Hip pain may affect the shoulder, elbow in baseball pitchers

John D. Kelly IV

PHILADELPHIA — Orthopedic surgeons should examine hip range of motion and look for asymmetry in baseball pitchers who present with shoulder pain, according to a presenter at the Advances in Throwing Symposium: Latest on Injury Treatment and Performance Optimization.

“Good pitching equals good hips,” John D. Kelly IV, MD, said in his presentation here. “If you have bad hips, you are not going to be able to rotate and turn like that.”

According to Kelly, limited hip range of motion has upstream and downstream effects in patients. He noted that researchers have shown increased shoulder torque in patients with loss of hip range of motion. Less hip abduction in the lead leg has also been found to diminish stride length, which Kelly noted correlates with diminished velocity.

“If a thrower comes in and has hip pain, we can help them because the average increase in internal rotation we see with cam resection is 18° in internal rotation,” Kelly said.

Kelly noted that previously published research has also shown a greater incidence of ulnar collateral ligament injury among patients with hip and groin injuries, as well as a six-fold increase in shoulder elbow pain among youth pitchers who had hip pain. He added pitchers with painful shoulders have had a return-to-play rate that ranged from 88% to 95% after undergoing hip arthroscopy.

“I am asking everybody to open their eyes, look at their hip and we can help these patients by taking off bone on the pincer, we can take off bone on the femur and make the X-ray look better,” Kelly said. – by Casey Tingle

Reference:

Kelly JD IV. FAI and shoulder elbow injuries. Presented at: Advances in Throwing Symposium: Latest on Injury Treatment and Performance Optimization; March 2, 2019; Philadelphia.

Disclosure: Kelly reports no relevant financial disclosures.