Risk Factors for Shoulder and Elbow Injuries in High School Baseball Pitchers: The Role of Preseason Strength and Range of Motion

Risk Factors for Shoulder and Elbow Injuries in High School Baseball Pitchers: The Role of Preseason Strength and Range of Motion

(Tyler et al.; The American Journal of Sports Medicine; June 3, 2014)

• Preseason strength and ROM measurements were made on 101 pitchers from 4 different high schools over 4 season (total 166 pitcher-seasons: 25 freshman, 46 JV, 95 varsity). Glenohumeral internal rotation (IR), glenohumeral external rotation, and posterior shoulder ROM were measured bilaterally. Strength in IR, external rotation, supraspinatus (empty-can test), and scapular retraction were measured bilaterally.
• Injury incidence (injuries/1000 pitches) was computed for players categorized as above normal (>=1 SD above mean), normal (within 1 SD of mean) and below normal (<=1>SD below mean) for each potential risk factor.
• Although excessive loss of IR ROM is thought to be a risk factor for injury, the opposite was the case in this study. The absence of IR ROM loss in high school pitchers may indicate inadequate prior exposure to pitching, resulting in increased injury risk. Preseason supraspinatus weakness was associated with increased risk for a major injury, and preventative supraspinatus strengthening may be helpful.