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Deficits in Glenohumeral Passive Range of Motion Increase Risk of Shoulder Injury in Professional Baseball Pitchers: A Prospective Study
Background: Shoulder injuries from repetitive baseball pitching continue to be a serious, common problem. Purpose: To determine whether passive range of motion of the glenohumeral joint was predictive of shoulder injury or shoulder surgery in professional baseball pitchers. Study Design: Cohort stud...
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| Published in: | The American journal of sports medicine 2015-10, Vol.43 (10), p.2379-2385 |
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| Main Authors: | , , , , , , , |
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| container_end_page | 2385 |
| container_issue | 10 |
| container_start_page | 2379 |
| container_title | The American journal of sports medicine |
| container_volume | 43 |
| creator | Wilk, Kevin E. Macrina, Leonard C. Fleisig, Glenn S. Aune, Kyle T. Porterfield, Ron A. Harker, Paul Evans, Timothy J. Andrews, James R. |
| description | Background:
Shoulder injuries from repetitive baseball pitching continue to be a serious, common problem.
Purpose:
To determine whether passive range of motion of the glenohumeral joint was predictive of shoulder injury or shoulder surgery in professional baseball pitchers.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Passive range of motion of the glenohumeral joint was assessed with a bubble goniometer during spring training for all major and minor league pitchers of a single professional baseball organization over a period of 8 successive seasons (2005-2012). Investigators performed a total of 505 examinations on 296 professional pitchers. Glenohumeral external and internal rotation was assessed with the pitcher supine and the arm abducted to 90° in the scapular plane with the scapula stabilized anteriorly at the coracoid process. Total rotation was defined as the sum of internal and external glenohumeral rotation. Passive shoulder flexion was measured with the pitcher supine and the lateral border of the scapula manually stabilized. After examination, shoulder injuries and injury durations were recorded by each pitcher’s respective baseball organization and reported to the league as an injury transaction as each player was placed on the disabled list.
Results:
Highly significant side-to-side differences were noted within subjects for each range of motion measurement. There were 75 shoulder injuries and 20 surgeries recorded among 51 pitchers, resulting in 5570 total days on the disabled list. Glenohumeral internal rotation deficit, total rotation deficit, and flexion deficit were not significantly related to shoulder injury or surgery. Pitchers with insufficient external rotation ( |
| doi_str_mv | 10.1177/0363546515594380 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1718904686</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0363546515594380</sage_id><sourcerecordid>3831296031</sourcerecordid><originalsourceid>FETCH-LOGICAL-c248t-900a8e709ec2e2f59f3a176b36c9be659698b17c6538bb528eda4ba75061c1f3</originalsourceid><addsrcrecordid>eNp1kd1LwzAUxYMoOqfvPknBF1-q-WjS5FHn10Bx6N5Lmt1umV2jSSvsvzdlU0TwKSHnd8695CB0QvAFIXl-iZlgPBOccK4yJvEOGsQrTRkTfBcNejnt9QN0GMISY0xyIffRARU0p5yIAQo3UFlj25DYJrmvoXGLbgVe18lEh2A_IXnRzRwSVyVPrrWuScaN8aBDFGx4699fF66rZ-Cjsuz8ug-aeFdBtLsmBl1HuNR1TLStWYAPR2iv0nWA4-05RNO72-noIX18vh-Prh5TQzPZpgpjLSHHCgwFWnFVMR33L5kwqgTBlVCyJLkRnMmy5FTCTGelzjkWxJCKDdH5Jvbdu48OQlusbDBQ17oB14WC5EQqnAkpInr2B126zsfle4pGRvVfOUR4QxnvQvBQFe_errRfFwQXfR_F3z6i5XQb3JUrmP0YvguIQLoBgp7Dr6n_BX4BFmuR5g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1720469036</pqid></control><display><type>article</type><title>Deficits in Glenohumeral Passive Range of Motion Increase Risk of Shoulder Injury in Professional Baseball Pitchers: A Prospective Study</title><source>Sage Journals Online</source><source>SPORTDiscus with Full Text</source><creator>Wilk, Kevin E. ; Macrina, Leonard C. ; Fleisig, Glenn S. ; Aune, Kyle T. ; Porterfield, Ron A. ; Harker, Paul ; Evans, Timothy J. ; Andrews, James R.</creator><creatorcontrib>Wilk, Kevin E. ; Macrina, Leonard C. ; Fleisig, Glenn S. ; Aune, Kyle T. ; Porterfield, Ron A. ; Harker, Paul ; Evans, Timothy J. ; Andrews, James R.</creatorcontrib><description>Background:
Shoulder injuries from repetitive baseball pitching continue to be a serious, common problem.
