D6 @7 E9:D DEF5J H2D E@ 56D4C:36 H6:89E65
32== EC2:?:?8 2?5 :?;FC:6D 2?5 4@>A2C6 :?;FCJ C2E6D 36EH66?
E9@D6 AC@76DD:@?2= A:E496CD FD:?8 H6:89E65 32== EC2:?:?8 2?5
E9@D6 E92E 5:5 ?@E FD6 H6:89E65 32== EC2:?:?8 5FC:?8 E96
 AC6 2?5 C68F=2C D62D@?
$*&)
)*+. ) %
*9:D DEF5J H2D 2AAC@G65 3J E96 'C:D>2 ?DE:EFE:@?2= (6G:6H
@2C5 )EF5J %F>36C  *96 DEF5J H2D 56D:8?65 2D 2
AC@DA64E:G6 4@9@CE DEF5J 4@?5F4E65 5FC:?8 E96  D62
D@? @? $:?@C #628F6 2D632== $:# A:E496CD :? @?6 $2;@C
#628F6 2D632== $# @C82?:K2E:@? *96 DEF5J :?E6?565 2D
2 >F=E:J62C AC@;64E FD65 =@?8:EF5:?2= D2>A=6 D:K6 42=4F=2
E:@? 32D65 @? 2? :?;FCJ C2E6 @7  H:E9 2? ( @7 
E@ A6C7@C> 2 @I )FCG:G2= 2?2=JD:D *9:D :D 2? :?E6C:> D276EJ
2?2=JD:D 27E6C @?6 J62C @7 7@==@H FA *96 )EC6?8E96?:?8
E96 (6A@CE:?8 @7 &3D6CG2E:@?2= )EF5:6D :? A:56>:@=@8J 7@C
)A@CE ?;FCJ 2?5 ==?6DD )FCG6:==2?46 )*(&) ) H2D
FD65 E@ :?7@C> DEF5J C6A@CE:?8 'C@76DD:@?2= A:E496CD A2C
E:4:A2E65 :? AC6D62D@? E6DE:?8 :6 )AC:?8 EC2:?:?8 AC:@C E@
E2<:?8 A2CE :? E62> DA@?D@C65 32D632== C6=2E65 24E:G:E:6D
== 52E2 25>:?:DEC2E@CD H6C6 3=:?565 E@ 92?5 5@>:?2?46
':E496CD F?56CH6?E C@FE:?6 A9JD:42= 6I2>:?2E:@? :?4=F5:?8
AC6G:@FD :?;FCJ 9:DE@CJ 2?5 :?;FCJ D4C66?:?8 5FC:?8 AC6D62
D@? >65:42= A9JD:42=D FC:?8 C@FE:?6 A9JD:42= 6I2>:?2E:@?
A6C AC6G:@FD=J 5@4F>6?E65 >6E9@5D :?4=FD:G6 @7 46CG:42=
D9@F=56C 2?5 9:A (&$ 2?5 9:A DEC6?8E9 >62DFC6DM
2?5 >FD4F=@D<6=6E2= D4C66?:?8 A:E496CD H6C6 DFCG6J65 @?
E96:C FD6 @7 H6:89E65 32D632== EC2:?:?8 56D4C:365 36=@H
*9C@F89@FE DAC:?8 EC2:?:?8 2?5 E96 $:# D62D@? A:E496CD
H6C6 >@?:E@C65 7@C 2E9=6E:4 6IA@DFC6D 2?5 :?;FC:6D
)*+. '(*  '%*)
$:?@C #628F6 2D632== A:E496CD 7C@> @?6 $# @C82?:K2
E:@? H6C6 :?4=F565 :? E9:D DEF5J ?4=FD:@? 4C:E6C:2 4@?
D:DE65 @7  4FCC6?E=J A2CE:4:A2E:?8 :? 2== 32D632== C6=2E65
EC2:?:?8 AC24E:46D 2?5 4@>A6E:E:@?D I4=FD:@? 4C:E6C:2
4@?D:DE65 @7  4FCC6?E=J :?;FC65 @C ?@E A2CE:4:A2E:?8 :? 2==
EC2:?:?8 AC24E:46D @C DAC:?8 EC2:?:?8 4@>A6E:E:@?D  A2C
E:4:A2E:?8 2E $# DAC:?8 EC2:?:?8  D:8?65 2 AC@76DD:@?2=
4@?EC24E :? E96 >:55=6 @7 E96 D62D@?  DFDE2:?65 2 EC2F
>2E:4 :?;FCJ H9:49 :?G@=G65 4@==:D:@? H:E9 2?@E96C 2E9=6E6
E96 8C@F?5 @C :?2?:>2E6 @3;64E 5FC:?8 E96 D62D@? ':E496CD
E92E H6C6 ?@E 4FCC6?E=J A2CE:4:A2E:?8 :? H6:89E65 32== EC2:?
:?8 -* H6C6 :?4=F565 :? E96 ?@?H6:89E65 32== EC2:?
:?8 %-* 8C@FA 9@H6G6C E96J 6I4=F565 7C@> A2CE:4:A2E
:?8 :? E96 DEF5J :7 E96J 925 EC2:?65 H:E9 H6:89E65 32==D :?
2?J @7 E96 AC6G:@FD E9C66 J62CD *96 :?4=FD:@? @7 -* E@ 2
A:E496CND H@C< @FE AC@8C2> H2D G@=F?E2CJ 2?5 2? :?5:G:5F2=
564:D:@? ?4=FD:@? :? E96 -* 8C@FA C6BF:C65 E96 2E9=6E6
2EE6DE E@ 4@?E:?F@FD 2?5 C68F=2C FD6 @7 H6:89E65 32== EC2:?
:?8 2 >:?:>F> @7 EH@ E:>6D A6C H66<
'C@76DD:@?2= 2D632== ':E496CD +D6 @7 -6:89E65 2== *C2:?:?8 ?;FCJ ?4:56?46 2?5 *:>6 #@DD 'C6=:>:?2O
International
Journal
of
Sports
Physical
Therapy
&+*&$) ))))$%*
WEIGHTED
BALL
TRAINING
':E496CD H6C6 DFCG6J65 :? DAC:?8 EC2:?:?8 @? E96:C 9:DE@CJ
2?5 FD6 @7 H6:89E65 32== 2?5 E96:C 2DD@4:2E65 EC2:?:?8
923:ED ':E496CD H6C6 BF6DE:@?65 :7 E96J FD65 H6:89E65 32==
EC2:?:?8 J6D?@ 7 2?DH6C65 J6D A:E496CD H6C6 7FCE96C65
BF6DE:@?65 @? E96:C DA64:P4 EC2:?:?8 923:ED :?4=F5:?8 FD6 2D
2 H2C>FA DEC2E68J A6C7@C>2?46 EC2:?:?8 :6 :?4C62D6 G6
=@4:EJ 2?5@C 2D 2 C64@G6CJ DEC2E68J :6 A@DE E9C@H D
:D 4@?G6?E:@?2= 2 C2?86 @7 32== H6:89ED :? EC2:?:?8 AC@8C2>D
2?5 AF3=:D965 DEF5:6D H6C6 C6A@CE65 3J E9:D 4@9@CE @7 AC@
76DD:@?2= A:E496CD
ATHLETE
EXPOSURE
DEFINITION
? 2E9=6E66IA@DFC6  H2D 56P?65 2D @?6 2E9=6E6 A2CE:4
:A2E:?8 :? @?6 AC24E:46 @C 4@>A6E:E:@? H96C6 2 A=2J6C H2D
2E C:D< @7 DFDE2:?:?8 2? :?;FCJ 2D632== 6IA@DFC6 H2D 56
P?65 7C@> E96 368:??:?8 @7 AC6D62D@? :6 DAC:?8 EC2:?:?8
E@ E96 6?5 @7 E96 $:# D62D@? ':E49:?8 2AA62C2?46 6I
A@DFC6 H2D 56P?65 2D 2 A:E496C E9C@H:?8 2E =62DE @?6 A:E49
H:E9:? 2 82>6 ??:?8D A:E4965 6IA@DFC6 H2D 56P?65 2D
@3E2:?:?8 2E =62DE @?6 @FE :6  @7 2? :??:?8 H:E9:? 2
82>6
INJURY
DEFINITION
? :?;FCJ H2D 56P?65 2D 2? :?;FCJ E@ 2 E6?5@? =:82>6?E
?6CG6 >FD4=6 @C 3@?6 E92E @44FCC65 5FC:?8 2?J 32D632==
E62> DA@?D@C65 24E:G:EJ @C 6G6?E H2D 7@==@H65 3J 2E =62DE
@?6 52J @7 >:DD65 AC24E:46 @C 82>6D 2?5 C646:G65 >65:42=
2EE6?E:@? 7C@> 2 >65:42= AC@76DD:@?2= 7 2 A=2J6C H2D F?
2G2:=23=6 E@ A=2J 7@C :?;FCJ AC6G6?E:@? C62D@?D :6 92D
C624965 =628F6 @C :?5:G:5F2==J 56E6C>:?65 A:E49 @C :??:?8D
4@F?E =:>:ED E96? E96:C 23D6?46 H2D ?@E 4@?D:56C65 2D
2? :?;FCJ ?;FC:6D H6C6 56P?65 3J E96 &C492C5 )A@CED
?;FCJ =2DD:P42E:@? DJDE6> 2?5 :?;FC:6D DEC2E:P65 3J C6
8:@? D9@F=56C4=2G:4=6 FAA6C 2C> 6=3@H 7@C62C> 4@C6
2?5 =@H6C 6IEC6>:EJ == :?;FC:6D 2?5 :==?6DD H6C6
C64@C565 2?5 E:>6 =@DD H2D E2<6? :?E@ 244@F?E 7@C @G6C2==
6IA@DFC6 &?=J :?;FC:6D @7 ?@?EC2F>2E:4 @C:8:? H6C6 :?
4=F565 2D E96 @FE4@>6 @7 :?E6C6DE 7@C DE2E:DE:42= 2?2=JD:D
*C2F>2E:4 :?;FC:6D 2?5 :==?6DD H:E9 2DD@4:2E65 E:>6=@DD
H6C6 FD65 E@ 4=2C:7J A2CE:4:A2E:@? ?;FCJ D6G6C:EJ H2D 7FC
E96C 4=2DD:P65 3J E:>6 =@DD @7 @?6 E@ D:I 52JD *# 7C@>
A2CE:4:A2E:@? :? AC24E:46 @7 82>6D E:>6 =@DD @7  52JD
* 2?5 E:>6 =@DD @7  52JD *
INITIAL
INJURY
? :?:E:2= :?;FCJ H2D 56P?65 H96? :E H2D E96 PCDE :?;FCJ
2?5 F?E:= E96 A:E496C 925 7F==J C64@G6C65 4=62C65 3J E96
DA@CED >65:4:?6 E62> E@ C6EFC? E@ 4@>A6E:E:@? 2?5 A=2J65
7@C 2E =62DE EH@ H66<D @7 4@>A6E:E:@?
OUTCOMES
OF
INTEREST
@C E96 AC:>2CJ 2?2=JD:D E96 @FE4@>6 H2D DFDE2:?:?8 2?
@G6CFD6 :?;FCJ 5FC:?8 E96 D62D@? *96 D64@?52CJ 2?2=JD:D
@FE4@>6 H2D DFDE2:?:?8 2? 2C> D9@F=56C @C 6=3@H @C 4@C6
:?;FCJ 5FC:?8 E96 D62D@?
+(*( ,( #) &##*
