Stiff Necks Raise Injury Risk for Baseball Pitchers, UConn Study Finds

As the World Series approaches each October, baseball fans brace for the sight of a star pitcher scratched from the lineup at the worst possible moment. This season, Los Angeles Dodgers fans watched reliever Edwin Díaz lose more than a month to a neck injury, one of many players sidelined by neck problems across the league. For most observers, a stiff neck seems like a minor ailment compared with a torn elbow ligament or a rotator cuff strain. A new study from the University of Connecticut suggests otherwise: the neck may be a critical, and largely overlooked, link in the chain of biomechanics that determines whether a pitcher’s arm stays healthy.

The research, led by Laurie Devaney, head of the Department of Kinesiology in UConn’s College of Agriculture, Health and Natural Resources and co-director of the UConn Institute for Sports Medicine, was published in the Journal of Athletic Training. The study, titled “Preseason Neck Mobility and Risk of Shoulder and Elbow Injury in College Baseball Pitchers,” examined 126 pitchers drawn from seven collegiate baseball teams across the United States. At the start of the season, researchers measured each athlete’s neck mobility using standardized clinical tests. They then tracked the players throughout the competitive season, recording arm complaints, pitching-related injuries, and time lost from play.

The results were striking. Pitchers who entered the season with reduced neck mobility were significantly more likely to report arm problems and to sustain a pitching-related injury to the shoulder or elbow than teammates with better neck mobility. Across the season, the stiff-necked group also accumulated more days lost to injury overall. In other words, a measurable restriction in how far and freely the cervical spine could move at the start of a season predicted who would end up in the training room months later.

For Devaney, the finding confirmed a hypothesis first planted two decades earlier. During the early 2000s, Boston Red Sox ace Pedro Martinez, one of her favorite players, was removed from the lineup with a stiff neck. “I said to myself, ‘Huh, that has to affect his pitching mechanics, I wonder how he’s going to do when he comes back,'” Devaney recalls. “That got me thinking, because the neck is my area of expertise and it had not been explored in baseball.” A smaller pilot study she previously conducted had already identified the same association in college pitchers, and the new, larger multi-team investigation showed the relationship held across different settings and populations.

Why would the neck matter so much for an arm injury? The answer lies in the biomechanics of the pitching motion itself. Biomechanical models of pitching typically trace the kinetic chain from the legs through the hips, trunk, shoulder, and elbow, but as Devaney points out, “it stops at the neck.” Researchers have studied the shoulder and elbow extensively, along with the trunk, hip, and knee, yet head and neck position has been largely absent from the literature. The new findings suggest that omission may have left a genuine blind spot in injury-prevention science.

One plausible mechanism involves targeting and timing. “If you have neck stiffness, it affects the downstream mechanics in your pitching motion,” Devaney explains. “So, for instance, if you can’t turn your head to find the target, then it might be that your trunk opens up early and that trunk rotation may predispose you to a throwing-related injury.” A pitcher who cannot fully rotate the head toward home plate may compensate by rotating the trunk prematurely, disrupting the carefully sequenced transfer of force up the kinetic chain and placing excess stress on the shoulder and elbow at the moment of ball release.

Anatomy offers a second possible pathway. The muscles and nerves of the neck are directly connected to the structures most vulnerable in throwing athletes: the shoulder blade, the rotator cuff, and the forearm. Restricted cervical mobility could alter neural tension, muscle activation patterns, or scapular control, any of which might change how loads are distributed across the arm during the violent, high-velocity act of throwing a baseball. The researchers caution that they do not yet know exactly how neck stiffness translates into shoulder and elbow injury risk, but these anatomical and mechanical links provide testable hypotheses for the next phase of work.

Importantly, the concern is not confined to college athletes. Neck stiffness is a potential risk factor at every level of play, from youth leagues through the major leagues, where pitchers throw harder and more often than ever. Devaney is currently leading a collaboration with the Wake Forest Pitching Laboratory to explore the underlying mechanisms in controlled biomechanical studies. This spring, her lab will extend the research to high school baseball players to determine when the association between neck mobility and arm injury first emerges, information that could guide earlier screening and intervention.

“We’ve identified this as a risk factor,” Devaney says. “Now we’re trying to find out why and what we can do to change it in hopes of reducing injury burden in this population of athletes.” If neck mobility proves to be a modifiable risk factor, simple preseason screening could identify pitchers at elevated risk before symptoms appear, and targeted mobility or strengthening programs might reduce the enormous toll that shoulder and elbow injuries take on pitching staffs at every level of the sport.

The implications reach beyond the diamond. Because the neck anchors the head’s sensory input and connects to the rest of the spine, understanding how cervical mobility shapes whole-body movement has applications far from sport. Devaney notes that the same principles may illuminate fall risk in older adults, where impaired neck function and altered postural control can contribute to dangerous instability. “The lessons that we are learning through our work with athletes actually help us in assessing and managing other people and keeping them healthy too,” she says. What began with a star pitcher’s stiff neck two decades ago may ultimately inform how clinicians evaluate movement and prevent injury across the lifespan.

Subject of Research: The relationship between neck mobility and the risk of shoulder and elbow injuries in baseball pitchers

Article Title: Neck stiffness puts pitchers at risk of throwing-related injuries

Article References: Neck stiffness puts pitchers at risk of throwing-related injuries. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: neck mobility, baseball pitchers, shoulder injury, elbow injury, sports medicine, biomechanics, injury prevention, Journal of Athletic Training, college athletics, cervical spine, kinetic chain, University of Connecticut