Purpose:
To determine whether passive range of motion of the glenohumeral joint was predictive of shoulder injury or shoulder surgery in professional baseball pitchers.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Passive range of motion of the glenohumeral joint was assessed with a bubble goniometer during spring training for all major and minor league pitchers of a single professional baseball organization over a period of 8 successive seasons (2005-2012). Investigators performed a total of 505 examinations on 296 professional pitchers. Glenohumeral external and internal rotation was assessed with the pitcher supine and the arm abducted to 90° in the scapular plane with the scapula stabilized anteriorly at the coracoid process. Total rotation was defined as the sum of internal and external glenohumeral rotation. Passive shoulder flexion was measured with the pitcher supine and the lateral border of the scapula manually stabilized. After examination, shoulder injuries and injury durations were recorded by each pitcher’s respective baseball organization and reported to the league as an injury transaction as each player was placed on the disabled list.
Results:
Highly significant side-to-side differences were noted within subjects for each range of motion measurement. There were 75 shoulder injuries and 20 surgeries recorded among 51 pitchers, resulting in 5570 total days on the disabled list. Glenohumeral internal rotation deficit, total rotation deficit, and flexion deficit were not significantly related to shoulder injury or surgery. Pitchers with insufficient external rotation (<5° greater external rotation in the throwing shoulder) were 2.2 times more likely to be placed on the disabled list for a shoulder injury (P = .014; 95% CI, 1.2-4.1) and were 4.0 times more likely to require shoulder surgery (P = .009; 95% CI, 1.5-12.6).
Conclusion:
Insufficient shoulder external rotation on the throwing side increased the likelihood of shoulder injury and shoulder surgery. Sports medicine clinicians should be aware of these findings and develop a preventive plan that addresses this study’s findings to reduce pitchers’ risk of shoulder injury and surgery.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546515594380</identifier><identifier>PMID: 26272516</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Athletic Injuries - physiopathology ; Athletic Injuries - surgery ; Baseball - injuries ; Follow-Up Studies ; Humans ; Male ; Orthopedic Procedures - methods ; Professional baseball ; Prospective Studies ; Range of Motion, Articular - physiology ; Shoulder ; Shoulder Joint - injuries ; Shoulder Joint - physiopathology ; Shoulder Joint - surgery ; Sports injuries ; Sports medicine</subject><ispartof>The American journal of sports medicine, 2015-10, Vol.43 (10), p.2379-2385</ispartof><rights>2015 The Author(s)</rights><rights>2015 The Author(s).</rights><rights>Copyright Sage Publications Ltd. Oct 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c248t-900a8e709ec2e2f59f3a176b36c9be659698b17c6538bb528eda4ba75061c1f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,79364</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26272516$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wilk, Kevin E.</creatorcontrib><creatorcontrib>Macrina, Leonard C.</creatorcontrib><creatorcontrib>Fleisig, Glenn S.</creatorcontrib><creatorcontrib>Aune, Kyle T.</creatorcontrib><creatorcontrib>Porterfield, Ron A.</creatorcontrib><creatorcontrib>Harker, Paul</creatorcontrib><creatorcontrib>Evans, Timothy J.</creatorcontrib><creatorcontrib>Andrews, James R.</creatorcontrib><title>Deficits in Glenohumeral Passive Range of Motion Increase Risk of Shoulder Injury in Professional Baseball Pitchers: A Prospective Study</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
Shoulder injuries from repetitive baseball pitching continue to be a serious, common problem.
