scholarly journals Evaluation of hip internal and external rotation range of motion as an injury risk factor for hip, abdominal and groin injuries in professional baseball players

2015 ◽  
Vol 7 (4) ◽  
Author(s):  
Xinning Li ◽  
Richard Ma ◽  
Hanbing Zhou ◽  
Matthew Thompson ◽  
Courtney Dawson ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Injury Risk ◽  
External Rotation ◽  
Professional Organization ◽  
Hamstring Injury ◽  
Professional Baseball ◽  
Baseball Players ◽  
N 93 ◽  
Hip Internal Rotation

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.

scholarly journals The Impact of Workload on the Evolution of Hip Internal and External Rotation in Professional Baseball Players Over the Course of the Season

2018 ◽  
Vol 6 (2) ◽  
pp. 232596711775210 ◽  
Author(s):  
Christopher L. Camp ◽  
John M. Zajac ◽  
Dave Pearson ◽  
Dean Wang ◽  
Alec S. Sinatro ◽  
...  
Keyword(s):  
External Rotation ◽  
Professional Baseball ◽  
Level Of Evidence ◽  
Baseball Players ◽  
Increased Risk ◽  
Hip Range Of Motion ◽  
Hip Motion ◽  
Hip Internal Rotation ◽  
Loss Of Motion ◽  
The Impact

Background: Although restricted hip range of motion (ROM) is associated with an increased risk for injuries in baseball players, the evolution of hip ROM over the season remains undefined. Hypothesis: Hip ROM profiles would be symmetric between hips and positions (pitchers vs position players) but would decrease from preseason to postseason. Additionally, it was hypothesized that this decrease in motion would correlate with workload. Study Design: Cohort study; Level of evidence, 2. Methods: Bilateral hip ROM was assessed in 96 professional baseball players (54 pitchers, 42 position players) preseason and postseason. ROM comparisons were made between lead and trailing hips, pitchers and position players, and preseason and postseason measures. The change from preseason to postseason was correlated with player demographics and measures of workload for pitchers and position players. Results: Preseason hip ROM was symmetric between hips; however, pitchers demonstrated increased preseason lead hip internal rotation (IR) ( P = .018) and bilateral hip total ROM (TROM) ( P < .020) compared with position players. From preseason to postseason, position players lost 7° of external rotation (ER) ( P ≤ .005 ). In pitchers, the loss of IR correlated with increased pitches ( P = .016) and innings ( P = .037), while the loss of ER ( P = .005 ) and TROM ( P = .014) correlated with increasing mean fastball velocity. Workload for position players did not correlate with motion loss. Conclusion: Symmetric hip ROM profiles should be anticipated in baseball players; however, pitchers may have increased preseason IR and TROM and postseason ER and TROM relative to position players. Although loss of motion correlated with workload in pitchers, this was not the case for position players. Hip motion should be monitored over the course of the season. This is particularly true for pitchers who lose IR as workload increases, which may place them at a greater risk for injuries.

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

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.

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

2007 ◽  
Vol 35 (8) ◽  
pp. 1371-1376 ◽  
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.

Decreased Hip Internal Rotation Increases the Risk of Back and Abdominal Muscle Injuries in Professional Baseball Players

2018 ◽  
Vol 26 (9) ◽  
pp. e198-e206 ◽  
Author(s):  
Christopher L. Camp ◽  
Andrea M. Spiker ◽  
John M. Zajac ◽  
Dave Pearson ◽  
Alec M. Sinatro ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Abdominal Muscle ◽  
Professional Baseball ◽  
Muscle Injuries ◽  
Baseball Players ◽  
Hip Internal Rotation

scholarly journals Glenohumeral and Hip Range-of-Motion and Strength Measures in Youth Baseball Athletes

2016 ◽  
Vol 51 (6) ◽  
pp. 466-473 ◽  
Author(s):  
Kelsey J. Picha ◽  
Josie L. Harding ◽  
Kellie C. Huxel Bliven
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Gluteus Medius ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Hip Strength ◽  
Older Athletes ◽  
Youth Baseball ◽  
Hip Internal Rotation

