Skip to main content
SpringerLink
Log in

Passive Range of Motion Characteristics in the Overhead Baseball Pitcher and Their Implications for Rehabilitation

  • Symposium: Injuries in Overhead Athletes
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Repetitive overhead throwing motion causes motion adaptations at the glenohumeral joint that cause injury, decrease performance, and affect throwing mechanics. It is essential to define the typical range of motion (ROM) exhibited at the glenohumeral joint in the overhead thrower.

Questions/purposes

We (1) assessed the glenohumeral joint passive range of motion (PROM) characteristics in professional baseball pitchers; and (2) applied these findings clinically in a treatment program to restore normal PROM and assist in injury prevention.

Methods

From 2005 to 2010, we evaluated 369 professional baseball pitchers to assess ROM parameters, including bilateral passive shoulder external rotation (ER) at 45° of abduction, external and internal rotation (IR) at 90° abduction while in the scapular plane, and supine horizontal adduction.

Results

The mean ER was greater for the throwing and nonthrowing shoulders at 45° of abduction, 102° and 98°, respectively. The throwing shoulder ER at 90° of abduction was 132° compared with 127° on the nonthrowing shoulder. Also, the pitcher’s dominant IR PROM was 52° compared with 63° on the nondominant side. We found no statistically significant differences in total rotational motion between the sides.

Conclusions

Although we found side-to-side differences for rotational ROM and horizontal adduction, the total rotational ROM was similar.

Clinical Relevance

The clinician can use these PROM values, assessment techniques, and treatment guidelines to accurately examine and develop a treatment program for the overhead-throwing athlete.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Andrews JR, Casey PJ. Internal impingement. In: Krishnan SG, Hawkins RJ, Warren RF, eds. The Shoulder and the Overhead Athlete. Philadelphia: Lippincott Williams and Wilkins; 2004:125–134.

    Google Scholar 

  2. Bigliani LU, Codd TP, Connor PM, Levine WN, Littlefield MA, Hershon SJ. Shoulder motion and laxity in the professional baseball player. Am J Sports Med. 1997;25:609–613.

    Article  PubMed  CAS  Google Scholar 

  3. Borich MR, Bright JM, Lorello DJ, Cieminski CJ, Buisman T, Ludewig PM. Scapular angular positioning at end range internal rotation in cases of glenohumeral internal rotation deficit. J Orthop Sports Phys Ther. 2006;36:926–934.

    Article  PubMed  Google Scholar 

  4. Borsa PA, Dover GC, Wilk KE, Reinold MM. Glenohumeral range of motion and stiffness in professional baseball pitchers. Med Sci Sports Exerc. 2006;38:21–26.

    Google Scholar 

  5. Borsa PA, Wilk KE, Jacobson JA, Scibek JS, Dover GC, Reinold MM, Andrews JR. Correlation of range of motion and glenohumeral translation in professional baseball pitchers. Am J Sports Med. 2005;33:1392–1399.

    Article  PubMed  Google Scholar 

  6. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology. Part I: pathoanatomy and biomechanics. Arthroscopy. 2003;19:404–420.

    Article  PubMed  Google Scholar 

  7. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology. Part III: The SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy. 2003;19:641–661.

    Article  PubMed  Google Scholar 

  8. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology. Part II: evaluation and treatment of SLAP lesions in throwers. Arthroscopy. 2003;19:531–539.

    Article  PubMed  Google Scholar 

  9. Chant CB, Litchfield R, Griffin S, Thain LM. Humeral head retroversion in competitive baseball players and its relationship to glenohumeral rotation range of motion. J Orthop Sports Phys Ther. 2007;37:514–520.

    PubMed  Google Scholar 

  10. Conte S, Requa RK, Garrick JG. Disability days in major league baseball. Am J Sports Med. 2001;29:431–436.

    PubMed  CAS  Google Scholar 

  11. Crockett HC, Gross LB, Wilk KE, Schwartz ML, Reed J, O’Mara J, Reilly MT, Dugas JR, Meister K, Lyman S, Andrews JR. Osseous adaptation and range of motion at the glenohumeral joint in professional baseball pitchers. Am J Sports Med. 2002;30:20–26.

