title: A bilateral comparison of posterior capsule thickness and its correlation with glenohumeral range of motion and scapular upward rotation in collegiate baseball players.
abstract: OBJECTIVE
  We hypothesized that posterior capsule thickness (PCT) would be greater on the dominant arm compared to the non-dominant arm. We also hypothesized that PCT would negatively correlate with glenohumeral internal rotation and scapular upward rotation. In addition, PCT would positively correlate with glenohumeral external rotation. However, currently PCT has not been measured nor have correlations been identified to exist with glenohumeral and scapular motion. Therefore, the purpose of the study was to determine if the posterior capsule was hypertrophied on the dominant arm and to identify if relationships exist with glenohumeral internal rotation (IR), external rotation (ER), and scapular upward rotation (SUR).
  
  
  METHODS
  PCT was measured using a 10-MHz transducer. Glenohumeral IR and ER was measured supine using a digital inclinometer. SUR was measure at 0°, 60°, 90°, and 120° of glenohumeral abduction using a modified digital inclinometer.
  
  
  RESULTS
  PCT was greater on the dominant compared with the nondominant arm (P = .001). A negative correlation was found between PCT and IR (-0.498, P = .0001). A positive correlation was found between PCT and ER (0.450, P = .002) and between PCT and SUR at 60°, 90°, and 120° of glenohumeral abduction (0.388, P = .006; 0.327, P = .023; 0.304, P = .036, respectively).
  
  
  CONCLUSIONS
  This in vivo study demonstrated a hypertrophied posterior capsule and its association with GIRD, ER, and SUR. These observations suggest that PCT does occur on the throwing arm of baseball players and is linked with glenohumeral and scapular alterations.
  
  
  CONCLUSIONS
  This methodology could be used as a noninvasive screening evaluation for overhead athletes to identify those who may be at risk for shoulder injuries due to excessive capsular thickening.
authors.affiliation: McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA 19104, USA. sjthomasatc@gmail.com
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Thomas
authors.forename: Charles Buz
authors.initials: CB
authors.lastname: Swanik
authors.forename: Jill S
authors.initials: JS
authors.lastname: Higginson
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Kaminski
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Swanik
authors.forename: Arthur R
authors.initials: AR
authors.lastname: Bartolozzi
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Abboud
authors.forename: Levon N
authors.initials: LN
authors.lastname: Nazarian
mesh_terms: D001484:Baseball / Q000293:injuries*; D006801:Humans; D017746:Joint Capsule / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D012399:Rotation; D012540:Scapula / Q000503:physiopathology*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology; D014463:Ultrasonography; D055815:Young Adult