Context: The repetitive demands of throwing affect glenohumeral (GH) range of motion (ROM) and strength. Less is known about hip alterations in skeletally immature athletes. Objective: To compare GH and hip ROM and strength between age, position, and side of youth baseball athletes. Design: Cross-sectional study. Setting: Multicenter testing. Patients or Other Participants: Seventy-two healthy baseball athletes. Participants' self-reported characteristics were age group (7−11 years [n = 28] or 12−18 years [n = 44]), position (pitcher [n = 22], position player [n = 47], unreported [n = 3]), and side (throwing or nonthrowing arm, lead or stance leg). Main Outcome Measure(s): Bilateral GH and hip internal- and external-rotation ROM were measured passively and summed for total arc of motion (TAM). Glenohumeral and hip rotation and gluteus medius strength were measured. Analyses included linear mixed models. Results: Glenohumeral internal rotation was less in throwing than in nonthrowing arms (P &lt; .05) except in younger pitchers (P = .86). Compared with older athletes, younger athletes had more GH external rotation (103.3° ± 7.7° versus 97.5° ± 9.4°; P = .002), TAM (156.4° ± 8.7° versus 147.9° ± 10.9°; P = .04), and external rotation in throwing compared with nonthrowing arms (101.9° ± 1.2° versus 97.9° ± 1.1°; P &lt; .001). Glenohumeral TAM was less in throwing than in nonthrowing arms (150.5° ± 2.1° versus 154.9° ± 1.3°; P = .01). Younger athletes had more hip internal rotation (38.9° ± 6.8° versus 31.2° ± 7.5°; P &lt; .001) and TAM (68.4° ± 10.0° versus 60.7° ± 9.8°; P = .001) than older athletes. Lead-leg hip internal-rotation ROM was greater than in the stance leg (34.8° ± 8.9° versus 32.8° ± 7.7°; P = .01). Overall, older players were stronger than younger players (P &lt; .05), and the throwing arm was stronger in internal rotation than the nonthrowing arm (10.12 ± 3.72 lb [4.59 ± 1.69 kg] versus 9.43 ± 3.18 lb [4.28 ± 1.44 kg]; P = .047). Conclusions: Youth baseball athletes had typical GH ROM adaptations of less internal rotation and more external rotation in the throwing versus the nonthrowing arm. Greater ROM in younger athletes may be explained by prepubertal characteristics. We obtained hip-strength values in youth baseball athletes, and as expected, older athletes were stronger.

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
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Future Research ◽  
Baseball Players ◽  
Collegiate Baseball ◽  
The Relationship

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.

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

2014 ◽  
Vol 49 (4) ◽  
pp. 507-513 ◽  
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.

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

2010 ◽  
Vol 45 (2) ◽  
pp. 191-197 ◽  
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.

Humeral Retroversion and Its Relationship to Glenohumeral Rotation in the Shoulder of College Baseball Players

2002 ◽  
Vol 30 (3) ◽  
pp. 354-360 ◽  
Author(s):  
K.M. Reagan ◽  
Keith Meister ◽  
Mary Beth Horodyski ◽  
Dave W. Werner ◽  
Cathy Carruthers ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Soft Tissues ◽  
External Rotation ◽  
Baseball Players ◽  
Bony Anatomy ◽  
Humeral Retroversion ◽  
College Baseball ◽  
The Difference ◽  
Mean Differences

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.

scholarly journals Differences in Passive Shoulder Range of Motion Between Baseball Players With Neurogenic Thoracic Outlet Syndrome and Matched Healthy Controls

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110007
Author(s):  
J. Craig Garrison ◽  
Joseph P. Hannon ◽  
John E. Conway
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Thoracic Outlet Syndrome ◽  
External Rotation ◽  
Limited Information ◽  
Level Of Evidence ◽  
Baseball Players ◽  
Shoulder Range Of Motion ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
Shoulder Range

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.

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