Duke University School of Medicine, Durham, North Carolina.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Sports Health. 2020 Mar/Apr;12(2):132-138. doi: 10.1177/1941738119900799. Epub 2020 Feb 6.
Humeral torsion (HT) has been linked to various injuries and benefits. However, the exact interplay between HT, shoulder range of motion (ROM), competition level differences, and injury risk is unclear.
To determine the relationship between HT, ROM, and injury risk in baseball players. Secondarily, to determine HT based on competition level.
PubMed, Embase, Web of Science, CINAHL, and Cochrane databases were searched from inception until November 4, 2018.
Inclusion criteria consisted of (1) HT measurements and (2) arm injury or shoulder ROM.
Systematic review.
Level 3.
Two reviewers recorded patient demographics, competition level, HT, shoulder ROM, and injury data.
A total of 32 studies were included. There was no difference between baseball players with shoulder and elbow injuries and noninjured players (side-to-side HT difference: mean difference [MD], 1.75 [95% CI, -1.83 to 2.18]; dominant arm: MD, 0.17 [95% CI, -1.83 to 2.18]). Meta-regression determined that for every 1° increase in shoulder internal rotation (IR), there was a subsequent increase of 0.65° in HT (95% CI, 0.28 to 1.02). HT did not explain external rotation (ER ROM: 0.19 [95% CI, -0.24 to 0.61]) or horizontal adduction (HA ROM: 0.18 [95% CI, -0.46 to 0.82]). There were no differences between HT at the high school, college, or professional levels.
No relationship was found between HT and injury risk. However, HT explained 65% of IR ROM but did not explain ER ROM or HA ROM. There were no differences in HT pertaining to competition level. The majority of IR may be nonmodifiable. Treatment to restore and maintain clinical IR may be important, especially in players with naturally greater torsion. HT adaptation may occur prior to high school, which can assist in decisions regarding adolescent baseball participation.
肱骨扭转（HT）与各种损伤和益处有关。然而，HT、肩部活动范围（ROM）、竞技水平差异和受伤风险之间的确切相互作用尚不清楚。
确定棒球运动员中 HT、ROM 和受伤风险之间的关系。其次，根据竞技水平确定 HT。
从创建到 2018 年 11 月 4 日，PubMed、Embase、Web of Science、CINAHL 和 Cochrane 数据库进行了搜索。
纳入标准包括（1）HT 测量值和（2）手臂受伤或肩部 ROM。
系统评价。
3 级。
两名评审员记录患者的人口统计学资料、竞技水平、HT、肩部 ROM 和受伤数据。
共纳入 32 项研究。肩部和肘部受伤的棒球运动员与未受伤运动员之间没有差异（侧-侧 HT 差异：均数差[MD]，1.75 [95%CI，-1.83 至 2.18]；优势臂：MD，0.17 [95%CI，-1.83 至 2.18]）。元回归确定，每增加 1°肩内旋（IR），HT 随后增加 0.65°（95%CI，0.28 至 1.02）。HT 不能解释外旋（ER ROM：0.19 [95%CI，-0.24 至 0.61]）或水平内收（HA ROM：0.18 [95%CI，-0.46 至 0.82]）。高中、大学和职业水平之间的 HT 没有差异。
HT 与受伤风险之间未发现相关性。然而，HT 解释了 65%的 IR ROM，但未解释 ER ROM 或 HA ROM。HT 与竞技水平无关。大多数 IR 可能是不可改变的。恢复和维持临床 IR 的治疗可能很重要，尤其是在自然扭转度较大的运动员中。HT 适应可能发生在高中之前，这有助于做出关于青少年参与棒球的决策。
