Relationship Between Glenohumeral and Thoracolumbar Rotation Range of Motion in Baseball Players

2020 ◽  
Vol 25 (1) ◽  
pp. 21-26
Author(s):  
Jeffrey G. Williams ◽  
Lauryn Darnall ◽  
Conrad Schumann

Baseball players have demonstrated greater thoracolumbar rotation (TLR) range of motion (ROM) toward their nonthrowing arm sides. This imbalance is thought to be compensatory to ROM deficiencies at the throwing arm’s shoulder. The purpose of this study was to examine the relationship between TLR and glenohumeral (GH) ROM measures (internal rotation, external rotation, horizontal adduction) among collegiate baseball players. Findings demonstrated limited and no relationships between TLR and GH ROM. Future research should advance these findings by examining symptomatic participants and hip ROM as additional variables. Doing so may enhance clinicians’ abilities to comprehensively predict, prevent, detect, and treat movement deficiencies, and subsequent injuries, suffered by competitive baseball players.

2014 ◽  
Vol 49 (4) ◽  
pp. 507-513 ◽  
Author(s):  
Elizabeth E. Hibberd ◽  
Sakiko Oyama ◽  
Justin Tatman ◽  
Joseph B. Myers

Context: Biomechanically, the motions used by baseball and softball pitchers differ greatly; however, the throwing motions of position players in both sports are strikingly similar. Although the adaptations to the dominant limb from overhead throwing have been well documented in baseball athletes, these adaptations have not been clearly identified in softball players. This information is important in order to develop and implement injury-prevention programs specific to decreasing the risk of upper extremity injury in softball athletes. Objective: To compare range-of-motion and humeral-retrotorsion characteristics of collegiate baseball and softball position players and of baseball and softball players to sex-matched controls. Design: Cross-sectional study. Setting: Research laboratories and athletic training rooms at the University of North Carolina at Chapel Hill. Patients or Other Participants: Fifty-three collegiate baseball players, 35 collegiate softball players, 25 male controls (nonoverhead athletes), and 19 female controls (nonoverhead athletes). Intervention(s): Range of motion and humeral retrotorsion were measured using a digital inclinometer and diagnostic ultrasound. Main Outcome Measure(s): Glenohumeral internal-rotation deficit, external-rotation gain, total glenohumeral range of motion, and humeral retrotorsion. Results: Baseball players had greater glenohumeral internal-rotation deficit, total–range-of-motion, and humeral-retrotorsion difference than softball players and male controls. There were no differences between glenohumeral internal-rotation deficit, total–range-of-motion, and humeral-retrotorsion difference in softball players and female controls. Conclusions: Few differences were evident between softball players and female control participants, although range-of-motion and humeral-retrotorsion adaptations were significantly different than baseball players. The throwing motions are similar between softball and baseball, but the athletes adapt to the demands of the sport differently; thus, stretching/strengthening programs designed for baseball may not be the most effective programs for softball athletes.


Author(s):  
Tomonobu Ishigaki ◽  
Motoki Hirokawa ◽  
Yuya Ezawa ◽  
Masanori Yamanaka

AbstractBaseball players commonly show altered glenohumeral range of motion during internal rotation, external rotation, total rotation, and horizontal adduction. These altered ranges of motion appear to be associated with throwing shoulder injuries, which frequently involve the supraspinatus tendons; thus, we aimed to examine the relationship between altered glenohumeral range of motion and supraspinatus tendon changes in collegiate baseball players. To investigate this association using the Pearson correlation coefficient, we measured glenohumeral internal rotation, external rotation, total rotation, and horizontal adduction ranges of motion and supraspinatus tendon thickness in 22 college baseball players. Consequently, there was a significant relationship between increase in supraspinatus tendon thickness and greater deficit of internal rotation (r=–0.520, P=0.013). Increased supraspinatus tendon thickness tended to be associated with greater external rotation gain (r=0.394, P=0.073). No other range of motion had any relationship with supraspinatus tendon changes. These results might indicate that restricted glenohumeral internal rotation and excessive gain in external rotation increase the risk of supraspinatus tendon abnormalities in baseball players.


2020 ◽  
pp. 112070002091037 ◽  
Author(s):  
Shinya Hayashi ◽  
Shingo Hashimoto ◽  
Tomoyuki Matsumoto ◽  
Koji Takayama ◽  
Nao Shibanuma ◽  
...  

