Mechanisms of Shoulder Range of Motion Deficits in Asymptomatic Baseball Players

Bailey, Lane; Shanley, Ellen; Hawkins, Richard J.; Beattie, Paul; Fritz, Stacy L.; Kwartowitz, David M.; Thigpen, Charles A.

doi:10.1177/0363546515602446

Cited by 94 publications

(110 citation statements)

References 55 publications

(105 reference statements)

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“…9 Increased humeral retroversion is thought to be performance enhancing; 10 as the bony adaptations enable an increased external rotation position during the throw. 11 This additional ROM theoretically allows for a longer acceleration phase enabling greater upper limb rotational speeds to be achieved.…”

Section: Introductionmentioning

confidence: 99%

Reference Values for Glenohumeral Joint Rotational Range of Motion in Elite Tennis Players

Nutt

Mirkovic

Hill

et al. 2018

Intl J Sports Phys Ther

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Background: Due to the repetitive overhead activity involved in playing tennis and the physical demands of the game, shoulder joint injury is common. There is limited research available describing sport specific risk factors for injury in tennis, however, changes in shoulder rotational range of motion (ROM) have been associated with injury in other overhead 'throwing' type sports.Purpose: This study had two purposes: i) to identify reference values for passive glenohumeral joint rotational ROM in elite tennis players, and, ii) to investigate differences in ROM between various age groups of players. Study design:Cross-sectional analysis. Methods:Data was collected at national performance camps held at a National Tennis Centre between September 2012 and July 2015. One hundred and eighty-four tennis players aged between 11 and 24 years took part. All had a top eight national ranking within their respective age group. Participants were divided into three age groups; under 14 years, 14-15 years, and 16 years and over. The main outcome measures were dominant and non-dominant internal and external rotation as well as total glenohumeral joint passive ROM. Results:Reduced internal, and greater external rotation passive ROM were identified on the dominant side (p < 0.05), however, no side-to-side differences in total rotation ROM were found (p > 0.05). A glenohumeral joint internal rotation deficit (GIRD) was prevalent on the dominant side, which increased in magnitude with rising player age. Differences in dominant side internal and external rotation ROM were identified between age groups with the 14-15-year olds having less internal and greater external rotation than the under 14-year olds and the over 16-year old athletes (p < 0.05). The total range of motion values were not found to differ between age groups (p > 0.05). Conclusions:This study provides reference values for glenohumeral joint rotational ROM in elite tennis players and demonstrates age specific differences. Future studies should investigate links between changes in ROM and injury risk. Level of evidence: 3

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Section: Introductionmentioning

confidence: 99%

Reference Values for Glenohumeral Joint Rotational Range of Motion in Elite Tennis Players

Nutt

Mirkovic

Hill

et al. 2018

Intl J Sports Phys Ther

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“…no intervention, static self-stretching measures, and Thera-band warm-up measures), study procedures, and ROM measurements (e.g., internal rotation, horizontal adduction). [1][2][3] Current research identifies a few soft tissue therapy techniques for treating pain and increasing ROM including myofascial release, Active Release Technique (ART), and instrument-assisted soft tissue mobilization (IASTM). 4 All of these techniques are backed by similar theoretical bases, and utilize application procedures that involve multiple treatment directions to treat fascial disfigurement.…”

Section: Abstract Clinical Scenario: Shoulder Range Of Motion (Rom) Imentioning

confidence: 99%

“… The literature was searched for studies that investigated IASTM versus self-stretching measures to increase shoulder range of motion and yielded 3 possible studies (all randomized control trials) [1][2][3] related to the clinical question.…”

Section: Summary Of Search Best Evidence Appraised and Key Findingsmentioning

confidence: 99%

“… All three studies [1][2][3] reported a significant increase in internal rotation and horizontal adduction in the experimental group  One article 1,2 reported a significant increase in internal rotation in the experimental group  One article 1 reported an increase in total arc of shoulder ROM in the experimental group and suggested that utilization of IASTM may help to prevent further loss of ROM…”

Section: Summary Of Search Best Evidence Appraised and Key Findingsmentioning

confidence: 99%

“…There have been several studies that address the relationship between ROM deficits and overhead injuries; however, it is unclear which interventions are most effective for restoring ROM to normative ranges. [1][2][3] Clinical Question: In overhead athletes that have deficient shoulder ROM, is IASTM more effective at acutely increasing ROM over the course of a patient's treatment when compared to self-stretching? …”

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confidence: 99%

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The Comparison of Instrument-Assisted Soft Tissue Mobilization and Self-Stretch Measures to Increase Shoulder Range of Motion in Overhead Athletes: A Critically Appraised Topic

Hussey¹,

Boron-Magulick²,

McLeod³

et al. 2018

Journal of Sport Rehabilitation

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CLINICAL SCENARIO: Shoulder range of motion (ROM) in throwing athletesrelies on a balance of mobility and stability in order to maintain proper function and health. Prior research has reported that deficits in internal rotation greater than 20 degrees, decreases in total arc of motion greater than 5 degrees when compared to the contralateral side, and decreases in horizontal adduction greater than 16 degrees have all been identified as factors that could lead to throwing related injuries. 1 Due to the increased risk of injury associated with ROM deficits, it is important for clinicians to be cognizant of how to most effectively treat these issues.Laudner et al 2 reported that the results related to interventions intending to increase shoulder ROM have not been consistent and have not been able to indicate a standard of best practice for clinicians. To date, published studies on this topic have included various control measures (e.g. no intervention, static self-stretching measures, and Thera-band warm-up measures), study procedures, and ROM measurements (e.g., internal rotation, horizontal adduction). [1][2][3] Current research identifies a few soft tissue therapy techniques for treating pain and increasing ROM including myofascial release, Active Release Technique (ART), and instrument-assisted soft tissue mobilization (IASTM). 4 All of these techniques are backed by similar theoretical bases, and utilize application procedures that involve multiple treatment directions to treat fascial disfigurement. 4 One key differentiating factor that sets IASTM apart is the utilization of a tool or instrument that provides the clinician with a mechanical advantage. These instruments help to provide clinicians with the ability to apply a greater amount of force to the tissues while minimizing stress to the clinician's own hands and joints. 4 McMurray et al 4 states that IASTM can be used for immediate improvements in ROM and can have a positive impact on degraded tissue. 4 Another potential advantage of IASTM is that it may produce improvements in ROM and function in shorter individual treatment periods than other methods of manual therapy. There have been several studies that address the relationship between ROM deficits and overhead injuries; however, it is unclear which interventions are most effective for restoring ROM to normative ranges. [1][2][3] Clinical Question: In overhead athletes that have deficient shoulder ROM, is IASTM more effective at acutely increasing ROM over the course of a patient's treatment when compared to self-stretching?

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The Role of the Scapula in the Overhead Athlete

Kibler

Thomas

Sciascia

2019

Mechanics, Pathomechanics and Injury in the Overhead Athlete

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Mechanisms of Shoulder Range of Motion Deficits in Asymptomatic Baseball Players

Abstract: Reducing rotator cuff stiffness may be beneficial in improving the ROM deficits associated with injury risk in overhead athletes.

Cited by 94 publications

References 55 publications

Reference Values for Glenohumeral Joint Rotational Range of Motion in Elite Tennis Players

Reference Values for Glenohumeral Joint Rotational Range of Motion in Elite Tennis Players

The Comparison of Instrument-Assisted Soft Tissue Mobilization and Self-Stretch Measures to Increase Shoulder Range of Motion in Overhead Athletes: A Critically Appraised Topic

The Role of the Scapula in the Overhead Athlete

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