FCE96C G2C:23=6D 4@==64E65 H6C6 56E6C>:?65 E9C@F89 4=:?:
42= C62D@?:?8 2>@?8DE E96 DEF5J E62> 2?5 2 56E2:=65 C6G:6H
@7 E96 C6=6G2?E =:E6C2EFC6 *96D6 G2C:23=6D :?4=F565 A:E49
:?8 C@=6 :6 DE2CE6C G6CDFD C6=:6G6C ?F>36C @7 A:E49:?8
2AA62C2?46D :??:?8D A:E4965 2?5 72DE32== A:E49:?8
G6=@4:EJM
STATISTICAL
ANALYSES
'C:@C E@ 52E2 2?2=JD6D >:DD:?8 52E2 H6C6 2DD6DD65 7@C >:DD
:?8 52E2 AC6G2=6?46 A2EE6C?D @7 >:DD:?8?6DD 2?5 >6492
?:D>D @7 >:DD:?8?6DD AA6?5:I  $:DD:?8 52E2 H6C6 =@H
 H:E9 ?@ 5:D46C?23=6 >:DD:?8 52E2 A2EE6C? 2 4@>A=6E6
42D6 2?2=JD:D H2D A6C7@C>65 *96 DEF5J :?E6?565 2D 2
>F=E:J62C AC@;64E 5@4F>6?E65 2 D2>A=6 D:K6 @7  A:E49
6CD E@ A6C7@C> 2 @I )FCG:G2= 2?2=JD:D
A:56>:@=@8:42= 2=4F=2E:@?D == 6A:56>:@=@8:42= :?7@C
>2E:@? H6C6 42=4F=2E65 7@C E96 6?E:C6 4@9@CE :6 2== A:E49
6CD 2?5 DEC2E:P65 3J H6:89E65 32== EC2:?:?8 &G6C2== :?;FCJ
C2E6D :6 2== :?;FC:6D DF776C65 E9C@F89@FE E96 D62D@? H6C6
42=4F=2E65 7@C 2E9=6E6 6IA@DFC6D A:E49:?8 2AA62C2?46 6I
A@DFC6D 2?5 :??:?8D 6IA@DFC6D 2== C6A@CE65 A6C  6I
A@DFC6D &G6C2== :?;FCJ AC6G2=6?46 H2D 2=D@ 42=4F=2E65 ?:
E:2= :?;FCJ C2E6D H6C6 42=4F=2E65 A6C  2E9=6E6 6IA@DFC6
52JD 2?5 :?:E:2= :?;FCJ AC6G2=6?46 H2D 2=D@ 56E6C>:?65 ?
;FCJ C2E6 2?5 AC6G2=6?46  4@?P56?46 :?E6CG2=D H6C6 56
E6C>:?65 E9C@F89  3@@EDEC2AD 2E68@C:42= 52E2 H:E9
2 K6C@ @FE4@>6 H6C6 42=4F=2E65 E9C@F89 E96 =@AA6C'62C
D@? >6E9@5
== 2?2=JD6D H6C6 A6C7@C>65 :? ( G6CD:@?  ( @C6
*62>  ( =2?8F286 2?5 6?G:C@?>6?E 7@C DE2E:DE:42=
4@>AFE:?8 FD:?8 E96 dplyr A24<286 7@C 4=62?:?8 2?5 4@5
:?8 E96 DFCG:G2= A24<286 7@C DFCG:G2= 2?2=JD6D 2?5 E96
survminer 2?5 ggplot2 A24<286D 7@C 52E2 G:DF2=:K2E:@?
== DE2E:DE:42= 4@56 42? 36 @3E2:?65 E9C@F89 E96 &A6?
)4:6?46 C2>6H@C< =:?< 9EEAD@D7:@92B< F6 E@
28C66>6?ED H:E9 E96 $# @C82?:K2E:@? ?@ 52E2 ?@C DJ?
E96E:4 52E2 42? 36 D92C65
()+#*)
E@E2= @7  A:E496CD H6C6 2DD6DD65 2E E96 368:??:?8 @7
DAC:?8 EC2:?:?8 I4=F5:?8 E9@D6 E92E H6C6 C6=62D65 :?
DAC:?8 EC2:?:?8 2?5 A:E496CD ?6G6C 24E:G2E65 7C@> E96 :?
;FC65 =:DE  A:E496CD H6C6 :?4=F565 :8FC6  *23=6 56
D4C:36D E96 56>@8C2A9:4D 2?5 4=:?:42= >62DFC6D @7 E96 4@
9@CE 2?5 3@E9 8C@FAD @7 A:E496CD A:E496CD H9@ FD65 -*
2?5 5:5 ?@E FD6 H6:89E65 32==D :? E96:C EC2:?:?8 %-*
&7 E96  D2>A=6 A:E496CD  C6A@CE65 FD:?8 H6:89E65
32== EC2:?:?8 2?5  5:5 ?@E FD6 H6:89E65 32== EC2:?:?8
== A:E496CD E92E A2CE:4:A2E65 :? H6:89E65 32== EC2:?:?8 C6
A@CE65 FD6 @7 2 G2C:6EJ @7 D:K65 @G6CH6:89E 32==D C2?86
E@ @F?46D :? H6:89E 3FE 56?:65 FD:?8 F?56CH6:89E 32==D
':E496CD C6A@CE65 E92E E96 D:K6H6:89E @7 E96 32== 49@D6?
'C@76DD:@?2= 2D632== ':E496CD +D6 @7 -6:89E65 2== *C2:?:?8 ?;FCJ ?4:56?46 2?5 *:>6 #@DD 'C6=:>:?2O
International
Journal
of
Sports
Physical
Therapy
Figure 1. Sample Flow Chart
H2D 32D65 @? 2G2:=23:=:EJ ?@E EC2:?:?8 AC@E@4@= ':E496CD
E92E FD65 H6:89E65 32== EC2:?:?8 2AA62C D:>:=2C E@ E9@D6
E92E 5:5 ?@E FD6 H6:89E65 32== EC2:?:?8 H96? G:DF2=:K:?8
E96:C 56>@8C2A9:4D H@C<=@25 A:E49:?8 G6=@4:EJ 2?5 A9JD
:42= >62DFC6D @7 (&$ 2?5 DEC6?8E9 *23=6  &7 A:E496CD
E92E FD65 H6:89E65 32== EC2:?:?8 3@E9 :? 2?5 @77 D62D@?
 C6A@CE65 FD:?8 H6:89E65 32==D 7@C H2C> FA  7@C C6
4@G6CJ 2?5  E@ :>A24E A6C7@C>2?46 E9C@F89 G6=@4:EJ
EC2:?:?8 *96 2G6C286 ?F>36C @7 6IA@DFC6 52JD 7@C A:E496CD
H9@ FD65 H6:89E65 32== EC2:?:?8 H2D   52JD 2?5
A:E496CD E92E 5:5 ?@E FD6 H6:89E65 32== EC2:?:?8 @7 
 52JD E@E2= @7  2E9=6E6 6IA@DFC6 52JD H6C6
4@==64E65 @G6C E96 4@FCD6 @7 E96 $:# D62D@?
E@E2= @7  :?;FC:6D H6C6 DF776C65 3J A:E496CD 5FC:?8 E96
>:?@C =628F6 32D632== D62D@? &7 E96  :?;FC:6D C6A@CE65
+AA6C 6IEC6>:EJ  *CF?<@C6  #@H6C IEC6>:EJ
 2== H6C6 ?@?4@?E24E ':E496CD E92E FD65 H6:89E65 32==
EC2:?:?8 DF776C65 6:89E >@C6 :?;FC:6D 2E 2  8C62E6C :?;FCJ
C2E6 A6C  2E9=6E6 6IA@DFC6 52JD  8C62E6C :?;FCJ C2E6
A6C  A:E49:?8 2AA62C2?46 6IA@DFC6D 2?5  8C62E6C :?
;FCJ C2E6 A6C  :??:?8D A:E4965 6IA@DFC6D 4@>A2C65 E@
A:E496CD E92E 5:5 ?@E FD6 H6:89E65 32== EC2:?:?8 *23=6 
':E496CD E92E FD65 H6:89E65 32== EC2:?:?8 56>@?DEC2E65 2?
2C> :?;FCJ C2E6 @7  2C> :?;FC:6D A6C  A:E49:?8 82>6
6IA@DFC6D A:E496CD H9@ 5:5 ?@E FD6 H6:89E65 32== EC2:?
:?8 56>@?DEC2E65 2? 2C> :?;FCJ C2E6 @7  2C> :?;FC:6D A6C
 A:E49:?8 82>6 6IA@DFC6D ':E496CD E92E FD65 H6:89E65
32== EC2:?:?8 56>@?DEC2E65 2 ECF?< :?;FCJ C2E6 @7  ECF?<
:?;FC:6D A6C  A:E49:?8 82>6 6IA@DFC6D A:E496CD H9@
5:5 ?@E FD6 H6:89E65 32== EC2:?:?8 56>@?DEC2E65 2 ECF?< :?
;FCJ C2E6 @7  ECF?< :?;FC:6D A6C  A:E49:?8 82>6 6I
A@DFC6D 55:E:@?2==J E96 3FC56? @7 :?;FCJ E:>6=@DD :?
E96 A:E496CD E92E FD65 H6:89E65 32== EC2:?:?8 H6C6 2=>@DE
EH@ E:>6D 9:896C E92? :? A:E496CD E92E 5:5 ?@E FD6 H6:89E65
32==D :? EC2:?:?8 *23=6 
 )+)) &%
*96 >@DE :>A@CE2?E P?5:?8 @7 E9:D DEF5J :D E92E >@C6 E92?
 @7 >:?@C =628F6 A:E496CD 56>@?DEC2E65 4@?D:DE6?E FD6
@7 H6:89E65 32== EC2:?:?8 *9:D AC6=:>:?2CJ DEF5J 56>@?
DEC2E6D D@>6 4@?46C?:?8 EC6?5D C682C5:?8 E96 7C6BF6?4J
2?5 3FC56? @7 :?;FCJ 36EH66? 8C@FAD E@E2= @7  ?@?
4@?E24E :?;FC:6D H6C6 DF776C65 3J A:E496CD 5FC:?8 E96 >:?@C
=628F6 32D632== D62D@? *96 A:E496CD E92E FD65 -* DF7
76C65 6:89E >@C6 :?;FC:6D :? 2? 2G6C286 @7  76H6C 6IA@
DFC6D 4@>A2C65 E@ A:E496CD E92E 5:5 ?@E FD6 -* ':E496CD
E92E FD65 H6:89E65 32== EC2:?:?8 @? 2G6C286 >:DD65 2=>@DE
EH:46 2D >2?J 52JD @7 A=2J 2D E9@D6 E92E 5:5 ?@E FD6
H6:89E65 32== EC2:?:?8 *96D6 EC6?5D 2C6 G:E2= E@ E96 =:E6C2
EFC6 32D65 @? E96 9JA@E96D:K65 7C6BF6?4J @7 -* A@E6?
E:2= C:D<D 2?5 36?6PED @7 E96 G6=@4:EJ A6C7@C>2?46 EC2:?
:?8 2E E96 G2C:@FD =6G6=D @7 32D632== *96 2G2:=23=6 DEF5:6D
92G6 5@4F>6?E65 D@>6 36?6PED @7 EC2:?:?8 H:E9 H6:89E65
