The Case for the Inverted W Part 4 by Paul Nyman:

The inverted W injury “Witch Hunt”

In case you missed it, here is Part 3.

Almost without exception the articles stating or implying that the inverted W is a potential source of arm injury use Mark prior and/or Steve Strasburg to support their beliefs.

First and foremost is those who believe the inverted W is a precursor to injury are talking about THEIR VERSION of the inverted W i.e. lifting the elbow above the shoulders.

Lifting the elbow above the shoulder was NEVER part of the inverted W explanation. As stated previously the inverted W was an integral part of scapula loading which I believe is accepted in many throwing circles as being a positive thing.

What many perceive as “shoulder height” is based upon the perception that shoulder height is defined by this picture:

Figure 11

 And this is what must be taking place during their interpretation of the inverted W:

Figure 12

 Where the humorous (upper arm) is elevated above a straight line drawn through both shoulders.

In reality, what pitchers do when they pinch the shoulder blades up and back is to elevate the scapula.

Figure 13

This is a picture of the upper arm maintained abducted at 90° and the scapula is elevated 30° i.e. the relationship between the glenohumeral joint and the scapula is the same as this picture:

 

Figure 14

 Specific to the injuries of Prior and Strasburg.

Here’s Mark prior’s injury record (Wikipedia):

 

Figure 15

 The contention on the part of the inverted W critics is that Mark prior injured a shoulder because of the inverted W.

Considering prior’s injury record, is it possible that his shoulder problems were a simply a result of wear and tear?

From Wikipedia:

In 2003, Prior finished third in the National League’s Cy Young Award voting after compiling an 18–6 win-loss record despite missing three starts after an on-field collision with Atlanta Braves second baseman Marcus Giles. Prior and Giles had both been chosen to play in the All-Star Game, but were forced to miss the game as a result of their injuries. Prior and fellow right-handed pitcher Kerry Wood were dubbed “Chicago Heat” by Sports Illustrated, and the name stuck, as the twosome were dominant in leading the Cubs to an 88-win season and a division title. However, sportswriters and fans began to criticize Dusty Baker on the high pitch count of the two pitchers. Despite the concerns, Prior and Wood continued to pitch high counts throughout the season. In 2003, Prior averaged 113.4 pitches per starts in regular season. In the month of September, Prior recorded 126 pitches per start. Prior averaged another 120 pitches in games in the postseason and struggled with an injury the next season. Pundits often blame Baker for ruining the careers of both pitchers.[3][4]

Or possibly had to do with previous injuries altering his delivery (Dizzy Dean syndrome)?

Other than the perception that lifting the elbow above the shoulders early in the delivery is a negative,

I see no definitive proof that the inverted W had anything to do with Mark Prior’s shoulder problems.

With respect to Strasburg, I watched videotape of the game where it is believed he tore his UCL.

What is interesting to me is that the pitch that he threw before having to come off the mound was a change up. Anyone who has thrown effective changeup understands that the grip on the changeup and delivery  is different, which has the potential to change the forces on the elbow.

Also the pitch prior to the changeup was a fastball where Strasburg exhibited no indication or sign of discomfort.

And from numerous studies attempting to explain the cause of UCL injury, maximum stress on the elbow occurs just and along with maximum external rotation.