Purpose: The aim of this study was to evaluate the relationship between acetabular 3-dimensional (3D) alignment reorientation and clinical range of motion (ROM) after periacetabular osteotomy (PAO). Methods: 50 patients (58 hips) with hip dysplasia participated in the study and underwent curved PAO. The pre- and postoperative 3D centre-edge (CE) angles and femoral anteversion were measured and compared with clinical outcomes, including postoperative ROM. Results: The correlation between pre- and postoperative acetabular coverage and postoperative ROM was evaluated. Postoperative abduction and internal rotation ROM were significantly associated with postoperative lateral CE angles (abduction; p < 0.001, internal rotation; p = 0.028); flexion and internal rotation ROM was significantly associated with postoperative anterior CE angles (flexion; p < 0.001, internal rotation; p = 0.028). Femoral anteversion was negatively correlated with postoperative abduction ( p = 0.017) and external rotation ( p = 0.047) ROM. Conclusion: Postoperative anterior acetabular coverage may affect internal rotation ROM more than the lateral coverage. Therefore, the direction of acetabular reorientation should be carefully determined according to 3D alignment during PAO.


2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0040
Author(s):  
Caleb Gulledge ◽  
Toufic Jildeh ◽  
Joseph Tramer ◽  
Fabien Meta ◽  
Kevin Taylor ◽  
...  

Objectives: Overuse injuries in overhead athletes are becoming more prevalent, with an unclear relationship between shoulder biomechanics and medial elbow symptoms and injury. The purpose of this study was to investigate the relationship of shoulder range of motion to torque across the medial elbow in college pitchers using a validated MOTUS sensor baseball sleeve. Methods: Pitchers were recruited from three local university baseball teams. Exclusion criteria included injury or restricted activity due to pain. They were evaluated in the preseason, within two weeks before their first game of the season. Pitchers completed workload questionnaires and patient reported outcome measurement information system (PROMIS) pain interference (PI), physical function (PF), and upper extremity (UE) surveys. Shoulder range of motion and upper extremity lengths were measured bilaterally. After adequate warm-up, pitchers were fitted with a MOTUS sensor baseball sleeve (Motus Global, Massapequa, NY) and instructed to throw 5 fastballs in a standardized manner off the mound at game-speed effort. The sensor placed at the medial elbow reported elbow torque, arm speed, arm slot, and shoulder rotation for each pitch, while a radar gun measured peak ball velocity. The primary outcome was to evaluate the relationship between shoulder range of motion and increased stress across the medial elbow. Additional outcomes evaluated pitcher characteristics, demographics, and outcome scores. Outcomes were assessed via a multivariable model, which controlled for possible covariates. Results: Twenty-eight pitchers were included in the preseason analysis with an average (SD) age of 20.1 (1.3) years and playing experience of 15.3 (1.8) years, 2.5 (1.2) of those years at collegiate level. The dominant shoulder demonstrated decreased internal rotation (54.5+/-10.6 vs 65.8+/-9.1) and increased external rotation (ER, 94.1+/-10.4 vs 88.4+/-9.2) relative to the non-dominant side (p < 0.001), while total rotational range of motion (TRROM) was significantly decreased in the dominant arm (148.6+/-12.4 vs 154.1+/-10.6, p < 0.001). The average glenohumeral internal rotation deficiency (GIRD) was 11.3 (9.87) and average external rotation gain (ERG) was 5.71 (8.8). External rotation was found to be a predictor of arm stress, with an increase in 0.35 Nm of elbow torque for every degree increase in ER (beta = 0.35+/-0.06, p = 0.003); there was moderate correlation between ER and arm stress (r = .45, P<.001). Pitchers demonstrated significantly greater arm stress with the following shoulder ROM measurements: GIRD < 20 as compared to greater than 20 degrees (46.6 +/- 0.5 versus 43.5 +/- 1.1, P=.011), ERG greater than 5 as compared to < 5 degrees (47.4 +/- 0.7 versus 45.1 +/- 0.6, P=.014), and loss of total rotational ROM less than 5 as compared to > 5 degrees (46.6 +/- 0.5 versus 43.6 +/- 1.1, P=.013). Multivariate analysis demonstrated significant predictors of PROMIS PF and UE scores were arm stress, ERG, and GIRD (p<0.05), while increased PROMIS PI scores were predicted by increased ERG and GIRD (p<0.05). Conclusion: We found medial elbow stress, arm speed, arm slot, and shoulder rotation as measured by the MOTUS baseball sensor sleeve were influenced by rotational adaptations of the pitching shoulder in collegiate throwing athletes prior to their season. Likewise, arm stress and shoulder rotational adaptations were reflected as predictors of PROMIS PF, UE, and PI scores.


