Sports Health. 2021 May-Jun;13(3):237-244. doi: 10.1177/1941738120980016. Epub 2021 Feb 4.
Repetitive throwing in baseball pitchers can lead to pathologic changes in shoulder anatomy, range of motion (notably glenohumeral internal rotation deficit), and subsequent injury; however, the ideal strengthening, recovery, and maintenance protocol of the throwing shoulder in baseball remains unclear. Two strategies for throwing shoulder recovery from pitching are straight-line long-toss (SLT) throwing and ultra-long-toss (ULT) throwing, although neither is preferentially supported by empirical data.
ULT will be more effective in returning baseline internal rotation as compared with SLT in collegiate pitchers after a pitching session.
Cohort study.
Level 3.
A total of 24 National Collegiate Athletic Association Division I baseball pitchers with mean age 20.0 ± 1.1 years were randomized to either the ULT group (n = 13; 9 right-hand dominant, 4 left-hand dominant) or SLT group (n = 11; 10 right-hand dominant, 1 left-hand dominant). Measurements (dominant and nondominant, 90° abducted external rotation [ER], internal rotation [IR], and total range of motion [TROM]) were taken at 5 time points across 3 days: before and immediately after a standardized bullpen session on day 1; before and immediately after a randomized standardized ULT or SLT session on day 2; and before practice on Day 3.
ULT demonstrated significantly greater final ER compared with baseline (+10°; = 0.05), but did not demonstrate significant IR changes. Similarly, SLT demonstrated significantly greater post-SLT ER (+12°; = 0.02) and TROM (+12°; = 0.01) compared with baseline, but no significant IR changes. Final ER measurements were similar between ULT (135° ± 14°) and SLT (138° ± 10°) ( = 0.59). There was also no statistically significant difference in final IR between ULT (51° ± 14°) and SLT (56° ± 8°) ( = 0.27).
The routine use of postperformance, ULT throwing to recover from range of motion alterations, specifically IR loss, after a pitching session is not superior to standard, SLT throwing. Based on these findings, the choice of postpitching recovery throwing could be player specific based on experience and comfort.
The most effective throwing regimens for enhancing performance and reducing residual impairment are unclear, and ideal recovery and maintenance protocols are frequently debated with little supporting data. Two strategies for throwing shoulder recovery from pitching are SLT and ULT throwing. These are employed to help maintain range of motion and limit IR loss in pitchers. The routine use of ULT throwing for recovery and to limit range of motion alterations after a pitching session is not superior to SLT throwing.
棒球投手中的重复性投掷会导致肩部解剖结构、运动范围（尤其是盂肱关节内旋不足）发生病理性变化，进而导致受伤；然而，棒球投手肩部的理想强化、恢复和维持方案仍不清楚。两种从投球中恢复投肩的策略是直线长投（SLT）和超长投（ULT），尽管这两种策略都没有得到实证数据的支持。
在投球后，与 SLT 相比，ULT 在大学生投手中更能有效地恢复基线内旋。
队列研究。
3 级。
共有 24 名平均年龄 20.0 ± 1.1 岁的美国大学体育协会一级棒球投手被随机分为 ULT 组（n = 13；9 名右手优势，4 名左手优势）或 SLT 组（n = 11；10 名右手优势，1 名左手优势）。在 3 天内的 5 个时间点测量（优势和非优势，90°外展外旋 [ER]、内旋 [IR] 和总活动范围 [TROM]）：第 1 天进行标准化投球练习前后；第 2 天进行随机标准化 ULT 或 SLT 练习前后；以及第 3 天练习前。
ULT 与基线相比，最终 ER 显著增加（+10°； = 0.05），但 IR 无显著变化。同样，SLT 与基线相比，POST-SLT ER（+12°； = 0.02）和 TROM（+12°； = 0.01）均显著增加，但 IR 无显著变化。ULT（135°±14°）和 SLT（138°±10°）的最终 ER 测量值相似（ = 0.59）。ULT（51°±14°）和 SLT（56°±8°）的最终 IR 也无统计学差异（ = 0.27）。
在投球后，常规使用 ULT 投掷来恢复运动范围的改变，特别是 IR 丧失，并不优于标准的 SLT 投掷。基于这些发现，投球后恢复投掷的选择可以根据经验和舒适度因人而异。
增强性能和减少残留损伤的最有效投掷方案尚不清楚，理想的恢复和维持方案经常受到争议，而很少有支持数据。从投球中恢复投肩的两种策略是 SLT 和 ULT 投掷。这些方法用于帮助维持投手的运动范围并限制 IR 损失。在投球后，常规使用 ULT 进行恢复并限制运动范围的改变并不优于 SLT 投掷。
