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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 6/2012

01-06-2012 | Symposium: Injuries in Overhead Athletes

Passive Range of Motion Characteristics in the Overhead Baseball Pitcher and Their Implications for Rehabilitation

Authors: Kevin E. Wilk, PT, DPT, Leonard C. Macrina, MSPT, SCS, CSCS, Christopher Arrigo, MS, PT

Published in: Clinical Orthopaedics and Related Research® | Issue 6/2012

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Abstract

Background

Repetitive overhead throwing motion causes motion adaptations at the glenohumeral joint that cause injury, decrease performance, and affect throwing mechanics. It is essential to define the typical range of motion (ROM) exhibited at the glenohumeral joint in the overhead thrower.

Questions/purposes

We (1) assessed the glenohumeral joint passive range of motion (PROM) characteristics in professional baseball pitchers; and (2) applied these findings clinically in a treatment program to restore normal PROM and assist in injury prevention.

Methods

From 2005 to 2010, we evaluated 369 professional baseball pitchers to assess ROM parameters, including bilateral passive shoulder external rotation (ER) at 45° of abduction, external and internal rotation (IR) at 90° abduction while in the scapular plane, and supine horizontal adduction.

Results

The mean ER was greater for the throwing and nonthrowing shoulders at 45° of abduction, 102° and 98°, respectively. The throwing shoulder ER at 90° of abduction was 132° compared with 127° on the nonthrowing shoulder. Also, the pitcher’s dominant IR PROM was 52° compared with 63° on the nondominant side. We found no statistically significant differences in total rotational motion between the sides.

Conclusions

Although we found side-to-side differences for rotational ROM and horizontal adduction, the total rotational ROM was similar.

