Correlation of Range of Motion and Glenohumeral Translation in Professional Baseball Pitchers

Background Altered mobility patterns in the throwing shoulders of professional baseball pitchers have been reported. Most published reports examining glenohumeral laxity have not used an objective testing device. Objective Quantify and compare glenohumeral translation and rotational range of motion between the throwing and non-throwing shoulders in professional baseball pitchers. Study Design Descriptive laboratory study. Methods Force-displacement and range of motion measures were performed bilaterally on 43 asymptomatic professional baseball pitchers. Ultrasound imaging was used to measure glenohumeral translations under stressed and unstressed conditions. Results No significant difference in translation was found between the throwing and nonthrowing shoulders. For both shoulders, posterior translation (5.38 ± 2.7 mm) was significantly greater (P < .001) than was anterior translation (2.81 ± 1.6 mm). External rotation in the throwing shoulder was significantly greater than that in the nonthrowing shoulder (P < .001), whereas internal rotation in the throwing shoulder was significantly less than that in the nonthrowing shoulder (P < .001). The total arc of rotation for the throwing shoulder was not significantly different than that for the nonthrowing shoulder, and correlation coefficients were poor between rotational and translational range of motion in the throwing shoulder, ranging from r = 0.232 to 0.209 between variables. Conclusion No significant difference in glenohumeral translation exists between the throwing and nonthrowing shoulders in asymptomatic professional baseball pitchers, posterior translation is significantly greater than anterior translation in the throwing shoulders of professional baseball pitchers, and glenohumeral translation is not related to rotational range of motion in the throwing shoulders of professional baseball pitchers. Clinical Relevance Altered mobility patterns in asymptomatic professional baseball pitchers may be due to factors other than capsular adaptive changes.

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Incidence of Asymptomatic, Nontraumatic Unilateral Knee Hyperextension in the High School Athlete

Journal of Sport Rehabilitation ◽

10.1123/jsr.5.4.287 ◽

1996 ◽

Vol 5 (4) ◽

pp. 287-292

Author(s):

George A. Arangio ◽

Marie St. Amour-Myers ◽

James Reed

Keyword(s):

High School ◽

Range Of Motion ◽

Peak Torque ◽

Left Knee ◽

Control Group ◽

Control Groups ◽

Anterior Translation ◽

Significant Difference ◽

Posterior Translation ◽

And Control

Four hundred sixty-seven high school athletes were screened in apreparticipation athletic physical. Forty-six (9.8%) of these athletes presented with asymptomatic, nontraumatic unilateral hyperextension. Twenty-three athletes were reexamined and compared to a normal control group. A 2.5-cm, statistically significant heel-to-heel difference was recorded in the hyperextension group. Between the involved hyperextended and uninvolved legs, there were differences in average range of motion (132.04° vs. 130.74°, respectively), average manual anterior translation by KT-1000 (5.39 mm vs. 5.15 mm, respectively), average posterior translation (2.07 mm vs. 2.00 mm, respectively), average peak quadriceps torque (86.25 ft-lb vs. 84.06 ft-lb, respectively), and hamstring average peak torque (53.89 ft-lb vs. 52.93 ft-lb, respectively), though these differences were not statistically significant. In the control group, there was no heel-to-heel difference in the right versus the left knee. Heel-to-heel difference between the experimental and control groups was statistically significant. There was no statistically significant difference between range of motion, anterior translation, or posterior translation between the experimental and control groups.

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Descriptive Profile of Hip Rotation Range of Motion in Elite Tennis Players and Professional Baseball Pitchers

The American Journal of Sports Medicine ◽

10.1177/0363546507300260 ◽

2007 ◽

Vol 35 (8) ◽

pp. 1371-1376 ◽

Cited By ~ 52

Author(s):

Todd S. Ellenbecker ◽

Gail A. Ellenbecker ◽

E. Paul Roetert ◽

Rogerio Teixeira Silva ◽

Greg Keuter ◽

...

Keyword(s):

Range Of Motion ◽

Internal Rotation ◽

Hip Joint ◽

External Rotation ◽

Professional Baseball ◽

Tennis Players ◽

Active Range Of Motion ◽

Baseball Pitchers ◽

Hip Rotation ◽

Bilateral Difference

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.

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The Effect of Straight-Line Long-Toss Versus Ultra-Long-Toss Throwing on Passive Glenohumeral Range of Motion Recovery After Pitching

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738120980016 ◽

2021 ◽

pp. 194173812098001

Author(s):

T. David Luo ◽

Aaron D. Sciascia ◽

Austin V. Stone ◽

Chukwuweike U. Gwam ◽

Christopher A. Grimes ◽

...

