Movement Medicine

How Hip Mobility Impacts Elbow and Shoulder Injuries

Jun 17, 2025By Eric Nichols
Eric Nichols

In throwing sports like baseball, most athletes and coaches focus on arm strength, shoulder mechanics, or pitch count to prevent injury. But there is much more to the equation. Research shows that hip mobility, especially Internal rotation (IR) and External Rotation (ER) range of motion, play a significant role in reducing the risk of shoulder and elbow injuries. 

The Kinetic Chain 

Throwing is a full-body movement. Energy is generated from the ground up; from the ground, through the legs, hips, transfered through the trunk, and disepated through the arm. This sequence is known as the kinetic chain. When one link is restricted, such as limited hip internal or external rotation, the rest of the body must compensate. This often leads to excess stress on the shoulder or elbow.

Supportive Reasearch 

  1. A study of Division I collegiate pitchers found that limited hip internal rotation (IR) and total rotational arc (TRARC) significantly increased elbow extension and valgus stress at ball release. These altered mechanics increase the risk of ulnar collateral ligament (UCL)/Tommy John injury.
  2. Adolescent pitchers with decreased hip flexion and IR were more likely to report elbow pain over the course of a season.
  3.  Hip rotation defecits, specifically glove side hip IR, are associated with increased elbow vlagus torque. 
  4. Systematic reviews confirm that hip ROM deficits, particularly in the lead leg, are linked to altered trunk rotation timing and faster arm acceleration. Both of which are biomechanical risk factors for throwing injuries.

In summary, limited hip mobility doesn’t just make your lower half stiff. It changes how your arm moves and absorbs stress.

How We Measure Hip Mobility 

  • Motion Capture/3D Motion Techology
  • Sports Medicine Physical Therapy Evaluation 

How To Improve Hip Mobility 

Below is a link to our favorite hip mobility exercises/drills.

It is not just about flexibility. Athletes must also have elite control and strength throughout the full range of motion. 

Take Home Message 

If you’re only looking at the only the arm/shoulder, when evaluating injury risk in throwers, you’re missing a huge piece of the puzzle. Hip mobility is a critical foundation for healthy, high-velocity throwing. Whether you’re a youth pitcher or a hitter, screening and improving your hip ROM can be a game-changer in performance and longevity.


References

1. Laudner, K. G., et al. (2010). The Relationship Between Range of Motion and Throwing Mechanics in Collegiate Baseball Pitchers. Journal of Shoulder and Elbow Surgery, 19(3), 366–370.

2. Sauers, E. L., et al. (2014). Hip and Shoulder Passive Range of Motion and Motion Timing Differences in Baseball Pitchers With Elbow Pain. Athletic Training & Sports Health Care, 6(3), 129–136.

3. Camp, C. L., et al. (2017). Relationship Between Throwing Mechanics and UCL Injury Risk in Baseball Pitchers. The American Journal of Sports Medicine, 45(3), 728–735.

4. Oliver, G. D., et al. (2015). Differences in Hip Range of Motion Between Baseball Pitchers and Position Players. Sports Health, 7(2), 142–146.

5. Aguinaldo, A. L., & Chambers, H. (2009). Correlating Elbow Valgus Torque With Hip and Shoulder Kinematics in Baseball Pitchers. Journal of Applied Biomechanics, 25(2), 140–148.