2010 ◽  
Vol 45 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Stephen J. Thomas ◽  
Kathleen A. Swanik ◽  
Charles B. Swanik ◽  
John D. Kelly

Abstract Context: Conditions such as labral and rotator cuff injuries have been linked with decreases in glenohumeral internal-rotation and increases in external-rotation motion. Also, decreased glenohumeral internal rotation is strongly associated with scapular dyskinesis. Objective: To compare healthy collegiate and high school baseball players' glenohumeral joint range of motion and scapular position. Design: Cross-sectional study. Setting: Institutional research laboratory. Patients or Other Participants: Thirty-one male National Collegiate Athletic Association Division I collegiate (age  =  20.23 ± 1.17 years, height  =  186.24 ± 5.73 cm, mass  =  92.01 ± 7.68 kg) and 21 male high school baseball players (age  =  16.57 ± 0.76 years, height  =  180.58 ± 6.01 cm, mass  =  79.09 ± 11.51 kg). Main Outcome Measure(s): Glenohumeral internal and external rotation and scapular upward rotation were measured with a digital inclinometer. Scapular protraction was measured with a vernier caliper. All variables except scapular upward rotation were calculated as the difference between the dominant and nondominant sides. Results: Collegiate baseball players had more glenohumeral internal-rotation deficit (4.80°, P  =  .028) and total motion deficit (5.73°, P  =  .009) and less glenohumeral external-rotation gain (3.00°, P  =  .028) than high school players. Collegiate baseball players had less scapular upward rotation than high school players at the 90° (4.12°, P  =  .015, versus 3.00°, P  =  .025) and 120° (4.00°, P  =  .007, versus 3.40°, P  =  .005) positions. The scapular protraction difference was greater in collegiate baseball players than in high school players in the hands-on-hips and 90° positions (0.77 cm, P  =  .021, and 1.4 cm, P  =  .001). Conclusions: When comparing high school with collegiate baseball players, these data suggest that glenohumeral internal-rotation deficit and scapular position change as the level of competition increases.


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.


2002 ◽  
Vol 30 (3) ◽  
pp. 354-360 ◽  
Author(s):  
K.M. Reagan ◽  
Keith Meister ◽  
Mary Beth Horodyski ◽  
Dave W. Werner ◽  
Cathy Carruthers ◽  
...  

Background Previous studies have documented changes in musculature, bony anatomy, and glenohumeral rotation in the dominant shoulder of baseball players. Hypothesis In a group of asymptomatic college baseball players the total range of motion in the dominant and nondominant shoulders will be similar. Any measured increase in external rotation and decrease in internal rotation occurring between the two sides will be consistent and directly correlate with an increased angle of humeral retroversion in the dominant extremity. Study Design Descriptive anatomic study. Methods Fifty-four asymptomatic college baseball players were examined. Standard measurements of glenohumeral range of motion were made and humeral retroversion was determined radiologically. Results Total rotational motion, measured at 90° of glenohumeral abduction, was 159.5° for the dominant shoulders and 157.8° for the nondominant shoulders. Mean differences in external and internal rotation in the dominant versus nondominant extremities were 9.7° and 8.2°, respectively. Humeral retroversion measured 36.6° ± 9.8° in the dominant and 26° ± 9.4° in the nondominant extremity. The mean difference in retroversion correlated significantly by Pearson's product moment with the difference in external (P = 0.001) and internal (P = 0.003) rotation measurements. Conclusions There is a pattern of increased external rotation and decreased internal rotation in the dominant extremity that significantly correlates with an increase in humeral retroversion. The loss of internal rotation and gains in external rotation may be more strongly related to adaptive changes in proximal humeral anatomy than to changes in the soft tissues.


2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110007
Author(s):  
J. Craig Garrison ◽  
Joseph P. Hannon ◽  
John E. Conway

Background: Neurogenic thoracic outlet syndrome (nTOS) is becoming more recognized as a diagnosis in the throwing athlete. Currently, there is limited information on the clinical presentation and development of nTOS in baseball players. Purpose: To compare passive shoulder range of motion (ROM) and anatomic humeral retrotorsion (HRT) of baseball players diagnosed with nTOS with a group of healthy, matched controls. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 53 adolescent baseball players diagnosed with nTOS (age, 17.2 ± 2.3 years; height, 180.9 ± 10.1 cm; weight, 80.0 ± 13.3 kg) were compared with 53 healthy baseball players (age, 17.2 ± 2.4 years; height, 183.9 ± 9.0 cm; weight, 83.8 ± 11.5 kg). Participants were measured for shoulder internal rotation (IR) and external rotation (ER) ROM and HRT. All measurements were taken bilaterally, and the differences (throwing to nonthrowing arm) were used to calculate mean values for glenohumeral internal rotation difference, glenohumeral external rotation difference (GERD), total rotational motion difference (TRMdiff), and anatomic humeral retrotorsion difference. Group comparisons were made between the nTOS and control players using multivariate analysis of variance, and descriptive comparisons were made with independent t tests. Results: There were no significant differences between groups in age, height, weight, or years of experience. Players in the nTOS group had significantly less throwing arm ER compared with controls (103.4° ± 10.4° vs 109.6° ± 7.5°, respectively; P = .001) and GERD (3.0° ± 9.2° vs 8.8° ± 9.2°, respectively; P = .002). TRMdiff was significantly greater in nTOS (–11.1° ± 11.1°) than in controls (–3.7° ± 9.4°) ( P < .001). Conclusion: In the current study, adolescent baseball players diagnosed with nTOS were evaluated with shoulder ROM differences when compared with a matched healthy cohort. A loss of throwing arm ER appeared to be the main factor behind shoulder ROM changes in the nTOS group.


