Relationship between Glenohumeral Internal Rotation Deficit and Shoulder Conditions in Professional Baseball Pitchers

Author(s):  
Kohei Yamaura ◽  
Yutaka Mifune ◽  
Atsuyuki Inui ◽  
Hanako Nishimoto ◽  
Takashi Kurosawa ◽  
...  
2010 ◽  
Vol 39 (2) ◽  
pp. 329-335 ◽  
Author(s):  
Kevin E. Wilk ◽  
Leonard C. Macrina ◽  
Glenn S. Fleisig ◽  
Ronald Porterfield ◽  
Charles D. Simpson ◽  
...  

2007 ◽  
Vol 35 (8) ◽  
pp. 1371-1376 ◽  
Author(s):  
Todd S. Ellenbecker ◽  
Gail A. Ellenbecker ◽  
E. Paul Roetert ◽  
Rogerio Teixeira Silva ◽  
Greg Keuter ◽  
...  

Background Repetitive loading to the hip joint in athletes has been reported as a factor in the development of degenerative joint disease and intra-articular injury. Little information is available on the bilateral symmetry of hip rotational measures in unilaterally dominant upper extremity athletes. Hypothesis Side-to-side differences in hip joint range of motion may be present because of asymmetrical loading in the lower extremities of elite tennis players and professional baseball pitchers. Study Design Cohort (cross-sectional) study (prevalence); Level of evidence, 1. Methods Descriptive measures of hip internal and external rotation active range of motion were taken in the prone position of 64 male and 83 female elite tennis players and 101 male professional baseball pitchers using digital photos and computerized angle calculation software. Bilateral differences in active range of motion between the dominant and nondominant hip were compared using paired t tests and Bonferroni correction for hip internal, external, and total rotation range of motion. A Pearson correlation test was used to test the relationship between years of competition and hip rotation active range of motion. Results No significant bilateral difference (P > .005) was measured for mean hip internal or external rotation for the elite tennis players or the professional baseball pitchers. An analysis of the number of subjects in each group with a bilateral difference in hip rotation greater than 10° identified 17% of the professional baseball pitchers with internal rotation differences and 42% with external rotation differences. Differences in the elite male tennis players occurred in only 15% of the players for internal rotation and 9% in external rotation. Female subjects had differences in 8% and 12% of the players for internal and external rotation, respectively. Statistical differences were found between the mean total arc of hip range of internal and external rotation in the elite tennis players with the dominant side being greater by a clinically insignificant mean value of 2.5°. Significantly less (P < .005) dominant hip internal rotation and less dominant and nondominant hip total rotation range of motion were found in the professional baseball pitchers compared with the elite male tennis players. Conclusion This study established typical range of motion patterns and identified bilaterally symmetric hip active range of motion rotation values in elite tennis players and professional baseball pitchers. Asymmetric hip joint rotational active range of motion encountered during clinical examination and screening may indicate abnormalities and would indicate the application of flexibility training, rehabilitation, and further evaluation.


Author(s):  
Hwai-Ting Lin ◽  
Yu-Chuan Lin ◽  
You-Li Chou ◽  
Hung-Chien Wu ◽  
Rong-Tyai Wang ◽  
...  

Previous studies have reported that pitchers with glenohumeral internal rotation deficit (GIRD) may increase the risk of shoulder injury. However, limited information is available regarding the specific effects of GIRD in baseball pitching. The purpose of this study was to investigate whether baseball pitchers with GIRD change their pitching mechanism. Fifteen baseball pitchers with GIRD and 15 pitchers without GIRD were recruited from university or senior high-school teams. A three-dimensional motion analysis system (Eagle System, Motion Analysis Corporation, Santa Rosa, CA, USA) was used to capture the pitching motion while performing fastball pitches. The kinematics and kinetics of the throwing shoulder and trunk were analyzed based on motion captured data. The Mann–Whitney U test was used to test the differences of the analyzed parameters between two groups. At the instant of ball release, the GIRD group showed lower shoulder external rotation and trunk rotation, and larger shoulder horizontal adduction. In addition, the GIRD group exhibited a significantly larger shoulder inferior force in the cocking and acceleration phase, and a significantly larger internal rotation torque in the acceleration phase. The present results suggested that pitchers with GIRD need stretch training to enlarge joint range of motion, and to improve trunk strength and flexibility to alleviate potential problems associated with pitching in GIRD pitchers.