32==D :?4=F5:?8 :?4C62D65 G6=@4:EJ 2D 2 5:C64E @FE4@>6 @7
E9:D EC2:?:?8M &E96CD DEF5:6D 92G6 9:89=:89E65 E96 A@
E6?E:2= 7@C :?4C62D65 2C> D9@F=56C 2?5 6=3@H :?;FCJ C:D<
2?5 E:>6=@DD 7C@> A2CE:4:A2E:@? :? H6:89E65 EC2:?:?8M
)@>6 3:@>6492?:42= C6A@CED DF886DE E92E :?4C62D65 A:E49
:?8 G6=@4:EJ >2J :?4C62D6 6=3@H G2CFD E@CBF6 2?5 6=3@H :?
;FCJ C:D< *9:D 6G:56?46 >2J DF886DE E92E -* AC@
G:56D 3@E9 E96 36?6PE @7 :>AC@G65 A6C7@C>2?46 2?5 E96
92K2C5 @7 :?4C62D65 :?;FCJ C:D< 3J :?4C62D:?8 G6=@4:EJ
*96 6DE23=:D965 AC@76DD:@?2= A:E496CD :? E9:D 4@9@CE FD
:?8 H6:89E65 32== EC2:?:?8 5:DA=2J65 2 4@?46C?:?8 A2EE6C?
@7 E:>6 =@DD :?;FC:6D H:E9 2  5:776C6?46 :? :?;FCJ AC6G2
=6?46 -*      %-*  
  *96C6 H6C6 ?@ 5:776C6?46D H96? 4@>A2C:?8
H:E9:? DE2CE:?8 2?5 C6=:67 A:E496CD 2?5 H@C<=@25 H2D D:>:=2C
H96? 4@>A2C:?8 2AA62C2?46D @C :??:?8D A:E4965 36EH66?
EC2:?:?8 4@9@CED *9:D :D 4@?46C?:?8 2D H6:89E65 32== EC2:?
:?8 H2D AC:>2C:=J FD65 E@ :>A24E A6C7@C>2?46 E9C@F89 G6
=@4:EJ EC2:?:?8  H:E9:? E9:D 4@9@CE D2>A=6 H:E9@FE
DF3D6BF6?E 4C@DDD64E:@?2= A6C7@C>2?46 :>AC@G6>6?ED E
D9@F=5 36 ?@E65 E92E AC6G:@FD D62D@? A:E49 G6=@4:EJ AC:@C
H2D ?@E 4@==64E65 H:E9:? E9:D D2>A=6 ?@E 2==@H:?8 2DD6DD
>6?E @7 A@E6?E:2= A:E49 G6=@4:EJ :?4C62D6D ?@C >6492?:D>D
F?56C=J:?8 :?;FCJ @C A6C7@C>2?46
*96 >@DE 7C6BF6?E ?@?4@?E24E :?;FC:6D DFDE2:?65 :? E96
A:E496CD H2D 2 D:>:=2C 7C6BF6?4J @7 6=3@H :?;FC:6D ?
 GD  H96? 4@>A2C:?8 -* E@ %-* A:E496CD C6
DA64E:G6=J %:?6 D9@F=56C :?;FC:6D H6C6 C6A@CE65 @H6G6C
E96 >@DE DFCAC:D:?8 P?5:?8 H2D E96 ?F>36C @7 4@C6 :?;FC:6D
DFDE2:?65 3J @FC A:E496CD :89E 4@C6 :?;FC:6D H6C6 C6A@CE65
@G6C E96 4@FCD6 @7 E96 D62D@? H:E9 D:I @44FCC:?8 :? E96 -*
G6CDFD EH@ :? E96 %-* 4@9@CE -9:=6 E96D6 P?5:?8D H6C6
?@E D:8?:P42?E=J 5:776C6?E :E :D 4@?46C?:?8 E92E 8C62E6C E92?
 @7 E96 :?;FC:6D DFDE2:?65 3J A:E496CD :? E96 -* 8C@FA
H6C6 4@C6 :?;FC:6D
@CEJ7@FC @7 E96  AC@76DD:@?2= A:E496CD C6A@CE65 >F=
E:J62C H6:89E65 32== EC2:?:?8 5FC:?8 3@E9 E96 @77 D62D@? 2?5
E9C@F89@FE E96 C68F=2C D62D@? E H2D ?@E =@8:DE:42==J 762D:
3=6 E@ 4@==64E A@DE H6:89E65 32== EC2:?:?8 AC@8C2> (&$ :?
6:E96C E96 -* @C %-* 4@9@CE :C64E 4@>A2C:D@? H:E9
'C@76DD:@?2= 2D632== ':E496CD +D6 @7 -6:89E65 2== *C2:?:?8 ?;FCJ ?4:56?46 2?5 *:>6 #@DD 'C6=:>:?2O
International
Journal
of
Sports
Physical
Therapy
Table 1. Pitcher Descriptive Statistics
Variable All
Pitchers
(n = 88)
Pitchers Who Used
Weighted Balls
(n = 46)
Pitchers Who Did Not Use
Weighted Balls
(n = 42)
Age (years) 24.2
(2.4)
24.6 (2.5) 23.7 (1.9)
Body Mass Index (kg/m2) 25.1
(2.3)
25.2 (2.7) 24.8 (1.8)
Hand Dominance (% Right) 67 (76%) 39 (84%) 29 (69%)
Starter (%) 28 (31%) 15 (32%) 13 (31%)
Pitching Appearances 22.4
(13.7)
22.9 (13.5) 22.2 (12.5)
Innings Pitched 44.6
(26.7)
42.2 (28.2) 48.4 (24.9)
Average Fastball Velocity (mph) 92.3
(1.8)
92.5 (1.7) 92.9 (1.9)
Hip Clinical Measurements
Dominant Hip Internal Rotation (⯑) 34.5
(9.5)
32.6 (7.0) 35.7 (7.2)
Non-Dominant Hip Internal Rotation (⯑) 34.6
(7.0)
34.1 (7.1) 35.5 (8.0)
Dominant Hip External Rotation (⯑) 29.4
(7.5)
28.3 (7.1) 30.9 (8.0)
Non-Dominant Hip External Rotation
(⯑)
29.4
(7.4)
29.3 (7.0) 29.9 (8.2)
Dominant Hip Adductor Strength (n) 39.8
(8.4)
41.0 (9.1) 38.3 (8.1)
Non-Dominant Hip Adductor Strength
(n)
39.5
(7.9)
41.4 (8.4) 37.3 (7.3)
Dominant Hip Abductor Strength (n) 38.2
(6.3)
39.3 (6.5) 37.1 (6.3)
Non-Dominant Hip Abductor Strength
(n)
38.5
(6.3)
38.9 (6.0) 37.9 (7.0)
Shoulder Clinical Measurements
Dominant Shoulder External Rotation
(⯑)
131.6
(19.5)
131.8 (22.5) 133.2 (15.6)
Non-Dominant Shoulder External
Rotation (⯑)
120.7
(18.7)
121.6 (18.7) 121.3 (19.4)
Dominant Shoulder Internal Rotation (⯑) 37.4
(11.1)
37.8 (11.1) 37.0 (11.2)
Non-Dominant Shoulder Internal
Rotation (⯑)
45.9
(12.9)
46.5 (12.9) 46.2 (13.0)
Dominant Shoulder Horizontal
Adduction (⯑)
10.7
(12.6)
12.3 (13.7) 10.4 (11.3)
Non-Dominant Shoulder Horizontal
Adduction (⯑)
24.0
(10.4)
24.1 (9.4) 24.3 (11.6)
Dominant Shoulder Humeral Torsion (⯑) 4.4
(12.5)
5.7 (12.4) 3.7 (13.0)
Non-Dominant Shoulder Humeral
Torsion (⯑)
23.0
(14.5)
24.5 (14.8) 22.4 (14.1)
2E2 2C6 C6A@CE65 2D >62? DE2?52C5 56G:2E:@? 7@C 4@?E:?F@FD G2C:23=6D 2?5 4@F?E  7@C 4@F?E 52E2
AC6G:@FD 2CE:4=6D 4@==64E:?8 E96 :?QF6?46 @7 -* @? 6IE6C
?2= C@E2E:@? (&$ 52E2 :D ?@E A@DD:3=6
%F>6C@FD DEF5:6D 92G6 AC6G:@FD=J C6A@CE65 E96 FD6 @7
H6:89E65 32==D :? AC@8C2>D 7@4FD:?8 @? G6=@4:EJ 6?92?46
>6?E 2?5 H2C> FA 7@C 4@>A6E:E:@?M *96D6
DEF5:6D 5@4F>6?E 2 C2?86 @7 32== H6:89ED 7C@>  @F?46D
2?5 2 G2C:6EJ @7 D6ED 2?5 C6A6E:E:@?DM *96 G2C:
23:=:EJ :? EC2:?:?8 AC@E@4@=D C6D62C49 DEF5J 56D:8?D 2?5
2E9=6E6 A@AF=2E:@?D 4C62E6D 5:7P4F=EJ :? 56E6C>:?:?8 E96
36DE 2G2:=23=6 AC@8C2> 7@C 6249 A:E496C E@ >2:?E2:? 3@E9
'C@76DD:@?2= 2D632== ':E496CD +D6 @7 -6:89E65 2== *C2:?:?8 ?;FCJ ?4:56?46 2?5 *:>6 #@DD 'C6=:>:?2O
International
Journal
of
Sports
Physical
Therapy
Table 2. Pitch Injury Characteristics
Injury All Pitchers
Injured
(n = 88)
Pitchers Who Used
Weighted Balls
(n = 46)
Pitchers Who Did Not Use
Weighted Balls
(n = 42)
Overall Injury Rates
Non-Contact Time Loss Injury Rate
(per 1000 exposure days)
1.8
(95% CI: 1.5, 3.1)
2.6
(95% CI: 1.5, 3.8)
1.5
(95% CI: 0.8, 3.0)
Non-Contact Time Loss Injury Rate
(per 1000 exposure pitching
appearances)
16.9
(95% CI: 11.8,
25.2)
20.7
(95% CI: 12.1, 31.6)
12.9
(95% CI: 7.0, 25.6)
Non-Contact Time Loss Injury Rate
(per 1000 exposure innings
pitched)
8.7
(95% CI: 6.2, 13.0)
10.2
