Differences in Shoulder Internal Rotation Strength Between Baseball Players With Ulnar Collateral Ligament Reconstruction and Healthy Controls

Abstract

Background: Studies have indicated decreased shoulder internal rotation (IR) and external rotation (ER) strength in the throwing limb of baseball players after ulnar collateral ligament injury. There is limited evidence on the recovery of shoulder rotation strength after primary ulnar collateral ligament reconstruction (UCLR). Hypothesis: At the time of return to throwing, baseball players who underwent UCLR would demonstrate decreased IR and ER shoulder strength in the throwing arm as compared with healthy baseball players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Male competitive high school and collegiate baseball athletes participated in this study. Athletes who underwent UCLR were compared with healthy controls who were matched by age, height, weight, and position. Bilateral isometric shoulder ER and IR strength was measured using a handheld dynamometer for all participants at the time of initial evaluation (UCLR group) and throughout the course of a season (healthy group). Independent t tests were run to calculate mean differences in ER and IR shoulder strength between the groups, with significance set at P < .05. Results: A total of 86 baseball athletes participated in this study (43 UCLR group, 43 healthy group). At the time of return to throwing (mean ± SD, 194 ± 30 days postoperatively), the 2 groups demonstrated no significant differences in nonthrowing arm ER or IR strength ( P = .143 and .994, respectively). No significant difference was found between groups for throwing arm ER strength ( P = .921); however, the UCLR group demonstrated significantly less throwing arm IR strength than the healthy group (144.2 ± 27.8 vs 157.6 ± 27.1 N; P = .023). Conclusion: The results of this study demonstrate that throwing arm rotator cuff strength may not fully recover before the initiation of a return-to-throwing program after UCLR. These data provide a potential framework for clinicians to assist in the management and exercise prescription of the baseball athlete after UCLR and before medical release and the initiation of a return-to-throwing program.

Relationship Between Pitch Counts and Shoulder Strength in Collegiate Baseball Players

“…Subjects also provided a rating of perceived exertion (RPE) for practice using a 6–20 Borg scale (7) immediately after postpractice testing. RPE was converted to 3 categories based on pitching exertion: (a) light exertion (5–10), (b) moderate exertion (11–13), and (c) heavy exertion (14–19) to better represent throwing exertion during practice in comparison with simulated game scenarios (5).…”

“…To compare subjects based on strength, we divided subjects into “high-strength” and “low-strength” groups using the group median external rotation strength. External rotation strength was chosen to divide groups because internal rotation strength in the throwing arm can be influenced by previous injury, such as primary ulnar collateral ligament reconstruction, whereas external rotation strength is more stable (18). The median split was used to convert a continuous variable to a dichotomous variable, as used previously (28).…”

Periscapular Strength Profile Changes in Collegiate Baseball Pitchers Over the Course of a Season

“…30 Furthermore, MicroFET 2 ICCs of .94 for external rotation and .93 for internal rotation have been reported in the measurement of shoulder rotator strength in competitive high school and collegiate baseball athletes. 31,32 DATA COLLECTION PROCEDURES The data for each subject was recorded at three time points throughout the baseball season. Data collection sessions transpired on a single day during the pre-season, mid-season and immediately post-season, with a total duration of collection being a five-month period.…”