Keyword(s):

Range Of Motion ◽

Internal Rotation ◽

National Collegiate Athletic Association ◽

External Rotation ◽

Level Of Evidence ◽

Left Hand ◽

Right Hand ◽

Straight Line ◽

Significant Difference ◽

Baseball Pitchers

Background: Repetitive throwing in baseball pitchers can lead to pathologic changes in shoulder anatomy, range of motion (notably glenohumeral internal rotation deficit), and subsequent injury; however, the ideal strengthening, recovery, and maintenance protocol of the throwing shoulder in baseball remains unclear. Two strategies for throwing shoulder recovery from pitching are straight-line long-toss (SLT) throwing and ultra-long-toss (ULT) throwing, although neither is preferentially supported by empirical data. Hypothesis: ULT will be more effective in returning baseline internal rotation as compared with SLT in collegiate pitchers after a pitching session. Study Design: Cohort study. Level of Evidence: Level 3. Methods: A total of 24 National Collegiate Athletic Association Division I baseball pitchers with mean age 20.0 ± 1.1 years were randomized to either the ULT group (n = 13; 9 right-hand dominant, 4 left-hand dominant) or SLT group (n = 11; 10 right-hand dominant, 1 left-hand dominant). Measurements (dominant and nondominant, 90° abducted external rotation [ER], internal rotation [IR], and total range of motion [TROM]) were taken at 5 time points across 3 days: before and immediately after a standardized bullpen session on day 1; before and immediately after a randomized standardized ULT or SLT session on day 2; and before practice on Day 3. Results: ULT demonstrated significantly greater final ER compared with baseline (+10°; P = 0.05), but did not demonstrate significant IR changes. Similarly, SLT demonstrated significantly greater post-SLT ER (+12°; P = 0.02) and TROM (+12°; P = 0.01) compared with baseline, but no significant IR changes. Final ER measurements were similar between ULT (135° ± 14°) and SLT (138° ± 10°) ( P = 0.59). There was also no statistically significant difference in final IR between ULT (51° ± 14°) and SLT (56° ± 8°) ( P = 0.27). Conclusion: The routine use of postperformance, ULT throwing to recover from range of motion alterations, specifically IR loss, after a pitching session is not superior to standard, SLT throwing. Based on these findings, the choice of postpitching recovery throwing could be player specific based on experience and comfort. Clinical Relevance: The most effective throwing regimens for enhancing performance and reducing residual impairment are unclear, and ideal recovery and maintenance protocols are frequently debated with little supporting data. Two strategies for throwing shoulder recovery from pitching are SLT and ULT throwing. These are employed to help maintain range of motion and limit IR loss in pitchers. The routine use of ULT throwing for recovery and to limit range of motion alterations after a pitching session is not superior to SLT throwing.

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The relationship between range of motion and muscle strength of the shoulder joint in professional baseball pitchers

10.31083/jomh.2021.030 ◽

2021 ◽

Keyword(s):

Body Weight ◽

Range Of Motion ◽

Shoulder Joint ◽

External Rotation ◽

Linear Regression Analysis ◽

Isometric Strength ◽

Professional Baseball ◽

Baseball Pitchers ◽

Baseball Team ◽

The Relationship

Background and objective: This study aimed to assess the relationship between range of motion (ROM) and isometric strength of the shoulder joint, adjusted for humeral head retroversion angle (HHRA), in professional baseball pitchers. Material and Methods: A total of 18 pitchers from a professional baseball team were included in this study. The isometric strength of internal rotation (IR) and external rotation (ER) were measured using an isokinetic device at 85◦ and 30◦ ER, and at 25◦ IR. A linear regression analysis was then performed. Results: The HHRA of the dominant arm was approximately 7◦ greater than that of the non-dominant arm (P < 0.001). As the IR ROM increased by 1◦, the IR isometric strength at 25◦ IR was signiﬁcantly increased by 0.448% body weight (P < 0.05). However, as the ROM of IR increased, the IR isometric strength at 85◦ and 30◦ ER was not signiﬁcant (P > 0.05), and as the ROM of ER increased, the IR and ER isometric strength were not signiﬁcant (P > 0.05). Conclusions: Thus, the increase of IR ROM in professional baseball pitchers was associated with an increase in isometric strength at 25◦ IR, after adjustments were made for HHRA.