(95% CI: 6.1, 15.5)
6.9
(95% CI: 3.8, 13.6)
Overall Injury Prevalence 28
(31.8%; 95% CI:
27.2, 53.4)
18
(39.1%; 95% CI: 28.3,
65.3)
10
(23.8%; 95% CI: 15.9, 53.9)
Initial Non-Contact Injury
Non-Contact Initial Time Loss
Injury Rate
(per 1000 exposure days)
2.0
(95% CI: 1.3, 2.7)
2.5
(95% CI: 1.5, 3.6)
1.4
(95% CI: 0.6, 2.4)
Non-Contact Initial Time Loss
Injury Prevalence
28
(31.0%; 95% CI:
22.7, 42.1)
18
(39.0%; 95% CI: 26.1,
52.4)
10
(24.0% 95% CI: 11.9, 37.0)
Days Lost 35.5 (36.6) 44.4 (41.8) 23.2 (24.3)
Time Loss 1-7 Days (TL 1) 1
(1.1%; 95% CI: 0.0,
6.2)
0
(0.0%; 95% CI: 0.0, 7.7)
1
(2.3%; 95% CI: 0.0, 12.6)
Time Loss 8-27 Days (T7-27) 15
(17.0%; 95% CI:
10.0, 26.6)
9
(20%; 95% CI: 9.4, 33.9)
5
(11.9%; 95% CI: 4.0, 25.6)
Time Loss 28+ Days
(T-28)
15
(17.0%; 95% CI:
10.0, 26.6)
9
(20%; 95% CI: 9.4, 33.9)
6
(14.2%; 95% CI: 5.4, 28.5)
Elbow Injury 11
(12.5%; 95%CI:
6.4, 21.3)
8
(17.4%; 95% CI: 7.8, 31.4)
3
(7.1%; 95% CI: 1.5, 19.5)
Shoulder Injury 9
(10.2%; 95% CI:
4.8, 18.5)
4
(8.7%; 95% CI: 2.4, 20.8)
5
(11.9%; 95% CI: 4.0, 25.6)
Core/Trunk Injury 8 (9.1%; 95% CI:
4.0, 17.1)
6 (13.0%; 95% CI: 5.0,
26.3)
2 (4.7%; 95% CI: 0.6, 16.2)
2E2 2C6 C6A@CE65 2D >62? DE2?52C5 56G:2E:@? 7@C 4@?E:?F@FD 52E2 2?5 4@F?E  7@C 4@F?E 52E2
?;FCJ C2E6 2?5 :?;FCJ AC6G2=6?46 4@?P56?46 :?E6CG2=D H6C6 42=4F=2E65 E9C@F89  3@@EDEC2AD
'C6G2=6?46 4@?P56?46 :?E6CG2=D H:E9 4@F?ED H6C6 42=4F=2E65 E9C@F89 E96 =@AA6C'62CD@? $6E9@5
% %@E AA=:423=6
@AE:>2= A6C7@C>2?46 2?5 962=E9 *96 6G:56?46 @7 :?;FCJ
C:D< :? C6=2E:@? E@ H6:89E65 32== FD6 :D =:>:E65 @H6G6C
:? E96 @?=J @E96C DEF5J E@ AC@DA64E:G6=J 7@==@H A:E496CD E92E
FD65 H6:89E65 32== EC2:?:?8 E9C@F89@FE E96 32D632== D62D@?
A:E496CD E92E FD65 H6:89E65 32==D C6A@CE65 2  :?4C62D6
:? 2C> :?;FC:6D *96 4@>A2C:D@? @7 AC@76DD:@?2= A:E496CD
EC2:?:?8 H:E9 2?5 H:E9@FE 2 H6:89E65 32== AC@8C2> 56>@?
DEC2E6D E96 G2C:6EJ :? A6CD@?2= 8@2=D 2?5 :>A=6>6?E2E:@?
2D65 @? E96D6 62C=J C6DF=ED :E 2AA62CD E92E D6=7D6=64E65
H6:89E65 32== EC2:?:?8 AC:@C E@ 2?5 E9C@F89@FE E96 D62D@?
>2J :?4C62D6 E96 A:E496CND :?;FCJ C:D< 3@E9 E@ E96 FAA6C 6I
EC6>:EJ 2?5 :? 255:E:@? E@ E96 2E9=6E6ND 4@C6
)*(%*) & * )*+.
*96 DEC6?8E9D @7 E96 DEF5J :?4=F56 E96 6DE23=:D9>6?E @7 2
8C@FA @7 A:E496CD H:E9:? @?6 AC@76DD:@?2= 32D632== @C82?:
K2E:@? E92E 56>@?DEC2E65 D:>:=2C 56>@8C2A9:4D D62D@?2=
A:E49 H@C<=@25 A:E49:?8 >6EC:4D (&$ 2?5 DEC6?8E9 *9:D
D:>:=2C:EJ 4@>3:?65 4@?D:DE6?E=J 2G2:=23=6 2E9=6E:4 EC2:?6CD
E@ >@?:E@C 2?5 G6C:7J 2E9=6E:4 6IA@DFC6 :?;FC:6D 2?5 E:>6
=@DD 7C@> DA@CE 277@C5 9:89 BF2=:EJ 2?5 4@?D:DE6?E 52E2 4@=
=64E:@?
)*+. # $ ** &%)
E :D :>A@CE2?E E@ 9:89=:89E E96 =:>:E2E:@?D @7 E9:D DEF5J
*96 C6DF=ED @7 E96 :?:E:2= 2?2=JD:D H6C6 76=E E@ 36 :>A@CE2?E
'C@76DD:@?2= 2D632== ':E496CD +D6 @7 -6:89E65 2== *C2:?:?8 ?;FCJ ?4:56?46 2?5 *:>6 #@DD 'C6=:>:?2O
International
Journal
of
Sports
Physical
Therapy
3642FD6 @7 E96 ?F>36C 2?5 EJA6D @7 :?;FC:6D C6A@CE65 :? E9:D
4@9@CE @C E9:D C62D@? E96 >@DE D:8?:P42?E =:>:E2E:@? :D
E92E E9:D AC6=:>:?2CJ DEF5J :D F?56CA@H6C65 *96 4FCC6?E
A@H6C 2AC:@C: >6E9@5D 2?5 DE2E:DE:42= A=2? =:>:E65 E96 @FE
4@>6D E@ 6A:56>:@=@8:42= :?7@C>2E:@? 7@C E96 6?E:C6 4@9@CE
:6 2== A:E496CD 2?5 DEC2E:P65 3J H6:89E65 32== EC2:?:?8
*9:D :D E96 :?:E:2= J62C @7 2 >F=E:J62C DEF5J E96C67@C6 25
5:E:@?2= 52E2 >2J 492?86 E96 F=E:>2E6 P?5:?8D 2?5 C64@>
>6?52E:@?D @7 E96 DEF5J 249 2E9=6E6 D6=7D6=64E65 E96:C :?
5:G:5F2= 32== H6:89E EC2:?:?8 5FC2E:@? 2?5 G@=F>6 *96D6
A2C2>6E6CD >2J ?@E 92G6 366? 4@?D:DE6?E E9C@F89@FE 6G6CJ
EC2:?:?8 D6DD:@? 2D E96 >@DE 4@?D:DE6?E C6A@CE 7C@> A:E496CD
:?QF6?4:?8 32== H6:89E H2D 6BF:A>6?E 2G2:=23:=:EJ 2E E96
E:>6 @7 EC2:?:?8 ? 255:E:@? :E :D 4C:E:42= E@ 9:89=:89E E92E
E96 G2C:23:=:EJ @7 E96 H@C<=@25 2?5 EC2:?:?8 A2C2>6E6CD >2J
D:8?:P42?E=J :?QF6?46 E96 ECF6 :>A24E @7 E9:D EC2:?:?8 @?
E96 A@E6?E:2= :?;FCJ C:D< @7 E96 :?5:G:5F2= 2E9=6E6D
&%#+) &%
*96 C6DF=ED @7 E9:D DEF5J 255 E@ E96 3@5J @7 <?@H=6586 C6
82C5:?8 H6:89E65 32== EC2:?:?8 9:89=:89E:?8 E96 7C6BF6?4J
@7 FD6 EJA6 2?5 3FC56? @7 :?;FC:6D :? AC@76DD:@?2= A:E496CD
*96 :?7@C>2E:@? AC@G:56D :?:E:2= F?56CDE2?5:?8 @7 E96 >28
?:EF56 @7 EC2:?:?8 2?5 A@E6?E:2= :?;FCJ C:D< :? AC@76DD:@?2=
A:E496CD *96 A6C46?E286 @7 A:E496C :?;FC:6D :? E96 -* H2D
 G6CDFD  :? E96 %-* 8C@FA *96 A6C46?E286 @7
52JD =@DE :? E96 -* 8C@FA H2D  G6CDFD  :? E96
%-* 8C@FA *9:D AC6=:>:?2CJ 2?2=JD:D H2D D:8?:P42?E=J
F?56CA@H6C65 2?5 E96C67@C6 E96 :?;FCJ C2E6 2?5 52JD H2D
D:>:=2C 36EH66? 8C@FAD *96 >@DE DFCAC:D:?8 P?5:?8D :?
4=F56 E96 ?F>36C @7 4@C6ECF?< :?;FC:6D 5@4F>6?E65 2?5
E96 :?4C62D65 E:>6 2H2J 7C@> DA@CE :? E96 -* 4@9@CE 5
5:E:@?2= 7@==@H FA :D ?66565 E@ 4=2C:7J E96D6 P?5:?8D
&%# *) & %*()*
*96 2FE9@CD =:DE65 23@G6 5@ ?@E 92G6 2?J 4@?Q:4E @7 :?E6C
6DED H:E9 E96 DF3;64E @7 E9:D 2CE:4=6
L *96 FE9@CD
)F3>:EE65 63CF2CJ   * 446AE65 AC:=  
* 'F3=:D965 !F=J   *
This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License
(CCBY-NC-4.0). View this license’s legal deed at https://creativecommons.org/licenses/by-nc/4.0 and legal code at https://cre-
ativecommons.org/licenses/by-nc/4.0/legalcode for more information.
'C@76DD:@?2= 2D632== ':E496CD +D6 @7 -6:89E65 2== *C2:?:?8 ?;FCJ ?4:56?46 2?5 *:>6 #@DD 'C6=:>:?2O
International
Journal
of
Sports
Physical
Therapy
((%)
 $4#6==2? $ ==292325: ) '2?5J2 %" .@FE9
DA@CED DA64:2=:K2E:@? 2?5 :ED 67764E @? AC@76DD:@?2=
6=:E6 2?5 @=J>A:4 2E9=6E6 A6C7@C>2?46 42C66C
=@?86G:EJ 2?5 :?;FCJ C2E6D DJDE6>2E:4 C6G:6H
Orthop
J
Sports
Med
 5@:

