Proaxis Therapy, Orthopedic Research Foundation of the Carolinas, Greenville, South Carolina, USA.
Am J Sports Med. 2011 Sep;39(9):1997-2006. doi: 10.1177/0363546511408876. Epub 2011 Jun 17.
Range of motion deficits in shoulder external rotation (ER), internal rotation (IR), total rotation range of motion (ER + IR), and horizontal adduction (HA) have been retrospectively associated with overhand athletes' arm injuries.
The authors expected the incidence of upper extremity injury in high school softball and baseball players with side-to-side shoulder range of motion deficits to be greater than the incidence of upper extremity injury in players with normal shoulder range of motion.
Cohort study (prognosis); Level of evidence, 2.
High school softball and baseball players (N = 246) participated. Before the start of the season, passive shoulder ER, IR, and HA were assessed at 90° of abduction with the scapula stabilized. Relative risk (RR) was calculated to examine range of motion measure, by categorical criteria, and risk of upper extremity injury.
Twenty-seven shoulder and elbow injuries (9 softball, 18 baseball) were observed during the season. The dominant shoulder of all injured players and baseball players displayed a significant decrease in HA (P = .05) and IR (P = .04). The dominant shoulder total rotation of injured baseball players displayed a significant decrease (mean difference = 8.0° ± 0.1°; P = .05) as compared with the dominant shoulder of uninjured baseball players. Players who displayed a decrease of ≥25° of IR in the dominant shoulder were at 4 times greater risk of upper extremity injury compared with players with a <25° decrease in IR, especially for baseball players. While we observed a 1.5 to 2 times increased risk of injury for the 10° to 20° loss in rotational range of motion for the overall sample and baseball, the risk estimates were not statistically significant (P > .05).
There are large mean deficits in shoulder IR and HA between injured and noninjured players, but not in ER or total rotation. Passive shoulder IR loss ≥25° as compared bilaterally was predictive of arm injury. Shoulder range of motion deficits differed between sports and appeared more predictive of injury for baseball players.
肩部外旋（ER）、内旋（IR）、总旋转活动范围（ER+IR）和水平内收（HA）的活动范围不足与过顶运动员的手臂受伤有回顾性关联。
作者期望在肩部活动范围存在左右侧差异的高中垒球和棒球运动员中，上肢损伤的发生率会高于肩部活动范围正常的运动员。
队列研究（预后）；证据水平，2 级。
共有 246 名高中垒球和棒球运动员参与。在赛季开始前，在肩胛骨稳定的情况下，在 90°外展时评估被动肩部 ER、IR 和 HA。通过分类标准计算相对风险（RR），以检查运动范围测量值与上肢损伤的风险。
在整个赛季中观察到 27 例肩部和肘部损伤（9 例垒球，18 例棒球）。所有受伤运动员和棒球运动员的优势肩均出现明显的 HA 下降（P =.05）和 IR 下降（P =.04）。与未受伤的棒球运动员相比，受伤棒球运动员的优势肩总旋转活动范围明显下降（平均差异=8.0°±0.1°；P =.05）。与 IR 减少量＜25°的运动员相比，IR 减少量≥25°的运动员上肢损伤的风险增加 4 倍，尤其是棒球运动员。虽然我们观察到在整个样本和棒球中，旋转活动范围损失 10°至 20°时上肢损伤的风险增加 1.5 至 2 倍，但风险估计无统计学意义（P＞.05）。
受伤运动员与未受伤运动员之间的肩部 IR 和 HA 存在较大的平均差异，但 ER 或总旋转活动范围没有差异。与双侧相比，IR 损失≥25°是手臂受伤的预测指标。肩部活动范围的差异存在于不同的运动中，对棒球运动员的损伤更具预测性。
