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Pitchers with bilateral differences in total rotational motion at increased risk for elbow injuries
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CHICAGO — Pitchers with bilateral differences of more than 5° in total rotational motion may have a increased risk for elbow injuries, according to a presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting.
“Clinicians need to be aware of this and plan a preventative and rehabilitation program that addresses these findings. This will prevent or treat elbow injuries in the overhead pitcher,” Kevin E. Wilk, PT, DPT, stated in his presentation, here.
Researchers assessed whether glenohumeral internal rotation deficit, bilateral difference in total rotational motion of the glenohumeral joint or bilateral differences in flexion of the glenohumeral joint correlated with elbow injuries in professional baseball pitchers throughout 8 seasons from 2005 to 2012. During each season’s spring training, the same two examiners assessed passive range of motion of both the dominant and non-dominant shoulders of professional pitchers using a bubble goniometer.
Kevin E. Wilk
In total, the researchers conducted 505 examinations on 296 pitchers for a total of 6,060 passive range of motion measurements. All pitchers were asymptomatic when tested and had no surgeries 2 years prior to testing. All measurements were taken before exercise, warm-up or throwing activities.
Glenohumeral joint motion was assessed in supine with the arm at 90° of abduction and in the plane of the scapula for external rotation and internal rotation. During total range of motion assessment, the scapula was stabilized. Wilk and his colleagues recorded the elbow injuries and days missed due to injury.
Wilk and colleagues found significant differences in external rotation and internal rotation during side-to-side comparisons within pitchers. Overall, there were 50 shoulder injuries in 38 pitchers accounting for a total of 2,528 days on the disabled list. Pitchers with a deficit of motion of more than 5° in total range of motion in their dominant shoulder had a 2.3 times higher risk of injury. Pitchers with a dominant shoulder loss of flexion exhibited a 2.8 times risk of an elbow injury. Glenohumeral internal rotation deficit did not correlate with elbow injuries, Wilk said.
Reference:
Wilk KE. Paper #17. Presented at the American Orthopaedic Society for Sports Medicine Annual Meeting; July 11-14, 2013; Chicago.
Disclosure: Wilk has no relevant financial disclosures.