 )92?=6J  ":DD6?36CE9 $! *9:8A6?  6E 2=
'C6D62D@? D9@F=56C C2?86 @7 >@E:@? D4C66?:?8 2D 2
AC65:4E@C @7 :?;FCJ 2>@?8 J@FE9 2?5 25@=6D46?E
32D632== A:E496CD J
Shoulder
Elbow
Surg
 5@:;;D6
 C:4<D@? ! E=66 *( 92=>6CD '% 6E 2= *C2:?:?8
H:E9 =:89E6C 32D632==D :?4C62D6D G6=@4:EJ H:E9@FE
:?4C62D:?8 E96 :?;FCJ C:D< Orthop
J
Sports
Med
 5@:

 C?@=5 ! *9:8A6?  62EE:6 ' ":DD6?36CE9 $!
*@<:D9 !$ )92?=6J  )A@CE )A64:2=:K2E:@? 2?5
:?4C62D65 :?;FCJ 7C6BF6?4J :? J@FE9 32D632== A=2J6CD
2 AC@DA64E:G6 DEF5J J
Athl
Train
 5@:

 C6:?6C !! *C@EE6C  -2=4K2<  6EK6= )! 26C
) ':E49:?8 3692G:@CD :? J@FE9 32D632== 4@>A2C:D@?
H:E9 E96 A:E49 D>2CE 8F:56=:?6D Orthop
J
Sports
Med
 5@:

 $6=F8:? ' )>2CE  ,6C9@6G6? $ :?6D !)
2>A # *96 6G:56?46 369:?5 H6:89E65 32==
E9C@H:?8 AC@8C2>D 7@C E96 32D632== A=2J6C 5@ E96J
H@C< 2?5 2C6 E96J D276 Curr
Rev
Musculoskelet
Med
 5@:D
(6:?@=5 $$ $24C:?2 # *96 D276EJ 2?5 67P424J @7
H6:89E65 32D632==D Int
J
Sports
Phys
Ther
 5@:4
 (6:?@=5 $$ $24C:?2 # =6:D:8 ) F?6 "
?5C6HD !( 7764E @7 2 H66< H6:89E65 32D632==
E9C@H:?8 AC@8C2> @? A:E49 G6=@4:EJ A:E49:?8 2C>
3:@>6492?:4D A2DD:G6 C2?86 @7 >@E:@? 2?5 :?;FCJ
C2E6D Sports
Health  5@:

 (6:?@=5 $$ $24C:?2 # =6:D:8 ) C@8@DK $
?5C6HD !( 4FE6 67764ED @7 H6:89E65 32D632==
E9C@H:?8 AC@8C2>D @? D9@F=56C C2?86 @7 >@E:@?
Sports
Health  5@:

