Increase in Humeral Retrotorsion Accounts for Age-Related Increase in Glenohumeral Internal Rotation Deficit in Youth and Adolescent Baseball Players

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.

Download Full-text

Dominant-Limb Range-of-Motion and Humeral-Retrotorsion Adaptation in Collegiate Baseball and Softball Position Players

Journal of Athletic Training ◽

10.4085/1062-6050-49.3.23 ◽

2014 ◽

Vol 49 (4) ◽

pp. 507-513 ◽

Cited By ~ 15

Author(s):

Elizabeth E. Hibberd ◽

Sakiko Oyama ◽

Justin Tatman ◽

Joseph B. Myers

Keyword(s):

Range Of Motion ◽

Internal Rotation ◽

Athletic Training ◽

External Rotation ◽

Cross Sectional Study ◽

Cross Sectional ◽

Baseball Players ◽

Glenohumeral Internal Rotation Deficit ◽

Total Range ◽

Collegiate Baseball

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.

Download Full-text

Associations Among Hip and Shoulder Range of Motion and Shoulder Injury in Professional Baseball Players

Journal of Athletic Training ◽

10.4085/1062-6050-45.2.191 ◽

2010 ◽

Vol 45 (2) ◽

pp. 191-197 ◽

Cited By ~ 67

Author(s):

Steve Scher ◽

Kyle Anderson ◽

Nick Weber ◽

Jeff Bajorek ◽

Kevin Rand ◽

...

Keyword(s):

Internal Rotation ◽

External Rotation ◽

Professional Baseball ◽

Shoulder Injury ◽

Baseball Players ◽

Glenohumeral Internal Rotation Deficit ◽

History Of ◽

Shoulder External Rotation ◽

The Relationship ◽

Hip Extension

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.

Download Full-text

Glenohumeral Internal Rotation Deficit Measured in the Coronal and the Sagittal Planes in Baseball Players

Journal of Exercise Sports & Orthopedics ◽

10.15226/2374-6904/4/1/00151 ◽

2016 ◽

Vol 4 (1) ◽

pp. 1-4

Author(s):

Hiroaki Inui

Keyword(s):

Internal Rotation ◽

Baseball Players ◽

Glenohumeral Internal Rotation Deficit

Download Full-text

Relationship Between Glenohumeral Internal Rotation Deficit and Medial Elbow Torque in High School Baseball Pitchers

The American Journal of Sports Medicine ◽

10.1177/0363546519868939 ◽

2019 ◽

Vol 47 (12) ◽

pp. 2821-2826 ◽

Cited By ~ 4

Author(s):

D. Grace Smith ◽

Alexander J. Swantek ◽

Caleb M. Gulledge ◽

Vincent A. Lizzio ◽

Angel Bermudez ◽

...

Keyword(s):

High School ◽

Internal Rotation ◽

Principal Component ◽

Baseball Players ◽

Glenohumeral Internal Rotation Deficit ◽

Ball Velocity ◽

Maximum Effort ◽

Baseball Pitchers ◽

The Difference ◽

Relative Differences

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.

Download Full-text