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Quantification of Anterior Translation of the Humeral Head in the Throwing Shoulder

The American Journal of Sports Medicine ◽

10.1177/03635465000280020501 ◽

2000 ◽

Vol 28 (2) ◽

pp. 161-167 ◽

Cited By ~ 32

Author(s):

Todd S. Ellenbecker ◽

Angelo J. Mattalino ◽

Eric Elam ◽

Roger Caplinger

Keyword(s):

Clinical Evaluation ◽

Humeral Head ◽

Glenohumeral Joint ◽

External Rotation ◽

Professional Baseball ◽

Intrarater Reliability ◽

Stress Radiography ◽

Significant Difference ◽

Baseball Pitchers ◽

Head Translation

Clinical evaluation of humeral head translation relies mainly on manual tests to measure laxity in the human shoulder. The purposes of this study were to determine whether side-to-side differences exist in anterior humeral head translation in professional baseball pitchers, to compare manual laxity testing with stress radiography for quantifying humeral head translation, and to test intrarater reliability of the manual humeral head translation and stress radiography tests. Twenty professional baseball pitchers underwent bilateral manual anterior humeral head translation and stress radiographic tests. Stress radiography was performed by imparting a 15-daN anterior load to the shoulder in 90° of abduction with both neutral and 60° of external rotation and recording the glenohumeral joint translation at rest and under stress in each position. Eight subjects were retested to assess the reliability of these methods. Results showed no significant difference between the dominant and nondominant extremity in the amount of anterior humeral head translation measured manually and with stress radiography, nor significant correlation between anterior humeral head translation measured manually and by stress radiography. Testretest reliability was moderate-to-poor for the manual humeral head translation test and moderate for stress radiography.

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Correlation of Range of Motion and Glenohumeral Translation in Professional Baseball Pitchers

Yearbook of Sports Medicine ◽

10.1016/s0162-0908(08)70297-6 ◽

2006 ◽

Vol 2006 ◽

pp. 61-62

Author(s):

R.C. Cantu

Keyword(s):

Range Of Motion ◽

Professional Baseball ◽

Baseball Pitchers

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The Relationship between Scapular Upward Rotation and Shoulder Internal and External Rotation Isokinetic Strength in Professional Baseball Pitchers

Healthcare ◽

10.3390/healthcare9060759 ◽

2021 ◽

Vol 9 (6) ◽

pp. 759

Author(s):

Byung Gon Kim ◽

Seung Kil Lim ◽

Sunga Kong

Keyword(s):

External Rotation ◽

Professional Baseball ◽

Isokinetic Strength ◽

Strength Ratio ◽

Shoulder Injury ◽

Isokinetic Dynamometer ◽

Normal Range ◽

History Of ◽

Baseball Pitchers ◽

The Relationship

This study aims to assess the relationship between scapular upward rotation (SUR) across varying humeral-elevation angles (HEAs) and shoulder isokinetic strength and ratio in professional baseball pitchers. The subjects were professional baseball pitchers (n = 16) without a history of shoulder injury in the last six months. The subject’s SUR angles were measured with the humerus elevated at HEAs of 0° (at rest), 60°, 90°, and 120° to the scapular plane. Shoulder isokinetic strength was evaluated for shoulder internal rotation (IR) and external rotation (ER) strength (PT%BW and TW%BW), and the ER/IR strength ratios were determined at 60, 120 and 180°/s using an isokinetic dynamometer. The SUR angle at an HEA of 0° was positively correlated with IR strength at 120°/s (r = 0.535) and 180°/s (r = 0.522). The SUR angle at an HEA of 60° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.505) and 120°/s (r = −0.500). The SUR angle at an HEA of 90° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.574; r = −0.554) and 120°/s (r = −0.521; r = −0.589) as well as with ER strength at 180°/s (r = −0.591, r = −0.556). The SUR angle at an HEA of 120° was negatively correlated with ER strength at 60°/s (r = −0.558), 120°/s (r = −0.504; r = −0.524), and 180°/s (r = −0.543) and the ER/IR strength ratio at 60°/s (r = −0.517). In this study, we found that the ratio of isokinetic strength between ER and IR became closer to the normal range on increasing the SUR angle. In particular, an HEA of 90°, which resembles the pitching motion, showed a clear relationship between SUR, shoulder ER, and the ratio of ER/IR isokinetic strength in professional baseball pitchers.

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An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

Applied Sciences ◽

10.3390/app11062852 ◽

2021 ◽

Vol 11 (6) ◽

pp. 2852

Author(s):

Maeruan Kebbach ◽

Christian Schulze ◽

Christian Meyenburg ◽

Daniel Kluess ◽

Mevluet Sungu ◽

...