Purpose:
To determine whether passive range of motion of the glenohumeral joint was predictive of shoulder injury or shoulder surgery in professional baseball pitchers.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Passive range of motion of the glenohumeral joint was assessed with a bubble goniometer during spring training for all major and minor league pitchers of a single professional baseball organization over a period of 8 successive seasons (2005-2012). Investigators performed a total of 505 examinations on 296 professional pitchers. Glenohumeral external and internal rotation was assessed with the pitcher supine and the arm abducted to 90° in the scapular plane with the scapula stabilized anteriorly at the coracoid process. Total rotation was defined as the sum of internal and external glenohumeral rotation. Passive shoulder flexion was measured with the pitcher supine and the lateral border of the scapula manually stabilized. After examination, shoulder injuries and injury durations were recorded by each pitcher’s respective baseball organization and reported to the league as an injury transaction as each player was placed on the disabled list.
Results:
Highly significant side-to-side differences were noted within subjects for each range of motion measurement. There were 75 shoulder injuries and 20 surgeries recorded among 51 pitchers, resulting in 5570 total days on the disabled list. Glenohumeral internal rotation deficit, total rotation deficit, and flexion deficit were not significantly related to shoulder injury or surgery. Pitchers with insufficient external rotation (<5° greater external rotation in the throwing shoulder) were 2.2 times more likely to be placed on the disabled list for a shoulder injury (P = .014; 95% CI, 1.2-4.1) and were 4.0 times more likely to require shoulder surgery (P = .009; 95% CI, 1.5-12.6).
Conclusion:
Insufficient shoulder external rotation on the throwing side increased the likelihood of shoulder injury and shoulder surgery. Sports medicine clinicians should be aware of these findings and develop a preventive plan that addresses this study’s findings to reduce pitchers’ risk of shoulder injury and surgery.</description><subject>Adult</subject><subject>Athletic Injuries - physiopathology</subject><subject>Athletic Injuries - surgery</subject><subject>Baseball - injuries</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Orthopedic Procedures - methods</subject><subject>Professional baseball</subject><subject>Prospective Studies</subject><subject>Range of Motion, Articular - physiology</subject><subject>Shoulder</subject><subject>Shoulder Joint - injuries</subject><subject>Shoulder Joint - physiopathology</subject><subject>Shoulder Joint - surgery</subject><subject>Sports injuries</subject><subject>Sports medicine</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNp1kd1LwzAUxYMoOqfvPknBF1-q-WjS5FHn10Bx6N5Lmt1umV2jSSvsvzdlU0TwKSHnd8695CB0QvAFIXl-iZlgPBOccK4yJvEOGsQrTRkTfBcNejnt9QN0GMISY0xyIffRARU0p5yIAQo3UFlj25DYJrmvoXGLbgVe18lEh2A_IXnRzRwSVyVPrrWuScaN8aBDFGx4699fF66rZ-Cjsuz8ug-aeFdBtLsmBl1HuNR1TLStWYAPR2iv0nWA4-05RNO72-noIX18vh-Prh5TQzPZpgpjLSHHCgwFWnFVMR33L5kwqgTBlVCyJLkRnMmy5FTCTGelzjkWxJCKDdH5Jvbdu48OQlusbDBQ17oB14WC5EQqnAkpInr2B126zsfle4pGRvVfOUR4QxnvQvBQFe_errRfFwQXfR_F3z6i5XQb3JUrmP0YvguIQLoBgp7Dr6n_BX4BFmuR5g</recordid><startdate>201510</startdate><enddate>201510</enddate><creator>Wilk, Kevin E.</creator><creator>Macrina, Leonard C.</creator><creator>Fleisig, Glenn S.</creator><creator>Aune, Kyle T.</creator><creator>Porterfield, Ron A.</creator><creator>Harker, Paul</creator><creator>Evans, Timothy J.</creator><creator>Andrews, James R.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>201510</creationdate><title>Deficits in Glenohumeral Passive Range of Motion Increase Risk of Shoulder Injury in Professional Baseball Pitchers</title><author>Wilk, Kevin E. ; Macrina, Leonard C. ; Fleisig, Glenn S. ; Aune, Kyle T. ; Porterfield, Ron A. ; Harker, Paul ; Evans, Timothy J. ; Andrews, James R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c248t-900a8e709ec2e2f59f3a176b36c9be659698b17c6538bb528eda4ba75061c1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Athletic Injuries - physiopathology</topic><topic>Athletic Injuries - surgery</topic><topic>Baseball - injuries</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Orthopedic Procedures - methods</topic><topic>Professional baseball</topic><topic>Prospective Studies</topic><topic>Range of Motion, Articular - physiology</topic><topic>Shoulder</topic><topic>Shoulder Joint - injuries</topic><topic>Shoulder Joint - physiopathology</topic><topic>Shoulder Joint - surgery</topic><topic>Sports injuries</topic><topic>Sports medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wilk, Kevin E.