 /232H2 # ==2?5 ! DD@4:2E:@? 36EH66?
A2C6?E2= F?56CDE2?5:?8 @7 A:E49 D>2CE 8F:56=:?6D 2?5
J@FE9 32D632== A=2J6C :?;FC:6D Orthop
J
Sports
Med
 5@:

 &CE:K !# *96 BF6DE 7@C 2 >A9 72DE32== 42?
>=3 AC@DA64ED D276=J 56G6=@A G6=@4:EJ USA
Today
 )=@H:< !) F?6 "* :776?52776C / 2:? #
F82D !( =6:D:8 ) 2DE32== G6=@4:EJ 2?5 6=3@H
G2CFD E@CBF6 :? AC@76DD:@?2= 32D632== A:E496CD J
Athl
Train  5@:

 2=5H6== ! =6I2?56C ! 9>25 ) -6:89E65
32== G6=@4:EJ 6?92?46>6?E AC@8C2>D 7@C 32D632==
A:E496CD 2 DJDE6>2E:4 C6G:6H Orthop
J
Sports
Med
 5@:

 336? -' :?EK $! ):>6?K ! )EC6?8E9 2?5
4@?5:E:@?:?8 AC24E:46D @7 >2;@C =628F6 32D632==
DEC6?8E9 2?5 4@?5:E:@?:?8 4@2496D J
Strength
Cond
Res  5@:(
 C66DE@? !# 2CE6C * -9:E2<6C  %:49@==D &
(@@?6J " )EC6?8E9 2?5 A@H6C 4@CC6=2E6D @7
E9C@H:?8 G6=@4:EJ @? DF36=:E6 >2=6 4C:4<6E A=2J6CD J
Strength
Cond
Res 
5@:!)
 6865FD ! 2C56DEJ "- )F?56C=2?5 "#
6865FD (! )>@=:82 !$ C2?5@>:K65 EC:2= @7
EC25:E:@?2= 2?5 8@=7DA64:P4 C6D:DE2?46 EC2:?:?8 :?
2>2E6FC 76>2=6 8@=76CD 36?6PED 36J@?5 8@=7
A6C7@C>2?46 Phys
Ther
Sport 
5@:;AEDA
 $@C:>@E@ . E@ " "2H2>FC2 * $FC2<: .
>>65:2E6 67764E @7 2DD:DE65 2?5 C6D:DE65 EC2:?:?8
FD:?8 5:776C6?E H6:89E 32==D @? 32== DA665 2?5
244FC24J :? 32D632== A:E49:?8 International
journal
of
sport
and
health
science 
5@::;D9D
 )9:? . 9@: - 7764ED @7 H6:89E65 32D632==
E9C@H:?8 5FC:?8 H2C>FA @? 32== G6=@4:EJ 2?5 FAA6C
6IEC6>:EJ >FD4=6 24E:G2E:@? :? 32D632== A:E496CD J
Exerc
Rehabil  5@:
;6C
 )92?=6J  *9:8A6?  @==:?D ) 6E 2=
?4=F5:?8 >@5:P23=6 2?5 ?@?>@5:P23=6 724E@CD
>AC@G6D :?;FCJ C:D< 2DD6DD>6?E :? AC@76DD:@?2=
32D632== A:E496CD J
Orthop
Sports
Phys
Ther
 5@:;@DAE
'C@76DD:@?2= 2D632== ':E496CD +D6 @7 -6:89E65 2== *C2:?:?8 ?;FCJ ?4:56?46 2?5 *:>6 #@DD 'C6=:>:?2O
International
Journal
of
Sports
Physical
Therapy
 ?E6C?2E:@?2= &=J>A:4 @>>:EE66 ==?6DD
6A:56>:@=@8J 4@?D6?DFD 8 29C ( 6E 2=
:?E6C?2E:@?2= @=J>A:4 4@>>:EE66 4@?D6?DFD
DE2E6>6?E >6E9@5D 7@C C64@C5:?8 2?5 C6A@CE:?8 @7
6A:56>:@=@8:42= 52E2 @? :?;FCJ 2?5 :==?6DD :? DA@CED
 :?4=F5:?8 E96 DEC@36 6IE6?D:@? 7@C DA@CED :?;FCJ
2?5 :==?6DD DFCG6:==2?46 DEC@36D::D Orthop
J
Sports
Med  5@:

