title: Glenohumeral internal rotation deficits in professional pitchers enrolled in an internal rotation stretching program.
abstract: BACKGROUND
  Repetitive throwing motion creates increased external rotation and decreased internal rotation in the glenohumeral joint. There is controversy regarding the contribution of osseous and soft tissue adaptations to these changes in rotation.
  
  
  OBJECTIVE
  To evaluate internal rotation deficits in the professional baseball thrower's shoulder and determine the impact of an internal rotation stretch program on that deficit.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 3.
  
  
  METHODS
  Eighty-five male professional pitchers were evaluated in this study. Players were divided into 2 groups based on length of participation in an appropriate internal rotation stretch program. Data were collected on internal and external rotations and total range of motion in both dominant and nondominant arms using a goniometer. Internal rotation deficit (the lack of internal rotation relative to the opposite side) was calculated. Generalized comparative statistical tests were used.
  
  
  RESULTS
  Pitchers with 3 or more years in a stretch program (group 1) had greater internal rotation (74.3 degrees vs 54.3 degrees ) and greater total range of motion (217.0 degrees vs 194.2 degrees ) in dominant shoulders than did pitchers with less than 3 years (group 2). Total range of motion was greater in the dominant than in the nondominant arm for group 1. Internal rotation deficit in dominant arms was significantly greater for group 2 than for group 1. The analysis of dominant arm rotation relative to years in an internal rotation stretching program for pitchers in both groups showed a progressive increase in both internal rotation and total arc of motion with the number years in such a program plateauing after year 3.
  
  
  CONCLUSIONS
  The throwing motion shifts the total arc of motion toward external rotation and diminishes internal rotation. The increased external rotation may be attributable to increased humeral retroversion. The internal rotation deficit, however, is caused by soft tissue adaptations that can be addressed by consistent participation in a stretching program focused on internal rotation.
authors.affiliation: Methodist Center for Sports Medicine, The Methodist Hospital, Houston, TX 77030, USA. dlintner@tmh.tmc.edu
authors.forename: David
authors.initials: D
authors.lastname: Lintner
authors.forename: Magdiel
authors.initials: M
authors.lastname: Mayol
authors.forename: Obinna
authors.initials: O
authors.lastname: Uzodinma
authors.forename: Rex
authors.initials: R
authors.lastname: Jones
authors.forename: David
authors.initials: D
authors.lastname: Labossiere
mesh_terms: D000328:Adult; D053587:Arthrometry, Articular; D001484:Baseball / Q000293:injuries*; D003430:Cross-Sectional Studies; D006801:Humans; D006811:Humerus / Q000293:injuries* / Q000502:physiology; D008297:Male; D052580:Muscle Stretching Exercises; D016059:Range of Motion, Articular; D012782:Shoulder / Q000033:anatomy & histology / Q000502:physiology*; D013997:Time Factors