2021 ◽  
pp. 036354652110413
Author(s):  
Joseph E. Manzi ◽  
Brittany Dowling ◽  
Joshua S. Dines ◽  
Alexander Richardson ◽  
Kathryn L. McElheny ◽  
...  

Background: Inefficient energy transfer from the pelvis and trunk has been shown to increase compensation at the level of the shoulder. Kinetic chain sequencing of the core segments is underexamined in professional baseball pitchers, especially as it relates to changes in upper extremity kinetics. Purpose: To evaluate elbow and shoulder kinetics in a cohort of professional pitchers differentiated by instances of discordant pelvic to upper torso sequencing during the pitch. Study Design: Descriptive laboratory study. Methods: 285 professional baseball pitchers were evaluated using 3D motion capture (480 Hz). Pitchers were divided into “chronological” and “discordant” groups based on whether maximum pelvic rotation velocity occurred before (chronological) or after (discordant) maximum upper torso rotation velocity during the pitch motion. Pelvic, upper torso, and shoulder kinematic parameters, shoulder distraction force, shoulder internal rotation torque, and pitch efficiency (PE) were compared between groups. Results: Pitchers with discordant torso sequencing (n = 30; 110 pitches) had greater shoulder horizontal adduction at maximum external rotation (mean difference, 3.6°; 95% CI, −5.2° to −2.0°; t = −4.5; P < .001) and greater maximum shoulder external rotation (mean difference, 3.7°; 95% CI, 5.7° to 1.5°; t = −3.5; P < .001) than chronological pitchers (n = 255; 2974 pitches). PE did not differ between groups ( P = .856), whereas ball velocity was significantly faster in the discordant group (mean difference, 0.6 m/s; 95% CI, −1.1 to −0.3 m/s; t = −3.3; P = .0012). Chronological pitchers had significantly reduced shoulder distraction force (mean difference, −4.7% body weight (BW); 95% CI, −7.9% to −1.5% BW; t = −2.9; P = .004) with no difference in shoulder internal rotation torque ( P = .160). These kinematic and kinetic differences were not observed when accounting for interpitcher variability. Conclusion: Between pitchers, those who had a discordant pelvic to upper torso sequence experienced significantly greater shoulder distraction forces, potentially compensating by increasing maximum shoulder external rotation and horizontal abduction. Achieving maximal pelvic rotation velocity before maximal rotation velocity may be advantageous in preventing compensation at the upper extremity and excessive throwing arm loading. Clinical Relevance: Identifying risk factors for increased upper extremity forces has potential implications in injury prevention. Specifically, mitigating shoulder distraction forces may be beneficial in reducing risk of injury.


2010 ◽  
Vol 45 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Steve Scher ◽  
Kyle Anderson ◽  
Nick Weber ◽  
Jeff Bajorek ◽  
Kevin Rand ◽  
...  

Abstract Context: The overhead throwing motion is complex, and restrictions in range of motion (ROM) at the hip may place additional demands on the shoulder that lead to injury. However, the relationship between hip and shoulder ROM in athletes with and without a history of shoulder injury is unknown. Objective: To (1) determine if differences exist in hip and shoulder ROM between professional baseball players with a history of shoulder injury and those with no history of shoulder injury and (2) assess relationships between hip and shoulder ROM in these players. Design: Cross-sectional study. Patients or Other Participants: Fifty-seven professional baseball players. Main Outcome Measure(s): Outcome measures consisted of hip extension and internal rotation, shoulder internal and external rotation, glenohumeral internal-rotation deficit, and history of shoulder injury. Differences in shoulder and hip ROM were assessed with a 1-way analysis of variance. Associations between hip and shoulder ROM were assessed with linear regression. Results: Nonpitchers with a history of shoulder injury had more external rotation and less internal rotation of the shoulder than nonpitchers with no history of shoulder injury. Glenohumeral internal-rotation deficit was greater in both pitchers and nonpitchers with a history of shoulder injury. The relationship between dominant hip extension and shoulder external rotation was significant for pitchers with a history of shoulder injury and nonpitchers with a history of shoulder injury. Conclusions: Shoulder injury may be associated with specific measures of hip and shoulder ROM, and hip extension and shoulder external rotation may be related in baseball players with a history of shoulder injury. Additional research is necessary to understand the specific mechanisms of shoulder injury in the throwing athlete.


2022 ◽  
pp. 036354652110678
Author(s):  
Joseph E. Manzi ◽  
Brittany Dowling ◽  
Zhaorui Wang ◽  
Andrew Luzzi ◽  
Ryan Thacher ◽  
...  

