Deficits in Glenohumeral Passive Range of Motion Increase Risk of Shoulder Injury in Professional Baseball Pitchers

Wilk, Kevin E.; Macrina, Leonard C.; Fleisig, Glenn S.; Aune, Kyle T.; Porterfield, Ron; Harker, Paul; Evans, Timothy J.; Andrews, James R.

doi:10.1177/0363546515594380

Cited by 219 publications

(202 citation statements)

References 28 publications

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“…Four studies in this review evaluated modifiable risk factors. There was limited evidence that a lack of external rotation (but no other shoulder joint range of motion measures) may be a risk factor for shoulder injuries in baseball pitchers 45. This is in line with a recent cross-sectional study (which was not included in this review due to the study design), showing that pitchers with shoulder pain have reduced external and total rotation range of motion 20.…”

Section: Discussionsupporting

confidence: 57%

“…There was limited evidence that players with insufficient external rotation (>5° less than non-dominant shoulder) had higher odds of being placed on the disabled list compared with those without insufficient external rotation 45. There was limited evidence of an association between greater humeral torsion in the dominant arm of US baseball pitchers (3.5° greater) and shoulder injury 47…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis

Asker

Brooke

Waldén³

et al. 2018

Br J Sports Med

125

110

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Section: Discussionsupporting

confidence: 57%

Section: Resultsmentioning

confidence: 99%

Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis

Asker

Brooke

Waldén³

et al. 2018

Br J Sports Med

125

110

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show abstract

“…However, the CET does not indicate which joint motions contribute to the outcome, and if a subject had a poor outcome on the CET, follow up tests would be necessary to identify where the impairment was located e.g. passive shoulder flexion (Wilk et al, 2015), pectoralis minor length (Borstad, 2008), and thoracic intervertebral joint motion (Brismée et al, 2006). This would help guide the practitioner towards an appropriate intervention, e.g.…”

Section: Discussionmentioning

confidence: 99%

“…The CET is thought to identify impairments in range of motion during synchronised thoracic extension, glenohumeral joint (GHJ) flexion, and retraction and upward rotation of the scapula (Dennis et al, 2008a;Harvey, 1998). Whilst there are screening tests to assess shoulder flexion (Wilk et al, 2015), scapula upward rotation and retraction (Forthomme, Crielaard, & Croisier, 2008), and thoracic rotation (Johnson, Kyung-Min, Byung-Kyu, Salibar, & Grindstaff, 2012), extension of the thoracic spine does not feature in any other field-based assessment tool, thus demonstrating the value of the CET.…”

Section: Introductionmentioning

confidence: 99%

A biomechanical evaluation of the combined elevation test

Allen

Phillips

McCaig

2017

Physical Therapy in Sport

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Objectives:To biomechanically evaluate the relationships between the outcome of the Combined Elevation Test, its component joint motions, and thoracic spine angles. Design: Cross-sectional study. Setting: Laboratory. Participants: 18 elite swimmers and triathletes (11 males and 7 females). Main outcome measures: Combined Elevation Test outcome in forehead and chin positions. Individual joint contributions to test outcome. Results: No sex differences were found in test components, or between head positions. Test outcome was greater in the forehead position than the chin position (34.3 cm vs 30.2 cm; p<0.001). The variables most strongly associated with test outcome were glenohumeral joint flexion (r = 0.86 -0.97; p<0.001), and shoulder retraction (r = 0.75 -0.82; p<0.001). Total thoracic spine angle related strongly to test outcome in females (r = -0.77 --0.88; p<0.05), but not in males (r = -0.17 --0.24; p>0.05). Conclusions:The Combined Elevation Test is an effective screening tool to measure upper limb mobility into shoulder flexion and scapula retraction in both sexes, and thoracic extension in women. It is recommended that the test be performed in the forehead position. If a subject performs poorly on the test, follow up assessments are required to identify the impairment location.

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“…Wilk and colleagues [9] published ROM characteristics of professional baseball players including dominant arm ER at 90°, 132 ± 11°; IR at 90°, 52 ± 12°; total rotational motion, 184°; and horizontal adduction, 42 ± 8. Wilk also examined shoulder flexion on the throwing shoulder in 296 professional pitchers showing an average of 177.7° [10]. Significant side to side differences have been shown consistently in the literature which suggests that comparing motion to the non-dominant side may be inappropriate.…”

Section: Range Of Motion and Flexibilitymentioning

confidence: 99%

Return to Throwing after Shoulder or Elbow Injury

Sgroi

Zajac

2018

Curr Rev Musculoskelet Med

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Purpose of review Throwing places high demands on the human body, and specific characteristics are developed over time unique to these athletes. When returning to throw after injury, it is important to follow a criterion-based progression that allows the body to be prepared appropriately for the stresses that throwing will require. There is currently a void in the literature for criteria-based progression that helps these athletes return to the highest level of play. Recent findings As injury rates continue to rise in baseball, there is increased evidence showing contributions of the core and lower extremity to the baseball pitch. There is also additional data showing pitcher specific characteristics such as range of motion and scapular position in this unique population. The rehab professional should take into account every phase of the pitch starting from balance through ball release when designing a comprehensive return-to-throwing program. Summary Returning an athlete back to a throwing sport can be an overwhelming task. The rehabilitation specialist must have a sound understanding of the throwing motion as well as any biomechanical implications on the body, contributions throughout the kinetic chain, range of motion, and strength characteristics specific to the thrower as well as proper tissue loading principles. It is important that these athletes are not progressed too quickly through their programs and that a criteriabased progression is followed. They should have normalized range of motion, strength, and scapular mechanics, followed by a sound plyometric progression. Once this is achieved, they are advanced to an interval throwing program with increasing distance, effort, and volume which should be tracked for workload, making sure they do not throw more than their body is prepared for.

show abstract

Deficits in Glenohumeral Passive Range of Motion Increase Risk of Shoulder Injury in Professional Baseball Pitchers

Cited by 219 publications

References 28 publications

Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis

Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis

A biomechanical evaluation of the combined elevation test

Return to Throwing after Shoulder or Elbow Injury

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