    PubMed  Google Scholar 

  12. Dines JS, Frank JB, Akerman M, Yocum LA. Glenohumeral internal rotation deficits in baseball players with ulnar collateral ligament insufficiency. Am J Sports Med. 2009;37:566–570.

    Article  PubMed  Google Scholar 

  13. Drakos MC, Rudzki JR, Allen AA, Potter HG, Altchek DW. Internal impingement of the shoulder in the overhead athlete. J Bone Joint Surg Am. 2009;91:2719–2728.

    Article  PubMed  Google Scholar 

  14. Dwelly PM, Tripp BL, Tripp PA, Eberman LE, Gorin S. Glenohumeral rotational range of motion in collegiate overhead-throwing athletes during an athletic season. J Athl Train. 2009;44:611–616.

    Google Scholar 

  15. Ellenbecker TS, Roetert EP, Bailie DS, Davies GJ, Brown SW. Glenohumeral joint total rotation range of motion in elite tennis players and baseball pitchers. Med Sci Sports Exerc. 2002;34:2052–2056.

    Article  PubMed  Google Scholar 

  16. Freehill MT, Ebel BG, Archer KR, Bancells RL, Wilckens JH, McFarland EG, Cosgarea AJ. Glenohumeral range of motion in major league pitchers: changes over the playing season. Sports Health Journal. 2011;3:97–104.

    Google Scholar 

  17. Jazrawi LM, McCluskey GM, 3rd, Andrews JR. Superior labral anterior and posterior lesions and internal impingement in the overhead athlete. Instr Course Lect. 2003;52:43–63.

    PubMed  Google Scholar 

  18. Kibler WB. Role of the scapula in the overhead throwing motion. Contemp Orthop. 1991;22:525–532.

    Google Scholar 

  19. Laudner KG, Sipes RC, Wilson JT. The acute effects of sleeper stretches on shoulder range of motion. Journal of Athletic Training. 2008;43:359–363.

    Article  PubMed  Google Scholar 

  20. Lintner D, Mayol M, Uzodinma O, Jones R, Labossiere D. Glenohumeral internal rotation deficits in professional pitchers enrolled in an internal rotation stretching program. Am J Sports Med. 2007;35:617–621.

    Article  PubMed  Google Scholar 

  21. Litchfield R, Hawkins R, Dillman CJ, Atkins J, Hagerman G. Rehabilitation for the overhead athlete. J Orthop Sports Phys Ther. 1993;18:433–441.

    PubMed  CAS  Google Scholar 

  22. McClure P, Balaicuis J, Heiland D, Broersma ME, Thorndike CK, Wood A. A randomized controlled comparison of stretching procedures for posterior shoulder tightness. J Orthop Sports Phys Ther. 2007;37:108–114.

    PubMed  Google Scholar 

  23. McFarland EG, Wasik M. Epidemiology of collegiate baseball injuries. Clin J Sport Med. 1998;8:10–13.

    Article  PubMed  CAS  Google Scholar 

  24. Myers JB, Laudner KG, Pasquale MR, Bradley JP, Lephart SM. Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. Am J Sports Med. 2006;34:385–391.

    Article  PubMed  Google Scholar 

  25. Norkin CC, White DJ. Measurement of Joint Motion: A Guide to Goniometry. Philadelphia, PA, USA: FA Davis; 2003.

    Google Scholar 

  26. Osbahr DC, Cannon DL, Speer KP. Retroversion of the humerus in the throwing shoulder of college baseball pitchers. Am J Sports Med. 2002;30:347–353.

    PubMed  Google Scholar 

  27. Reagan KM, Meister K, Horodyski MB, Werner DW, Carruthers C, Wilk K. Humeral retroversion and its relationship to glenohumeral rotation in the shoulder of college baseball players. Am J Sports Med. 2002;30:354–360.