2015 ◽  
Vol 7 (4) ◽  
Author(s):  
Xinning Li ◽  
Richard Ma ◽  
Hanbing Zhou ◽  
Matthew Thompson ◽  
Courtney Dawson ◽  
...  

Normal hip range of motion (ROM) is essential in running and transfer of energy from lower to upper extremities during overhead throwing. Dysfunctional hip ROM may alter lower extremity kinematics and predispose athletes to hip and groin injuries. The purpose of this study is characterize hip internal/external ROM (Arc) and its effect on the risk of hip, hamstring, and groin injuries in professional baseball players. Bilateral hip internal and external ROM was measured on all baseball players (N=201) in one professional organization (major and minor league) during spring training. Players were organized according to their respective positions. All injuries were documented prospectively for an entire MLB season (2010 to 2011). Data was analyzed according to position and injuries during the season. Total number of players (N=201) with an average age of 24±3.6 (range=17-37). Both pitchers (N=93) and catchers (N=22) had significantly decreased mean hip internal rotation and overall hip arc of motion compared to the positional players (N=86). Players with hip, groin, and hamstring injury also had decreased hip rotation arc when compared to the normal group. Overall, there is a correlation between decreased hip internal rotation and total arc of motion with hip, hamstring, and groin injuries.


CommonHealth ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 37-43
Author(s):  
Ryan William Paul ◽  
Angela Tate ◽  
Joseph Sarver ◽  
Laura DiPaola ◽  
Jeffery Yim ◽  
...  

Background: Due to high training volume, competitive swimmers incur shoulder pain and injury1, but certain physical characteristics, such as shoulder ROM and endurance, and tissue adaptations such as posterior capsule thickness (PCT) and supraspinatus tendon structure may also be risk factors. Decreased endurance and ROM have been found in competitive swimmers along with being related to pain2. However, no longitudinal studies have examined pain and disability, range of motion, training volume, shoulder endurance and tendon structure over the course of a competitive season. Purpose: The purpose of this study was to: 1) to assess shoulder pain and disability, internal rotation (IR) and external rotation (ER) and horizontal adduction (HADD) ROM, and posterior shoulder endurance longitudinally over a competitive collegiate season, and 2) determine if there is a relationship between swimming yardage, supraspinatus tendon organization and posterior capsule thickness. Methods: 17 male and 13 female Division III swimmers aged 19.6 ± 1.1 years participated. Pain and disability were assessed using the Penn Shoulder Score and the Disability of Arm Shoulder Hand sports module. Internal rotation (IR), external rotation (ER), and horizontal adduction (HA) were measured using a digital inclinometer. Shoulder endurance was measured using the Posterior Shoulder Endurance Test (PSET). Anterior, center, and posterior supraspinatus tendon images were collected by locating the anterior aspect of the tendon insertion and moving posteriorly. The ultrasound images were analyzed using custom MATlab software to quantify tissue organization. All measures were found in the beginning (T1), middle (T2), and end (T3) of the season. Repeated measure ANOVAs were used to compare longitudinal changes across time.  If p-values were found to be ≤ 0.05, follow-up paired t-tests with Bonferroni corrections were used to compare T1, T2, and T3. This protocol was IRB-approved and participants signed a written consent form. Results: An increase in swimming yardage from T1 to T2 was followed by a significant decrease in yardage to finish the swimming season (Table 1). Disability decreased and endurance increased throughout the season with no observed changes in pain. IR and HA ROM decreased significantly between all timepoint comparisons. Tendon banding frequency did not change over time (Table 2). Discussion: Large amounts of IR during the pull phase and late initiation of ER during the recovery phase have been associated with a high risk of impingement4. The relationship between pain, disability, and range of motion may suggest that a reduction of IR could protect the swimmers’ shoulder by limiting impingement through the pull and recovery phases. However, further investigation is required to confirm. The lack of statistical significance longitudinally in tendon organization is not surprising since there were no changes in pain, a decrease in disability, and an increase in endurance. Conclusion/Clinical Relevance: Further research is required to understand the relationship between training volume, tendon organization, and disability. Collegiate swimmers demonstrate increased endurance and decreased disability over the course of the season. It may suggest that the loss of ROM is a positive adaptation and may be protective.


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