Department of Orthopedic Surgery, The Johns Hopkins University, Baltimore, MD.
Phys Sportsmed. 2014 Feb;42(1):69-74. doi: 10.3810/psm.2014.02.2049.
The relationship of changes in glenohumeral range of motion (ROM) in a pitcher's throwing shoulder to a single pitching episode is not well described, and the causes of such changes over a season are controversial. We hypothesized that in pitchers for a collegiate baseball team, external rotation (ER) would increase, internal rotation (IR) would decrease, total ROM would be maintained, and the glenohumeral IR deficit would worsen in starting pitchers' shoulders after single pitching episodes and after the season. Participants were 6 starting pitchers for all 25 home games from a Division III National Collegiate Athletic Association team during 1 regular spring season. One examiner measured glenohumeral ER, IR, and total ROM with the arm abducted 90° pregame before stretching or throwing and immediately postgame before shoulder icing. Bilateral measurements were obtained on supine pitchers via a long-arm goniometer and custom bubble inclinometer. Innings, pitch count, and types of pitches were recorded for possible associations with any glenohumeral motion changes. Paired t tests were used to compare dominant and nondominant glenohumeral differences in ROM (significance, P < 0.05). Compared with pregame values, single-start postgame glenohumeral ER significantly increased (7.9° ± 2.2°), single-start IR did not significantly change, and single-start total ROM significantly increased (7.4° ± 3.4°). Compared with preseason values, postseason glenohumeral ER significantly increased (10.2° ± 6.2°), IR significantly decreased (-17.8° ± 6.7°), and total ROM significantly decreased (-7.7° ± 5.2°). In the collegiate throwing shoulder, changes in ER and total ROM occurred after 1 episode of starting pitching, and changes in ER, IR, and total ROM occurred over the full season. There was no association between the ROM changes and innings pitched, pitch count, or types of pitches thrown. In conclusion, for collegiate pitchers, changes in glenohumeral ROM occur after single starts and over the season, suggesting that monitoring motion changes throughout the season may be beneficial.
投手投掷肩的盂肱关节活动范围（ROM）的变化与单次投球事件的关系描述得并不完善，并且一个赛季中这种变化的原因存在争议。我们假设，在大学棒球队的投手中，外旋（ER）会增加，内旋（IR）会减少，总 ROM 将保持不变，并且在单次投球事件后和整个赛季后，首发投手的肩部盂肱关节内旋不足会恶化。参与者为一个三级全国大学体育协会（NCAA）棒球队的 25 场主场比赛中的 6 名首发投手。一名检查者在伸展或投掷前的赛前 90° 时测量了盂肱关节 ER、IR 和总 ROM，并且在赛后立即在肩部冰敷前进行测量。通过长臂量角器和定制气泡倾斜计对仰卧位投手进行双侧测量。记录了局数、投球数和投球类型，以确定其与任何盂肱关节运动变化的可能关联。使用配对 t 检验比较了 ROM 的优势和非优势盂肱关节差异（显著性，P<0.05）。与赛前值相比，单次首发赛后盂肱关节 ER 显著增加（7.9°±2.2°），单次首发 IR 没有显著变化，并且单次首发总 ROM 显著增加（7.4°±3.4°）。与赛季前值相比，季后赛盂肱关节 ER 显著增加（10.2°±6.2°），IR 显著减少（-17.8°±6.7°），并且总 ROM 显著减少（-7.7°±5.2°）。在大学投掷肩中，单次首发后 ER 和总 ROM 发生变化，整个赛季中 ER、IR 和总 ROM 都发生了变化。ROM 变化与投球局数、投球数或投球类型之间没有关联。总之，对于大学生投手来说，单次首发和整个赛季后盂肱关节 ROM 的变化表明，在整个赛季中监测运动变化可能是有益的。