</creatorcontrib><creatorcontrib>Macrina, Leonard C.</creatorcontrib><creatorcontrib>Fleisig, Glenn S.</creatorcontrib><creatorcontrib>Aune, Kyle T.</creatorcontrib><creatorcontrib>Porterfield, Ron A.</creatorcontrib><creatorcontrib>Harker, Paul</creatorcontrib><creatorcontrib>Evans, Timothy J.</creatorcontrib><creatorcontrib>Andrews, James R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wilk, Kevin E.</au><au>Macrina, Leonard C.</au><au>Fleisig, Glenn S.</au><au>Aune, Kyle T.</au><au>Porterfield, Ron A.</au><au>Harker, Paul</au><au>Evans, Timothy J.</au><au>Andrews, James R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Deficits in Glenohumeral Passive Range of Motion Increase Risk of Shoulder Injury in Professional Baseball Pitchers: A Prospective Study</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2015-10</date><risdate>2015</risdate><volume>43</volume><issue>10</issue><spage>2379</spage><epage>2385</epage><pages>2379-2385</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background:
Shoulder injuries from repetitive baseball pitching continue to be a serious, common problem.
Purpose:
To determine whether passive range of motion of the glenohumeral joint was predictive of shoulder injury or shoulder surgery in professional baseball pitchers.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Passive range of motion of the glenohumeral joint was assessed with a bubble goniometer during spring training for all major and minor league pitchers of a single professional baseball organization over a period of 8 successive seasons (2005-2012). Investigators performed a total of 505 examinations on 296 professional pitchers. Glenohumeral external and internal rotation was assessed with the pitcher supine and the arm abducted to 90° in the scapular plane with the scapula stabilized anteriorly at the coracoid process. Total rotation was defined as the sum of internal and external glenohumeral rotation. Passive shoulder flexion was measured with the pitcher supine and the lateral border of the scapula manually stabilized. After examination, shoulder injuries and injury durations were recorded by each pitcher’s respective baseball organization and reported to the league as an injury transaction as each player was placed on the disabled list.
Results:
Highly significant side-to-side differences were noted within subjects for each range of motion measurement. There were 75 shoulder injuries and 20 surgeries recorded among 51 pitchers, resulting in 5570 total days on the disabled list. Glenohumeral internal rotation deficit, total rotation deficit, and flexion deficit were not significantly related to shoulder injury or surgery. Pitchers with insufficient external rotation (<5° greater external rotation in the throwing shoulder) were 2.2 times more likely to be placed on the disabled list for a shoulder injury (P = .014; 95% CI, 1.2-4.1) and were 4.0 times more likely to require shoulder surgery (P = .009; 95% CI, 1.5-12.6).
Conclusion:
Insufficient shoulder external rotation on the throwing side increased the likelihood of shoulder injury and shoulder surgery. Sports medicine clinicians should be aware of these findings and develop a preventive plan that addresses this study’s findings to reduce pitchers’ risk of shoulder injury and surgery.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>26272516</pmid><doi>10.1177/0363546515594380</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0363-5465 |
| ispartof | The American journal of sports medicine, 2015-10, Vol.43 (10), p.2379-2385 |
| issn | 0363-5465 1552-3365 |
| language | eng |
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| source | Sage Journals Online; SPORTDiscus with Full Text |
| subjects | Adult Athletic Injuries - physiopathology Athletic Injuries - surgery Baseball - injuries Follow-Up Studies Humans Male Orthopedic Procedures - methods Professional baseball Prospective Studies Range of Motion, Articular - physiology Shoulder Shoulder Joint - injuries Shoulder Joint - physiopathology Shoulder Joint - surgery Sports injuries Sports medicine |
| title | Deficits in Glenohumeral Passive Range of Motion Increase Risk of Shoulder Injury in Professional Baseball Pitchers: A Prospective Study |
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