Clinical Relevance

The clinician can use these PROM values, assessment techniques, and treatment guidelines to accurately examine and develop a treatment program for the overhead-throwing athlete.
Literature
1.
Andrews JR, Casey PJ. Internal impingement. In: Krishnan SG, Hawkins RJ, Warren RF, eds. The Shoulder and the Overhead Athlete. Philadelphia: Lippincott Williams and Wilkins; 2004:125–134.
2.
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.PubMedCrossRef
3.
Borich MR, Bright JM, Lorello DJ, Cieminski CJ, Buisman T, Ludewig PM. Scapular angular positioning at end range internal rotation in cases of glenohumeral internal rotation deficit. J Orthop Sports Phys Ther. 2006;36:926–934.PubMedCrossRef
4.
Borsa PA, Dover GC, Wilk KE, Reinold MM. Glenohumeral range of motion and stiffness in professional baseball pitchers. Med Sci Sports Exerc. 2006;38:21–26.
5.
Borsa PA, Wilk KE, Jacobson JA, Scibek JS, Dover GC, Reinold MM, Andrews JR. Correlation of range of motion and glenohumeral translation in professional baseball pitchers. Am J Sports Med. 2005;33:1392–1399.PubMedCrossRef
6.
Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology. Part I: pathoanatomy and biomechanics. Arthroscopy. 2003;19:404–420.PubMedCrossRef
7.
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.PubMedCrossRef
8.
Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology. Part II: evaluation and treatment of SLAP lesions in throwers. Arthroscopy. 2003;19:531–539.PubMedCrossRef
9.
Chant CB, Litchfield R, Griffin S, Thain LM. Humeral head retroversion in competitive baseball players and its relationship to glenohumeral rotation range of motion. J Orthop Sports Phys Ther. 2007;37:514–520.PubMed
10.
Conte S, Requa RK, Garrick JG. Disability days in major league baseball. Am J Sports Med. 2001;29:431–436.PubMed
11.
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
12.
Dines JS, Frank JB, Akerman M, Yocum LA. Glenohumeral internal rotation deficits in baseball players with ulnar collateral ligament insufficiency. Am J Sports Med. 2009;37:566–570.PubMedCrossRef
13.
Drakos MC, Rudzki JR, Allen AA, Potter HG, Altchek DW. Internal impingement of the shoulder in the overhead athlete. J Bone Joint Surg Am. 2009;91:2719–2728.PubMedCrossRef
14.
Dwelly PM, Tripp BL, Tripp PA, Eberman LE, Gorin S. Glenohumeral rotational range of motion in collegiate overhead-throwing athletes during an athletic season. J Athl Train. 2009;44:611–616.
15.
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.PubMedCrossRef
16.
Freehill MT, Ebel BG, Archer KR, Bancells RL, Wilckens JH, McFarland EG, Cosgarea AJ. Glenohumeral range of motion in major league pitchers: changes over the playing season. Sports Health Journal. 2011;3:97–104.
17.
Jazrawi LM, McCluskey GM, 3rd, Andrews JR. Superior labral anterior and posterior lesions and internal impingement in the overhead athlete. Instr Course Lect. 2003;52:43–63.PubMed
18.
Kibler WB. Role of the scapula in the overhead throwing motion. Contemp Orthop. 1991;22:525–532.
19.
Laudner KG, Sipes RC, Wilson JT. The acute effects of sleeper stretches on shoulder range of motion. Journal of Athletic Training. 2008;43:359–363.PubMedCrossRef
20.
Lintner D, Mayol M, Uzodinma O, Jones R, Labossiere D. Glenohumeral internal rotation deficits in professional pitchers enrolled in an internal rotation stretching program. Am J Sports Med. 2007;35:617–621.PubMedCrossRef
21.
Litchfield R, Hawkins R, Dillman CJ, Atkins J, Hagerman G. Rehabilitation for the overhead athlete. J Orthop Sports Phys Ther. 1993;18:433–441.PubMed
22.
McClure P, Balaicuis J, Heiland D, Broersma ME, Thorndike CK, Wood A. A randomized controlled comparison of stretching procedures for posterior shoulder tightness. J Orthop Sports Phys Ther. 2007;37:108–114.PubMed
23.
McFarland EG, Wasik M. Epidemiology of collegiate baseball injuries. Clin J Sport Med. 1998;8:10–13.PubMedCrossRef
24.
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.PubMedCrossRef
25.
Norkin CC, White DJ. Measurement of Joint Motion: A Guide to Goniometry. Philadelphia, PA, USA: FA Davis; 2003.
26.
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
27.
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
28.
Reinold MM, Wilk KE, Macrina LC, Sheheane C, Dun S, Fleisig GS, Crenshaw K, Andrews JR. Changes in shoulder and elbow passive range of motion after pitching in professional baseball players. Am J Sports Med. 2008;36:523–527.PubMedCrossRef
29.
Tehranzadeh AD, Fronek J, Resnick D. Posterior capsular fibrosis in professional baseball pitchers: case series of MR arthrographic findings in six patients with glenohumeral internal rotational deficit. Clin Imaging. 2007;31:343–348.PubMedCrossRef
30.
Thomas SJ, Swanik KA, Swanik CB, Kelly JDt. Internal rotation deficits affect scapular positioning in baseball players. Clin Orthop Relat Res. 2010;468:1551–1557.PubMedCrossRef
31.
Torres RR, Gomes JL. Measurement of glenohumeral internal rotation in asymptomatic tennis players and swimmers. Am J Sports Med. 2009;37:1017–1023.PubMedCrossRef
32.
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
33.
Whiteley RJ, Ginn KA, Nicholson LL, Adams RD. Sports participation and humeral torsion. J Orthop Sports Phys Ther. 2009;39:256–263.PubMed
34.
Wilk KE, Arrigo C. Current concepts in the rehabilitation of the athletic shoulder. J Orthop Sports Phys Ther. 1993;18:365–378.PubMed
35.
Wilk KE, Macrina LC, Fleisig GS, Porterfield R, Simpson CD 2nd, Harker P, Paparesta N, Andrews JR. Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers. Am J Sports Med. 2011;39:329–335.PubMedCrossRef
36.
Wilk KE, Meister K, Andrews JR. Current concepts in the rehabilitation of the overhead throwing athlete. Am J Sports Med. 2002;30:136–151.PubMed
37.
Wilk KE, Reinold MM, Macrina LC, Porterfield R, Devine KM, Suarez K, Andrews JR. Glenohumeral internal rotation measurements differ depending on stabilization techniques. Sports Health Journal. 2009;1:131–136.CrossRef
Metadata
Title
Passive Range of Motion Characteristics in the Overhead Baseball Pitcher and Their Implications for Rehabilitation
Authors
Kevin E. Wilk, PT, DPT
Leonard C. Macrina, MSPT, SCS, CSCS
Christopher Arrigo, MS, PT
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 6/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2265-z

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