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A lot of pitchers have limited extension on the order of a 5 to 10 degree deficit. It tends to be an adaptation that protects the elbow to some degree.

Has anyone dealt with larger deficits on the order or 20 degrees or more and was there a velocity loss? I'd estimate no more than a 1/2 mph loss at 10 degrees, i.e. well worth the added protection, but over 2 mph loss at 20 degrees with the losses increasing pretty rapidly as the loss goes beyond 20 degrees.

Has anybody had conservative treatment or even surgery for a elbow extension deficit and why did you go that route? Pain? Performance?
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CADad, I wouldn't say it's necessarily an adaptation for protection. It seems to be more a matter of not taking care of the biceps enough. Normally what a contracture like you describe is simply due to imflexibility of the biceps brachii.

I think, to an extent, most baseball players will experience this. I recently noticed that I have just a little bit of one. I've noticed it while lifting weights that my throwing arm does not appear to straighten out all the way. It's not terrible, but just a little bit.
It is very common in pitchers and it tends to provide some degree of protection for the elbow simply because the elbow can't hyperextend as a result.

It can happen as a result of tissue contraction such as you've noted after weightlifting and can also happen as a result of loose bodies or bone spurs in the posterior elbow. Both can become permanent and conventional wisdom is that it doesn't impact performance until it reaches about 25 degrees of extension loss which is quite unusual.

It isn't a matter of taking care of the biceps enough given what a high percentage of pitchers have some degree of extension loss.

Pitchers will see a temporary extension loss immediately after pitching but in most cases it recovers in a day or two. Pitchers also tend to have their extension loss increase over the course of a season when it is due to tissue contraction and it then takes a fair amount of time off to recover the extension. Sometimes it becomes permanent.
My son fractured his growth plate when he was thirteen and he has about 25% loss of range of motion. He is 18 now and playing college ball. He was clocked at 92mph recently but it had been about 4 years that he pitched, he is a catcher now. We always wonder if not for his elbow if could he have been able to hit 95-96. When he throws long toss he can throw it 300 feet with no problem and has been able to toss it up to 320 feet at times, so who knows if the elbow slowed him down.
How much of a loss of extension as opposed to change in overall ROM? The assumption is that pitchers find a way to adjust for the change to some degree but I don't know if there's any way to quantify how much is actually lost. Even if there were some way to simulate the extension loss for a study there's no way to determine if down the road the pitcher would be able to make an adjustment that would get their velocity back.

Eric Cressey considers extension loss something that has to be dealt with, yet I was talking to doctor who works with MLB players who said that many of the MLB pitchers have deficits up to 30 degrees. The studies I've seen show that most MLB pitchers are within the range of 0 to 15 degrees and that there would only be a very few with a 30 degree deficit as that would be 3 SD from the mean. If I remember my stats correctly that's about 1.5 in a thousand so it is actually unlikely that there is more than one MLB pitcher with that much of a deficit, especially when you consider that anything over 30 degrees is considered a problem when it comes to the activities of daily living. Then again stats and reality don't always match.
Last edited by CADad
He has a loss of about 15% extension and 10% on contraction. So he does not only have loss of extension he lost range when it comes to contraction. He can’t touch his thumb to his shoulder.
When we measure his biceps his right arm “throwing side” is about an inch smaller, but as far as strength he can curl as much or even more than his left side.
My estimates are probably off base as they are based on some pretty simple math and don't account for any adjustments a pitcher may be able to make but I estimate roughly a 1.4 mph velocity loss for a 15 degree loss in extension. I assume that's what you mean by %? The normal range of motion is about 135 degrees so 15% of that would be about 20 degrees. I estimate a 20 degree extension loss to result in about a 2.4 mph velocity loss.

Edited: Not worth bumping to the top but I did some research and the elbow is normally flexed about 20 degrees at ball release and doesn't flex much more if at all after release, probably due to the pronation. I can see where 25 degrees of contracture would be a problem but not for the reasons I was using to do my math. The real problem is simply the reduced extension velocity that can be attained going from fully flexed to 25 degrees or more rather than being able to go all the way to 20 degrees. I don't have any idea how to quantify that.
Last edited by CADad
Lesson learned.. be very cautious if the range of motion becomes impaired.

At age 13, my son began to experience a decrease in his throwing elbow range of motion. There was no pain and no noticeable loss of velocity but the condition persisted for several weeks. We had always been very careful with pitch counts and he was not allowed to pitch during winter ball. But we became concerned when he started to experience some minor inflammation and soreness.

We found out that he had OCD (osteochondritis dessicans) which is damage to the cartilage and bone in the joint. This condition can be caused by overuse, but can also be initiated by some trauma that causes bloodflow deprivation to the joint. He had to have microfracture surgery followed by 6 months of rest and physical therapy. The procedure was successful and he was cleared to resume playing. But it might have been possible to avoid surgery if he had shut it down and rested his arm when he first started to experience the decrease in range of motion.

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