Keyword(s):

Range Of Motion ◽

Internal Rotation ◽

Computer Aided Design ◽

External Rotation ◽

Patient Specific ◽

Computational Framework ◽

Total Hip ◽

Total Hip Replacements ◽

Significant Difference ◽

Hip Replacements

The calculation of range of motion (ROM) is a key factor during preoperative planning of total hip replacements (THR), to reduce the risk of impingement and dislocation of the artificial hip joint. To support the preoperative assessment of THR, a magnetic resonance imaging (MRI)-based computational framework was generated; this enabled the estimation of patient-specific ROM and type of impingement (bone-to-bone, implant-to-bone, and implant-to-implant) postoperatively, using a three-dimensional computer-aided design (CAD) to visualize typical clinical joint movements. Hence, patient-specific CAD models from 19 patients were generated from MRI scans and a conventional total hip system (Bicontact® hip stem and Plasmacup® SC acetabular cup with a ceramic-on-ceramic bearing) was implanted virtually. As a verification of the framework, the ROM was compared between preoperatively planned and the postoperatively reconstructed situations; this was derived based on postoperative radiographs (n = 6 patients) during different clinically relevant movements. The data analysis revealed there was no significant difference between preoperatively planned and postoperatively reconstructed ROM (∆ROM) of maximum flexion (∆ROM = 0°, p = 0.854) and internal rotation (∆ROM = 1.8°, p = 0.917). Contrarily, minor differences were observed for the ROM during maximum external rotation (∆ROM = 9°, p = 0.046). Impingement, of all three types, was in good agreement with the preoperatively planned and postoperatively reconstructed scenarios during all movements. The calculated ROM reached physiological levels during flexion and internal rotation movement; however, it exceeded physiological levels during external rotation. Patients, where implant-to-implant impingement was detected, reached higher ROMs than patients with bone-to-bone impingement. The proposed framework provides the capability to predict postoperative ROM of THRs.

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Upper Extremity and Hip Range of Motion Changes Throughout a Season in Professional Baseball Players

The American Journal of Sports Medicine ◽

10.1177/0363546519894567 ◽

2019 ◽

Vol 48 (2) ◽

pp. 481-487

Author(s):

Justin M. Chan ◽

John Zajac ◽

Brandon J. Erickson ◽

David W. Altchek ◽

Christopher Camp ◽

...

Keyword(s):

Lower Extremity ◽

Range Of Motion ◽

External Rotation ◽

Significant Risk ◽

Case Series ◽

Significant Risk Factor ◽

Professional Baseball ◽

Level Of Evidence ◽

Baseball Players ◽

Shoulder Flexion

Background: Loss of upper and lower extremity range of motion (ROM) is a significant risk factor for injuries in professional baseball players. Purpose/Hypothesis: The purpose was to determine changes in ROM in professional baseball players over the course of a single season and their careers. We hypothesized that pitchers and position players would lose ROM, specifically total shoulder motion (total ROM [TROM]) and hip internal rotation (IR), over the course of a season and their careers. Study Design: Case series; Level of evidence, 4. Methods: Upper and lower extremity ROM measurements were recorded during pre-, mid-, and postseason on all professional baseball players for a single organization between 2011 and 2018. ROM measurements were compared for pitchers and position players over the course of the season and their careers. Also, ROM measurements over the pre-, mid-, and postseason were compared between pitchers and position players. Results: A total of 166 professional baseball players (98 pitchers, 68 position players) were included. Pitcher hip external rotation (ER; P < .001), IR ( P = .010), and TROM ( P < .001) for lead and trail legs decreased over the course of the season. Pitcher shoulder ER ( P = .005), TROM ( P = .042), and horizontal adduction ( P < .001) significantly increased over the course of the season. Position player shoulder flexion ( P = .046), hip ER ( P < .001, lead leg; P < .001, trail leg), and hip TROM ( P = .001; P = .002) decreased over the course of the season. Position player shoulder ER ( P = .031) and humeral adduction ( P < .001) significantly increased over the course of the season. Over the course of pitchers’ careers, there was decreased shoulder IR ( P = .014), increased shoulder horizontal adduction ( P < .001), and hip IR ( P = .042) and hip TROM ( P = .027) for the lead leg. Position players experienced loss of hip TROM ( P = .010, lead leg; P = .018, trail leg) over the course of their careers. Pitchers started with and maintained more shoulder ER and gained more shoulder TROM over a season as compared with position players. Conclusion: Pitchers and position players saw overall decreases in hip ROM but increases in shoulder ROM over the course of the season and career.

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