title: Deficiencies in pitching biomechanics in baseball players with a history of superior labrum anterior-posterior repair.
abstract: BACKGROUND
  Baseball pitchers who undergo superior labrum anterior-posterior (SLAP) repair often have trouble returning to their previous level of performance. While the reason is often assumed to be diminished shoulder range of motion or other mechanical changes, differences in pitching biomechanics between baseball pitchers with a history of SLAP repair and pitchers with no injury history have not been studied previously.
  
  
  OBJECTIVE
  The primary hypothesis was that compared with the control group, the SLAP group would exhibit compromised shoulder range of motion (external rotation and horizontal abduction) and internal rotation torque during pitching.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Pitching biomechanics were compared retrospectively between a group of 13 collegiate and professional pitchers with a history of a SLAP tear and a control group of 52 pitchers with no history of surgery; groups were matched by age, height, weight, and pitch velocity. Data were collected with an automated 3-dimensional motion analysis system while participants threw fastballs from the windup. Biomechanics of the shoulder (horizontal abduction and external rotation), elbow (flexion, extension velocity, and flexion torque), and body (stride length, shoulder horizontal adduction, and forward trunk tilt) were compared between the 2 groups. For each variable, a Student t test was used at an α level of .05.
  
  
  RESULTS
  Pitchers in the SLAP group exhibited significantly less shoulder horizontal abduction (10.0° ± 13.2° vs 21.0° ± 11.7°, respectively; P = .013) and shoulder external rotation (168.3° ± 12.7° vs 178.3° ± 7.3°, respectively; P = .016) than those in the control group. In addition, players in the SLAP group pitched with a more upright trunk, demonstrated by a less forward trunk tilt at the instant of ball release (30.2° ± 6.3° vs 34.4° ± 6.6°, respectively; P = .048).
  
  
  CONCLUSIONS
  Pitchers with a history of SLAP repair produce less shoulder horizontal abduction, shoulder external rotation, and forward trunk tilt during pitching than do pitchers with no history of injury.
  
  
  CONCLUSIONS
  To facilitate normal pitching mechanics, shoulder external rotation and horizontal abduction at 90° should be primary objectives in surgical repair and rehabilitation after SLAP repair. In addition, pitchers should work with their pitching coaches to ensure proper forward trunk tilt.
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama, USA tonyl@asmi.org.
authors.forename: Walter A
authors.initials: WA
authors.lastname: Laughlin
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama, USA.
authors.forename: Glenn S
authors.initials: GS
authors.lastname: Fleisig
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Scillia
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama, USA.
authors.forename: Kyle T
authors.initials: KT
authors.lastname: Aune
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama, USA.
authors.forename: E Lyle
authors.initials: EL
authors.lastname: Cain
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Dugas
mesh_terms: D001484:Baseball / Q000293:injuries / Q000502:physiology*; D001696:Biomechanical Phenomena / Q000502:physiology; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D016022:Case-Control Studies; D004551:Elbow Joint / Q000502:physiology*; D006801:Humans; D008297:Male; D009068:Movement / Q000502:physiology*; D012189:Retrospective Studies; D012399:Rotation; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000502:physiology* / Q000601:surgery; D055815:Young Adult
keywords: abduction; external rotation; labral tear; shoulder