Top

Clinical Orthopaedics and Related Research®

Published in:

01-06-2010 | Clinical Research

Internal Rotation Deficits Affect Scapular Positioning in Baseball Players

Authors: Stephen J. Thomas, MEd, ATC, Kathleen A. Swanik, PhD, ATC, Charles B. Swanik, PhD, ATC, John D. Kelly IV, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 6/2010

Abstract

Background

Anecdotal evidence suggests an association between glenohumeral internal rotation deficits (GIRD) and scapular dysfunction, an observable alteration in the normal position or motion of the scapula in relation to the thoracic cage.

Questions/purposes

We therefore hypothesized players with GIRD (15° or greater) will have decreased dominant arm scapular upward rotation and increased scapular protraction compared with baseball players with GIRD (14° or less).

Methods

We studied 43 baseball players with no current shoulder or elbow symptoms; 22 had GIRD 15° or greater and 21 had GIRD 14° or less. We measured glenohumeral internal rotation supine with the scapula stabilized. Scapular upward rotation was tested at rest; 60°, 90°, and 120° abduction in the scapular plane; and scapular protraction at 0°, hands on hips, and 90° abduction in the scapular plane.

Results

The GIRD (15° or greater) group had less scapular upward rotation at 60° (3.58), 90° (5.01), and 120° (2.63) in the dominant arm. Scapular protraction at 90° (0.88 cm) also was greater in the dominant arm of the GIRD (15° or greater) group.

Conclusions

Baseball players with more GIRD have alterations to the position and motion of their scapula. A dual goal of minimizing GIRD and strengthening the scapular stabilizers may be warranted in this population.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Awan R, Smith J, Boon AJ. Measuring shoulder internal rotation range of motion: a comparison of 3 techniques. Arch Phys Med Rehabil. 2002;83:1229–1234.CrossRefPubMed

Bigliani LU, Codd TP, Connor PM, Levine WN, Littlefield MA, Hershon SJ. Shoulder motion and laxity in the professional baseball player. Am J Sports Med. 1997;25:609–613.CrossRefPubMed

Borsa PA, Timmons MK, Sauers EL. Scapular-positioning patterns during humeral elevation in unimpaired shoulders. J Athl Train. 2003;38:12–17.PubMed

Brown LP, Niehues SL, Harrah A, Yavorsky P, Hirshman HP. Upper extremity range of motion and isokinetic strength of the internal and external shoulder rotators in major league baseball players. Am J Sports Med. 1988;16:577–585.CrossRefPubMed

Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy. 2003;19:404–420.CrossRefPubMed

Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part III: the SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy. 2003;19:641–661.CrossRefPubMed

Clabbers KM, Kelly JD, Bader D, Eager M, Imhauser C, Siegler S, Moyer RA. Effect of posterior capsule tightness on glenohumeral translation in the late-cocking phase of pitching. J Sport Rehabil. 2007;16:41–49.PubMed

Crockett HC, Gross LB, Wilk KE, Schwartz ML, Reed J, O’Mara J, Reilly MT, Dugas JR, Meister K, Lyman S, Andrews JR. Osseous adaptation and range of motion at the glenohumeral joint in professional baseball pitchers. Am J Sports Med. 2002;30:20–26.PubMed

Ellenbecker TS, Roetert EP, Bailie DS, Davies GJ, Brown SW. Glenohumeral joint total rotation range of motion in elite tennis players and baseball pitchers. Med Sci Sports Exerc. 2002;34:2052–2056.CrossRefPubMed

10.

Ellenbecker TS, Roetert EP, Piorkowski PA, Schulz DA. Glenohumeral joint internal and external rotation range of motion in elite junior tennis players. J Orthop Sports Phys Ther. 1996;24:336–341.PubMed

11.

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–191.CrossRefPubMed

12.

Grossman MG, Tibone JE, McGarry MH, Schneider DJ, Veneziani S, Lee TQ. A cadaveric model of the throwing shoulder: a possible etiology of superior labrum anterior-to-posterior lesions. J Bone Joint Surg Am. 2005;87:824–831.CrossRefPubMed

13.

Harryman DT 2nd, Sidles JA, Clark JM, McQuade KJ, Gibb TD, Matsen FA III. Translation of the humeral head on the glenoid with passive glenohumeral motion. J Bone Joint Surg Am. 1990;72:1334–1343.PubMed

14.

Hébert LJ, Moffet H, McFadyen BJ, Dionne CE. Scapular behavior in shoulder impingement syndrome. Arch Phys Med Rehabil. 2002;83:60–69.CrossRefPubMed

15.

Huffman GR, Tibone JE, McGarry MH, Phipps BM, Lee YS, Lee TQ. Path of glenohumeral articulation throughout the rotational range of motion in a thrower’s shoulder model. Am J Sports Med. 2006;34:1662–1669.CrossRefPubMed

16.

Jobe FW, Kvitne RS, Giangarra CE. Shoulder pain in the overhand or throwing athlete: the relationship of anterior instability and rotator cuff impingement. Orthop Rev. 1989;18:963–975.PubMed

17.

Johnson MP, McClure PW, Karduna AR. New method to assess scapular upward rotation in subjects with shoulder pathology. J Orthop Sports Phys Ther. 2001;31:81–89.PubMed

18.

Kaplan LD, McMahon PJ, Towers J, Irrgang JJ, Rodosky MW. Internal impingement: findings on magnetic resonance imaging and arthroscopic evaluation. Arthroscopy. 2004;20:701–704.PubMed

19.

Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med. 1998;26:325–337.PubMed

20.

Kibler WB. Scapular involvement in impingement: signs and symptoms. Instr Course Lect. 2006;55:35–43.PubMed

21.

Kibler WB, Chandler TJ. Range of motion in junior tennis players participating in an injury risk modification program. J Sci Med Sport. 2003;6:51–62.CrossRefPubMed

22.

Kibler WB, Chandler JT, Livingston BP, Roetert EP. Shoulder range of motion in elite tennis players: effect of age and years of tournament play. Am J Sports Med. 1996;24:279–285.CrossRefPubMed

23.

Laudner KG, Myers JB, Pasquale MR, Bradley JP, Lephart SM. Scapular dysfunction in throwers with pathologic internal impingement. J Orthop Sports Phys Ther. 2006;36:485–494.PubMed

24.

Lukasiewicz AC, McClure P, Michener L, Pratt N, Sennett B. Comparison of 3-dimensional scapular position and orientation between subjects with and without shoulder impingement. J Orthop Sports Phys Ther. 1999;29:574–583; discussion 584–586.

25.

McClure PW, Michener LA, Karduna AR. Shoulder function and 3-dimensional scapular kinematics in people with and without shoulder impingement syndrome. Phys Ther. 2006;86:1075–1090.PubMed

26.

McClure PW, Michener LA, Sennett BJ, Karduna AR. Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo. J Shoulder Elbow Surg. 2001;10:269–277.CrossRefPubMed

27.

Meister K. Injuries to the shoulder in the throwing athlete. Part one: biomechanics/pathophysiology/classification of injury. Am J Sports Med. 2000;28:265–275.

28.

Meister K, Day T, Horodyski M, Kaminski TW, Wasik MP, Tillman S. Rotational motion changes in the glenohumeral joint of the adolescent/Little League baseball player. Am J Sports Med. 2005;33:693–698.CrossRefPubMed

29.

Michener LA, McClure PW, Karduna AR. Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clin Biomech (Bristol, Avon). 2003;18:369–379.CrossRef

30.

Myers JB, Laudner KG, Pasquale MR, Bradley JP, Lephart SM. Scapular position and orientation in throwing athletes. Am J Sports Med. 2005;33:263–271.CrossRefPubMed

31.

Myers JB, Laudner KG, Pasquale MR, Bradley JP, Lephart SM. Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. Am J Sports Med. 2006;34:385–391.CrossRefPubMed

32.

Osbahr DC, Cannon DL, Speer KP. Retroversion of the humerus in the throwing shoulder of college baseball pitchers. Am J Sports Med. 2002;30:347–353.PubMed

33.

Pieper HG. Humeral torsion in the throwing arm of handball players. Am J Sports Med. 1998;26:247–253.PubMed

34.

Pink M. Understanding the linkage system of the upper extremity. Sports Med Arthrosc Rev. 2001;9:52–60.CrossRef

35.

Reagan KM, Meister K, Horodyski MB, Werner DW, Carruthers C, Wilk K. Humeral retroversion and its relationship to glenohumeral rotation in the shoulder of college baseball players. Am J Sports Med. 2002;30:354–360.PubMed

36.

Smith J, Dietrich CT, Kotajarvi BR, Kaufman KR. The effect of scapular protraction on isometric shoulder rotation strength in normal subjects. J Shoulder Elbow Surg. 2006;15:339–343.CrossRefPubMed

37.

Smith J, Kotajarvi BR, Padgett DJ, Eischen JJ. Effect of scapular protraction and retraction on isometric shoulder elevation strength. Arch Phys Med Rehabil. 2002;83:367–370.CrossRefPubMed

38.

Thomas SJ, Swanik KA, Swanik C, Huxel KC. Glenohumeral rotation and scapular position adaptations after a single high school female sports season. J Athl Train. 2009;44:230–237.CrossRefPubMed

39.

Tyler TF, Nicholas SJ, Roy T, Gleim GW. Quantification of posterior capsule tightness and motion loss in patients with shoulder impingement. Am J Sports Med. 2000;28:668–673.PubMed

40.

Warner JJ, Micheli LJ, Arslanian LE, Kennedy J, Kennedy R. Scapulothoracic motion in normal shoulders and shoulders with glenohumeral instability and impingement syndrome: a study using Moire topographic analysis. Clin Orthop Relat Res. 1992;285:191–199.PubMed

Title: Internal Rotation Deficits Affect Scapular Positioning in Baseball Players
Authors: Stephen J. Thomas, MEd, ATC
Kathleen A. Swanik, PhD, ATC
Charles B. Swanik, PhD, ATC
John D. Kelly IV, MD
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 6/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-009-1124-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Internal Rotation Deficits Affect Scapular Positioning in Baseball Players

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

Please log in to get access to this content

Other articles of this Issue 6/2010

Staged Lengthening Arthroplasty for Pediatric Osteosarcoma around the Knee

Orthopaedic · Radiology · Pathology Conference: Hand Mass in an 18-year-old Woman

Current Concepts in Rotator Cuff Disease and Treatment: Editorial Comment

Distribution of Lubricin in the Ruptured Human Rotator Cuff and Biceps Tendon: A Pilot Study

Editorial: What is Varus or Valgus Knee Alignment?: A Call for a Uniform Radiographic Classification

Modified L’Episcopo Tendon Transfers for Irreparable Rotator Cuff Tears: 5-year Followup