Glenohumeral rotational motion and strength and baseball pitching biomechanics.
BACKGROUND
Addressing loss of shoulder range of motion and rotator cuff weakness in injury-prevention programs might be an effective strategy for preventing throwing arm injuries in baseball pitchers. However, the influence of these clinical measures on pitching biomechanics  is unclear.


OBJECTIVE
To evaluate the relationships among clinical measures of shoulder rotational motion and strength and 3-dimensional pitching biomechanics and to evaluate the presence of coupling between the shoulder and the elbow during pitching to provide insight into  the influence of clinical shoulder characteristics on elbow biomechanics.


METHODS
Cross-sectional study.


METHODS
Biomechanics laboratory.


METHODS
A total of 27 uninjured male high school baseball pitchers (age = 16  ± 1.1 years, height = 183 ± 7 cm, mass = 83 ± 12 kg).


METHODS
Clinical measures included shoulder internal- and external-rotation range of motion and peak isometric internal- and external-rotator strength. Three-dimensional upper extremity  biomechanics were assessed as participants threw from an indoor pitching mound to a target at regulation distance. Linear regressions were used to assess the influence of clinical measures on the peak shoulder internal and external rotation moments and the peak elbow-adduction moment.


RESULTS
We found a positive relationship between clinically measured internal-rotator strength and shoulder external-rotation moment (R(2) = 0.181, P = .04) during pitching. We also noted an inverse relationship between clinically measured external-rotation motion and the elbow-adduction  moment (R(2) = 0.160, P = .04) and shoulder internal-rotation moment (R(2) = 0.250, P = .008) during pitching. We found a positive relationship between peak shoulder internal-rotation moment and the peak elbow-adduction moment (R(2)  = 0.815, P < .001) during pitching.


CONCLUSIONS
This study provides insight into the effects of shoulder strength and motion on pitching biomechanics and how these clinical measures might contribute to throwing arm injuries in the baseball pitcher. A relationship  also was identified between peak shoulder and elbow moments in the throwing arm during pitching, providing biomechanical support for addressing clinical shoulder characteristics as a potential strategy for preventing elbow injury.
Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. hurd.wendy@mayo.edu
Wendy J
WJ
Hurd
Kenton R
KR
Kaufman
D000293:Adolescent; D001484:Baseball / Q000293:injuries / Q000502:physiology*; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D004551:Elbow Joint / Q000502:physiology; D006801:Humans; D008297:Male; D053580:Muscle Strength; D016059:Range of Motion, Articular / Q000502:physiology*; D017006:Rotator Cuff / Q000502:physiology; D000070636:Rotator Cuff Injuries; D012782:Shoulder / Q000502:physiology; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000502:physiology*; D013334:Students; D055815:Young Adult