title: Preseason shoulder range of motion screening as a predictor of injury among youth and adolescent baseball pitchers.
abstract: BACKGROUND
  Approximately 6 million youngsters play organized baseball yearly, and injuries are common. Defining of risk factors for injuries in the throwing shoulder has largely been confined to the professional thrower. Unfortunately, these risk factors apply to only 1% of pitchers at risk for injury. Risk factors for injury in youth pitchers have received far less attention than those in more mature professional pitchers. Development of such an understanding would help clarify injury prevention efforts for the other 99% of pitchers actively participating in competitive baseball. This study intended to determine the ability of range of motion (ROM) measures to predict arm injuries in baseball pitchers aged 8 to 18 years.
  
  
  METHODS
  Supine passive shoulder ROM was assessed in 115 pitchers with a digital inclinometer. Two trials of ROM were measured before the season. Arm injuries were prospectively tracked. Receiver operating characteristic curves were used to identify athletes who were at high risk for injury. Statistical significance was set a priori (α = .05).
  
  
  RESULTS
  There were 33 injured and 82 uninjured pitchers. Side-to-side differences of horizontal adduction >15° and internal rotation >13° may discriminate between those adolescent pitchers at 4 and 6 times greater risk of injury, respectively.
  
  
  CONCLUSIONS
  Preseason ROM differences were able to identify those adolescents at high risk for injury during the season. It appears that the risk profile for adolescent pitchers includes horizontal adduction differences that differ from the established prospective profile in adult pitchers.
authors.affiliation: Proaxis Therapy, Hawkins Foundation, Greenville, SC, USA. Electronic address: ellen.shanley@proaxistherapy.com.
authors.forename: Ellen
authors.initials: E
authors.lastname: Shanley
authors.affiliation: Greenville Heath System-Steadman Hawkins, Hawkins Foundation, Greenville, SC, USA.
authors.forename: Micheal J
authors.initials: MJ
authors.lastname: Kissenberth
authors.affiliation: Proaxis Therapy, Hawkins Foundation, Greenville, SC, USA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Thigpen
authors.affiliation: Memorial Hermann IRONMAN Sports Medicine Institute, Houston, TX, USA.
authors.forename: Lane B
authors.initials: LB
authors.lastname: Bailey
authors.affiliation: Greenville Heath System-Steadman Hawkins, Hawkins Foundation, Greenville, SC, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Hawkins
authors.affiliation: Department of Physical Therapy, Virginia Commonwealth University, Los Angeles, CA, USA.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Michener
authors.affiliation: Greenville Heath System-Steadman Hawkins, Hawkins Foundation, Greenville, SC, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Tokish
authors.affiliation: Doctor of Physical Therapy Program, San Diego State University, San Diego, CA, USA.
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Rauh
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000503:physiopathology / Q000517:prevention & control*; D001484:Baseball / Q000293:injuries*; D002648:Child; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000502:physiology*
keywords: Baseball; injury; shoulder ROM