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Injury Breakdown: Groin Injuries Continue To Make Pitchers Groan

By Abby Sims
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Since writing recently about Kevin Millwood of the Mariners and the Rangers Alexi Ogando, pitchers who suffered groin strains, several other pitchers have gone down or remain on the bench with the injury.  Ogando, a right-hander, appears to have suffered one of the more severe strains (to his right groin). He was expected to be out for six weeks following the June 10 right groin strain, and is making progress in his recovery.

The Yankees have placed left-hander CC Sabathia on the 15-day DL with a mild left groin strain that he evidently sustained in a game last Sunday. It is hoped Sabathia will miss only two starts and return after the All Star break. Right-hander Felipe Paulino, of the Royals, who was on the DL after leaving the game on the 6th with a right groin strain, won't be so fortunate. He has since been diagnosed with a ligament tear in his elbow and is slated to join three of his colleagues in rehab following Tommy John surgery.

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Right-hander Kevin Millwood of the Mariners, who left a game on the 8th (after six no-hit innings) with a mild right groin strain, did not go on the DL but missed a start and returned on the 16th, remaining in the rotation until exacerbating the injury while pitching on the 27th, when he was removed in the third inning. Still considered to have only a mild (Grade 1) strain, and reportedly feeling no pain yesterday, the Mariners are hoping Millwood will be back for his next start.

Mariners' right-handed reliever, rookie Stephen Pryor, was diagnosed with a left groin strain after leaving a game in the ninth inning on June 12th, following a play that required he cover first base. Also diagnosed with a mild strain, Pryor was placed on the DL and has yet to make another appearance.

Cubs' rookie right-handed relief pitcher Lendy Castillo, who was first placed on the 15-day DL in May with a Grade 2 (moderate) left groin strain, also remains out of their lineup.

Some of these pitchers suffered the injury in a manner typical of position players – either in a routine defensive play (Pryor) or on offense (Ogando) – while the majority did so due to the demands of pitching. Some of the latter injuries were to the groin on the side of the pitching arm, while others were to the opposite/glove side.

Along with other muscles of the core/hip, the adductors play a vital role in transferring power to a pitcher's upper body.  Their primary functions are to stabilize the lower extremity and pelvis when the foot is on the ground and, with the limb in motion, to draw the thigh toward midline.

During the pitching motion, the groin of the rear limb (throwing side) is put on significant stretch (with the hip extended) and then must flex to allow a pitcher's lead leg to stride fully before planting. This is then accompanied by rotation of the hips toward the plate. From the vulnerable stretched position the hip muscles on this side must exert a considerable force to drive the pitcher's body forward.

The hip on the opposite/leading side (that of the glove) moves into extreme flexion during the leg lift that starts the pitching motion before lowering the leg and then striding forward. This hip rotates inwardly absorbing considerable forces as the pitch and follow-through are completed and it becomes the primary weight-bearing limb.

The flexibility, strength and power required of the adductors in pitching, as well as the very repetitive nature of the work, places them at risk of strain.  It would be interesting to look at these types of injuries over time to see the relative proportion of occurrence on the throwing side (which is put on greater stretch and is required to exert more), versus the glove side.

Follow Abby on Twitter @abcsims

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