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" ... Severino’s injury is curious due to the unique circumstances in which his symptoms arise; by all accounts, the Yankee pitcher is pain free when throwing the baseball in any way that does not resemble a changeup. A changeup is usually thrown with the ball located deeper within the pitcher’s palm compared to a fast ball and most pitchers induce a greater amount of spin on the ball by over-pronating the wrist just prior to release. This over-pronation - twisting the hand down and out - ultimately causes the ball to drop and fadeaway from opposite handed batters. This is opposite of fast balls and sliders, in which pitchers supinate their wrist to cause spin and break. ... "