 F==@4< ) 64<  @==:?D ) :=32J )(
%:49@=D@? " :A :?E6C?2= 2?5 6IE6C?2= C@E2E:@?
C2?86 @7 >@E:@? C6=:23:=:EJ :? J@FE9 32D632== A=2J6CD J
Sports
Med
Phys
Fitness 
5@:)
 F==@4< ) )EC29> ! F=3FCE * 64< 
-2E6C>2? ( %:49@=D@? " *96 C6=2E:@?D9:A @7
C2?86 @7 >@E:@? 9:A D9@F=56C D6A2C2E:@? 2?5
A:E49:?8 <:?6>2E:4D Int
J
Sports
Phys
Ther
 5@::;DAE
 6G2?6J ## 6?682C ( *9:8A6?  #6A=6J )
582C  :)E672?@ #! 'C6D62D@? ?64< >@3:=:EJ :D
2DD@4:2E65 H:E9 E9C@H:?8C6=2E65 D9@F=56C 2?5 6=3@H
:?;FC:6D '2:? 2?5 :D23:=:EJ :? @==686 2D632==
':E496CD Orthop
J
Sports
Med
 5@:

 '@H6== !- 2C36C@DD " )6IC6=2E65 :?;FCJ
A2EE6C?D 2>@?8 D6=64E65 9:89 D49@@= DA@CED Am
J
Sports
Med  5@:

 &C492C5 !- "@F?E@FC:D  ):>D " ?4:56?46 2?5
AC6G2=6?46 @7 6=:E6 >2=6 4C:4<6E :?;FC:6D FD:?8
FA52E65 4@?D6?DFD 56P?:E:@?D Open
Access
J
Sports
Med  5@:&!)$)
 (2F9 $! $2C896C:E2 ! (:46 ) "@6AD6== *
(:G2C2 ' :89 D49@@= 4C@DD 4@F?ECJ CF??:?8 :?;FC:6D
2 =@?8:EF5:?2= DEF5J Clin
J
Sport
Med
 5@:

 (26 " &C492C5 ! *96 &C492C5 )A@CED ?;FCJ
=2DD:P42E:@? )JDE6> &) ) G6CD:@?  Clin
J
Sport
Med  5@:
!)$363
 &C492C5 !- (2?D@?  &=:G:6C  6E 2=
?E6C?2E:@?2= 4@?D6?DFD DE2E6>6?E @? :?;FCJ
DFCG6:==2?46 :? 4C:4<6E 2  FA52E6 Br
J
Sports
Med  5@:
3;DA@CED
 C56C? # =2D8@H ' )49?6:56CD  6E 2= 
@?D6?DFD DE2E6>6?E @? C6EFC? E@ DA@CE 7C@> E96 PCDE
H@C=5 4@?8C6DD :? DA@CED A9JD:42= E96C2AJ 6C? Br
J
Sports
Med  5@:
3;DA@CED
 F==@4< ) *9:8A6?  @==:?D ) 6E 2= 2K2C5
@7 C> ?;FCJ :? AC@76DD:@?2= DE2CE:?8 2?5 C6=:67
A:E496CD J
Athl
Train  5@:

 6CJ?:< # H2=5 *! )2DECJ  >:? % #:2@ !
*@> ! &FE4@>6D @7 :D@=2E65 8=6?@:5 =23C2= :?;FC:6D
:? AC@76DD:@?2= 32D632== A:E496CD Clin
J
Sport
Med
 5@:
!)$3626
 !@?6D "! @?E6 ) '2EE6CD@? % =EEC2496 %)
:?6D !) F?4E:@?2= @FE4@>6D 7@==@H:?8 C6G:D:@?
F=?2C 4@==2E6C2= =:82>6?E C64@?DECF4E:@? :? $2;@C
#628F6 2D632== A:E496CD J
Shoulder
Elbow
Surg
 5@:;;D6
 C253FCJ ! @C>2? )# *96 :>A24E @7 A:E49
4@F?ED 2?5 52JD @7 C6DE @? A6C7@C>2?46 2>@?8
>2;@C=628F6 32D632== A:E496CD J
Strength
Cond
Res
 5@:
!)36676
 %:49@=D@? " @==:?D ) -2E6C>2? ( F==@4<
) $249:?6 =62C?:?8 2?5 DE2E:DE:42= AC65:4E:@? @7
72DE32== G6=@4:EJ H:E9 3:@>6492?:42= AC65:4E@CD J
Biomech  5@:
;;3:@>649
 %:49@=D@? " @==:?D ) -2E6C>2? ( F==@4<
) $249:?6 =62C?:?8 2?5 DE2E:DE:42= AC65:4E:@? @7
A:E49:?8 2C> <:?6E:4D Am
J
Sports
Med
 5@:
 %:49@=D@? " F=3FCE * 64<  -2E6C>2?
( F==@4< ) *96 C6=2E:@?D9:A 36EH66? A:E49
G6=@4:EJ 2?5 D9@F=56C 5:DEC24E:@? 7@C46 2?5 6=3@H
G2=8FD E@CBF6 :? 4@==68:2E6 2?5 9:89 D49@@= A:E496CD J
Shoulder
Elbow
Surg 
5@:;;D6
 )9C:6C )E66=6 (! 2?=6J ! (:49  ?2=JD6D @7
:?;FCJ 4@F?E 52E2 D@>6 5@ND 2?5 5@?NED Am
J
Epidemiol  5@:2;6
<HA
 92=>6CD '% C:4<D@? ! 2==  (@>6@ 
,6C>2 %% 2DE32== A:E49 G6=@4:EJ 96=AD AC65:4E F=?2C
4@==2E6C2= =:82>6?E C64@?DECF4E:@? :? >2;@C =628F6
32D632== A:E496CD Am
J
Sports
Med
 5@:

 2>A # *F33D * =6:D:8 ) 6E 2= *96
C6=2E:@?D9:A @7 E9C@H:?8 2C> >6492?:4D 2?5 6=3@H
G2CFD E@CBF6 H:E9:?DF3;64E G2C:2E:@? 7@C
AC@76DD:@?2= 32D632== A:E496CD 24C@DD  E9C@HD
Am
J
Sports
Med 
5@:
'C@76DD:@?2= 2D632== ':E496CD +D6 @7 -6:89E65 2== *C2:?:?8 ?;FCJ ?4:56?46 2?5 *:>6 #@DD 'C6=:>:?2O
International
Journal
of
Sports
Physical
Therapy
 =6:D:8 ) :776?52776C / F?6 "* G6J 
#2F89=:? - :@>6492?:42= 2?2=JD:D @7 H6:89E65
32== 6I6C4:D6D 7@C 32D632== A:E496CD Sports
Health
 5@:
'C@76DD:@?2= 2D632== ':E496CD +D6 @7 -6:89E65 2== *C2:?:?8 ?;FCJ ?4:56?46 2?5 *:>6 #@DD 'C6=:>:?2O
International
Journal
of
Sports
Physical
Therapy
)+''#$%*(. $*( #)
Appendix 1
Download: https://ijspt.scholasticahq.com/article/140886-professional-baseball-pitchers-use-of-weighted-ball-
training-injury-incidence-and-time-loss-a-preliminary-study/attachment/289233.docx
'C@76DD:@?2= 2D632== ':E496CD +D6 @7 -6:89E65 2== *C2:?:?8 ?;FCJ ?4:56?46 2?5 *:>6 #@DD 'C6=:>:?2O
International
Journal
of
Sports
Physical
Therapy