    PubMed  CAS  Google Scholar 

  28. Reinold MM, Wilk KE, Macrina LC, Sheheane C, Dun S, Fleisig GS, Crenshaw K, Andrews JR. Changes in shoulder and elbow passive range of motion after pitching in professional baseball players. Am J Sports Med. 2008;36:523–527.

    Article  PubMed  Google Scholar 

  29. Tehranzadeh AD, Fronek J, Resnick D. Posterior capsular fibrosis in professional baseball pitchers: case series of MR arthrographic findings in six patients with glenohumeral internal rotational deficit. Clin Imaging. 2007;31:343–348.

    Article  PubMed  Google Scholar 

  30. Thomas SJ, Swanik KA, Swanik CB, Kelly JDt. Internal rotation deficits affect scapular positioning in baseball players. Clin Orthop Relat Res. 2010;468:1551–1557.

    Article  PubMed  Google Scholar 

  31. Torres RR, Gomes JL. Measurement of glenohumeral internal rotation in asymptomatic tennis players and swimmers. Am J Sports Med. 2009;37:1017–1023.

    Article  PubMed  Google Scholar 

  32. Tyler TF, Nicholas SJ, Roy T, Gleim GW. Quantification of posterior capsule tightness and motion loss in patients with shoulder impingement. Am J Sports Med. 2000;28:668–673.

    PubMed  CAS  Google Scholar 

  33. Whiteley RJ, Ginn KA, Nicholson LL, Adams RD. Sports participation and humeral torsion. J Orthop Sports Phys Ther. 2009;39:256–263.

    PubMed  Google Scholar 

  34. Wilk KE, Arrigo C. Current concepts in the rehabilitation of the athletic shoulder. J Orthop Sports Phys Ther. 1993;18:365–378.

    PubMed  CAS  Google Scholar 

  35. Wilk KE, Macrina LC, Fleisig GS, Porterfield R, Simpson CD 2nd, Harker P, Paparesta N, Andrews JR. Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers. Am J Sports Med. 2011;39:329–335.

    Article  PubMed  Google Scholar 

  36. Wilk KE, Meister K, Andrews JR. Current concepts in the rehabilitation of the overhead throwing athlete. Am J Sports Med. 2002;30:136–151.

    PubMed  Google Scholar 

  37. Wilk KE, Reinold MM, Macrina LC, Porterfield R, Devine KM, Suarez K, Andrews JR. Glenohumeral internal rotation measurements differ depending on stabilization techniques. Sports Health Journal. 2009;1:131–136.

    Article  Google Scholar 

Download references

Acknowledgments

We thank Glenn S. Fleisig, PhD, and his staff at The American Sports Medicine Institute for the statistical analysis. Also, a special thank you to Ron Porterfield, ATC, and the Tampa Bay Rays baseball organization for allowing us access to their players, facilities, and staff during the data collection process.

Author information

Authors and Affiliations

  1. Champion Sports Medicine, A Physiotherapy Associates Clinic, 805 St Vincent’s Drive, Suite G100, Birmingham, AL, 35205, USA

    Kevin E. Wilk PT, DPT & Leonard C. Macrina MSPT, SCS, CSCS

  2. Department of Rehabilitation Research, American Sports Medicine Institute, Birmingham, AL, USA

    Kevin E. Wilk PT, DPT & Leonard C. Macrina MSPT, SCS, CSCS

  3. Advanced Rehabilitation, Tampa, FL, USA

    Christopher Arrigo MS, PT

Authors
  1. Kevin E. Wilk PT, DPT
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Leonard C. Macrina MSPT, SCS, CSCS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christopher Arrigo MS, PT
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kevin E. Wilk PT, DPT.

Additional information

Each author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

About this article

Cite this article

Wilk, K.E., Macrina, L.C. & Arrigo, C. Passive Range of Motion Characteristics in the Overhead Baseball Pitcher and Their Implications for Rehabilitation. Clin Orthop Relat Res 470, 1586–1594 (2012). https://doi.org/10.1007/s11999-012-2265-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11999-012-2265-z

Keywords

Search

Navigation