Athletic trainer-supervised preseason programs clinically improved posterior shoulder flexibility

BOSTON — Adolescent pitchers who participated in an athletic trainer-supervised preseason program experienced clinically meaningful improvements in posterior shoulder flexibility and maintenance of their external rotation/internal rotation ratio, according to results presented here.

“Preseason programs are effective, but perhaps we need to do a little bit more, particularly in those [athletes] who have had a prior history of an injury,” Michael J. Kissenberth, MD, said in his presentation.

Kissenberth and his colleagues randomly assigned 106 adolescent baseball pitchers to receive an 8-week athletic trainer-supervised program and 109 pitchers to a control group that received regular training. Researchers measured strength and flexibility with regard to external rotation, internal rotation and horizontal abduction, and calculated the external/internal rotation ratios of both the supraspinatus and all the internal rotators. According to Kissenberth, humeral torsion was obtained using ultrasound.

Within 5 days after completing 3 months of the programs, researchers reassessed all players and found excellent compliance, with an even distribution of injuries between the intervention and control groups.

“What we did see is that in the intervention group, the horizontal abduction deficits and internal rotation deficit remarkably improved in the intervention group vs. the control group,” Kissenberth said. “When you look at those who were injured, the horizontal abduction was not normalized in the control group; whereas [in] the intervention group, they were equal.”

Results showed approximately 50% improvement in external rotation/internal rotation ratio in strength improvement. Kissenberth noted participants in the control group who had prior injury had a four-times greater risk of arm injury. In comparison, participants in the intervention group who had previous injury experienced improved external rotation strength and range of motion, as well as normalization of risk of injury. – by Casey Tingle

Reference:

Kissenberth MJ, et al. Paper #SS-28. Presented at: Arthroscopy Association of North America Annual Meeting; April 14-16, 2016; Boston.

Disclosure: Kissenberth reports he received other financial or material support from Arthrex Inc., Arthrocare, Arthrosurface, Breg, DJ Orthopaedics, Greenville Hospital System, Neurotech, Pacira and Smith & Nephew; is a paid consultant for Arthrex Inc. and is a board or committee member for The Hawkins Foundation.