Glenohumeral rotation deficits in high school, college, and professional baseball pitchers with and without a medial ulnar collateral ligament injury.
Baseball
GIRLoss
MUCL
elbow
pitchers
shoulder
Journal
Journal of shoulder and elbow surgery
ISSN: 1532-6500
Titre abrégé: J Shoulder Elbow Surg
Pays: United States
ID NLM: 9206499
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
15
04
2018
revised:
29
10
2018
accepted:
09
11
2018
entrez:
18
2
2019
pubmed:
18
2
2019
medline:
30
3
2019
Statut:
ppublish
Résumé
It is unclear how a glenohumeral internal rotation (IR) loss (GIRLoss), a glenohumeral external rotation (ER) gain (GERGain), or a total rotational motion (TRM) deficit (TRMD) predict medial ulnar collateral ligament (MUCL) injury risk among high school (HS), college (COLL), and professional (PRO) baseball pitchers with and without MUCL injury. We hypothesized that pitchers with MUCL injury would have more GIRLoss and TRMD compared with pitchers without MUCL injury, with no differences in IR, ER, TRM, GIRLoss, GERGain, and TRMD. The study equally divided 216 male HS, COLL, and PRO pitchers into the MUCL injury group (n = 108) and a control group (n = 108) without MUCL injury. The control group was matched with the MUCL injury group according to number, level of play, and age. Bilateral shoulder passive IR/ER was measured and GIRLoss, GERGain, TRM, and TRMD calculated. A 2-way analysis of variance (P < .05) was used to assess shoulder rotational differences among the 2 groups and 3 pitching levels. Compared with the control group, the MUCL injured group had more GIRLoss (21° ± 14° vs. 13° ± 8°; P < .001), GERGain (14° ± 9° vs. 10° ± 9°; P = .004), and TRMD (7° ± 13° vs. 3° ± 9°; P = .008). For all pitching levels, approximately 60% of pitchers in MUCL injury group had GIRLoss >18° compared with approximately 30% of those in the control group. Approximately 60% of pitchers in the MUCL injury group had TRMD >5° compared with 50% of pitchers in the control group. No differences were observed among HS, COLL, and PRO pitchers for GIRLoss (16° ± 12°, 17° ± 11°, 19° ± 13°, respectively; P = .131), GERGain (11° ± 9°, 11° ± 10°, 13° ± 10°, respectively; P = .171), TRMD (5° ± 11°, 6° ± 11°, 5° ± 14°, respectively; P = .711), and throwing shoulder ER (111° ± 10°, 111° ± 11°, 113° ± 9°, respectively; P = .427), IR (50° ± 11°, 49° ± 11°, 48° ± 10°, respectively; P = .121), and TRM (162° ± 14°, 160° ± 15°, 161° ± 14°, respectively; P = .770). Greater GIRLoss, GERGain, and TRMD in MUCL injured pitchers compared with uninjured pitchers implies these variables may be related to increased MUCL injury risk, especially because GIRLoss >18° and TRMD >5° demonstrate an increased MUCL injury risk. Shoulder rotational motion and deficits do not vary among HS, COLL, and PRO levels of pitchers.
Sections du résumé
BACKGROUND
BACKGROUND
It is unclear how a glenohumeral internal rotation (IR) loss (GIRLoss), a glenohumeral external rotation (ER) gain (GERGain), or a total rotational motion (TRM) deficit (TRMD) predict medial ulnar collateral ligament (MUCL) injury risk among high school (HS), college (COLL), and professional (PRO) baseball pitchers with and without MUCL injury. We hypothesized that pitchers with MUCL injury would have more GIRLoss and TRMD compared with pitchers without MUCL injury, with no differences in IR, ER, TRM, GIRLoss, GERGain, and TRMD.
METHODS
METHODS
The study equally divided 216 male HS, COLL, and PRO pitchers into the MUCL injury group (n = 108) and a control group (n = 108) without MUCL injury. The control group was matched with the MUCL injury group according to number, level of play, and age. Bilateral shoulder passive IR/ER was measured and GIRLoss, GERGain, TRM, and TRMD calculated. A 2-way analysis of variance (P < .05) was used to assess shoulder rotational differences among the 2 groups and 3 pitching levels.
RESULTS
RESULTS
Compared with the control group, the MUCL injured group had more GIRLoss (21° ± 14° vs. 13° ± 8°; P < .001), GERGain (14° ± 9° vs. 10° ± 9°; P = .004), and TRMD (7° ± 13° vs. 3° ± 9°; P = .008). For all pitching levels, approximately 60% of pitchers in MUCL injury group had GIRLoss >18° compared with approximately 30% of those in the control group. Approximately 60% of pitchers in the MUCL injury group had TRMD >5° compared with 50% of pitchers in the control group. No differences were observed among HS, COLL, and PRO pitchers for GIRLoss (16° ± 12°, 17° ± 11°, 19° ± 13°, respectively; P = .131), GERGain (11° ± 9°, 11° ± 10°, 13° ± 10°, respectively; P = .171), TRMD (5° ± 11°, 6° ± 11°, 5° ± 14°, respectively; P = .711), and throwing shoulder ER (111° ± 10°, 111° ± 11°, 113° ± 9°, respectively; P = .427), IR (50° ± 11°, 49° ± 11°, 48° ± 10°, respectively; P = .121), and TRM (162° ± 14°, 160° ± 15°, 161° ± 14°, respectively; P = .770).
CONCLUSIONS
CONCLUSIONS
Greater GIRLoss, GERGain, and TRMD in MUCL injured pitchers compared with uninjured pitchers implies these variables may be related to increased MUCL injury risk, especially because GIRLoss >18° and TRMD >5° demonstrate an increased MUCL injury risk. Shoulder rotational motion and deficits do not vary among HS, COLL, and PRO levels of pitchers.
Identifiants
pubmed: 30771827
pii: S1058-2746(18)30866-8
doi: 10.1016/j.jse.2018.11.038
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
423-429Informations de copyright
Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.