Background: Biomechanical predictors of pitching accuracy are underevaluated in baseball research. It is unclear how pitchers with higher accuracy differ in terms of kinematics and upper extremity kinetics. Purpose: To differentiate high- and low-accuracy professional pitchers by full-body kinematic and upper extremity kinetic parameters. Study Design: Descriptive laboratory study. Methods: In total, 121 professional baseball pitchers threw 8 to 12 fastballs while assessed with motion-capture technology (480 Hz). Pitchers were divided into high-accuracy (n = 33), moderate-accuracy (n = 52), and low-accuracy (n = 36) groups based on the absolute center deviation of each pitcher’s average pitch to the center of the pitching chart by greater or less than 0.5 SD from the mean, respectively. The 95% confidence ellipses with comparisons of major and minor radii and pitching probability density grids were constructed. Analysis of variance was used to compare kinematic and kinetic values between groups. Results: The absolute center deviation (14.5% ± 6.7% vs 33.5% ± 3.7% grid width; P < .001) was significantly lower in the high-accuracy compared with the low-accuracy group, with no significant difference in ball velocity (38.0 ± 1.7 vs 38.5 ± 2.0 m/s; P = .222). Lead knee flexion at ball release (30.6°± 17.8° vs 40.1°± 16.3°; P = .023) was significantly less for the high-accuracy pitchers. Peak normalized shoulder internal rotation torque (5.5% ± 1.0% vs 4.9% ± 0.7% body weight [BW] × body height [BH]; P = .008), normalized elbow varus torque (5.4% ± 1.0% vs 4.8% ± 0.7% BW × BH; P = .008), and normalized elbow medial force (42.9% ± 7.3% vs 38.6% ± 6.2% BW; P = .024) were significantly greater for the low-accuracy group compared with the high-accuracy group. Conclusion: Professional pitchers with increased accuracy experienced decreased throwing arm kinetics. These pitchers had increased lead knee extension at later stages of the pitch, potentially providing more stable engagement with the ground and transference of kinetic energy to the upper extremities. Professional pitchers can consider increasing lead knee extension at the final stages of the pitch to improve the accuracy of their throws and mitigate elbow varus torque. Clinical Relevance: Increased elbow varus torque, shoulder internal rotation torque, and elbow medial force in less accurate pitchers may contribute to increased injury risk in this group.


2019 ◽  
Vol 47 (12) ◽  
pp. 2821-2826 ◽  
Author(s):  
D. Grace Smith ◽  
Alexander J. Swantek ◽  
Caleb M. Gulledge ◽  
Vincent A. Lizzio ◽  
Angel Bermudez ◽  
...  

Background: Alterations in throwing mechanics have been identified as a risk factor for overuse injuries in baseball players. Glenohumeral internal rotation deficit (GIRD) has been found to adversely affect throwing mechanics, but the effect of GIRD on medial elbow torque is unclear. Purpose: To investigate the relationship between GIRD and medial elbow torque in high school–aged baseball pitchers. Study Design: Descriptive laboratory study. Methods: High school baseball pitchers (14-18 years old) were recruited for participation in this study. Players’ height, weight, body mass index, and arm measurements were recorded as well as shoulder and elbow range of motion measurements. GIRD was calculated from the difference between dominant and nondominant shoulder internal rotation. Participants then pitched 5 fastballs at maximum effort while wearing a wireless sensor that recorded elbow torque, arm slot, arm speed, shoulder rotation, and ball velocity. Principal component analysis was performed to determine which variables were associated with elbow torque or ball velocity. Results: Twenty-three high school pitchers participated in this study; 35% (n = 8) of participants exhibited GIRD of at least 20°. The mean GIRD was 15.3°± 11.2° and was not a predictor of medial elbow torque ( P = .205) or ball velocity ( P = .333). Ball velocity, age, and height were predictors of medial elbow torque ( P = .012, P = .003, and P = .024, respectively). Conclusion: In high school baseball pitchers, GIRD was not associated with medial elbow torque during the pitching motion. Instead, ball velocity, player age, and player height carried greater significance. Clinical Relevance: This study suggests that high school pitchers with GIRD do not have an inherently greater risk for increased medial elbow torque during the throwing motion. It is recommended that pitchers instead assess their ball velocity to evaluate for relative differences in medial elbow torque.


Sign in / Sign up

Export Citation Format

Share Document