University of Pittsburgh, Pittsburgh, Pennsylvania.
Fitchburg State University, Fitchburg, Massachusetts.
Sports Health. 2024 May-Jun;16(3):347-357. doi: 10.1177/19417381231197217. Epub 2023 Sep 22.
Overhead throwing in baseball and softball athletes induces shoulder adaptations theorized to increase risk of shoulder musculoskeletal injury (MSI) and/or pain due to range of motion (ROM) deficits.
Shoulder ROM adaptations are associated with a higher risk for developing shoulder MSI and pain.
Prospective cohort study.
Level 3.
A total of 60 National Collegiate Athletic Association Division I athletes cleared for full athletic participation and free from upper extremity MSI in the last 4 weeks (age, 19.0 ± 1.2 years; weight, 82.1 ± 13.7 kg; height, 178.6 ± 11.2 cm; softball, n = 23; baseball, n = 37). Passive glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HA) ROM were measured with the scapula stabilized and used to categorize participants with/without external rotation gain (ERG), external rotation insufficiency (ERI), glenohumeral internal rotation deficit (GIRD), pathological GIRD, and posterior shoulder tightness (PST) before the competitive season. Groups were then compared to assess the incidence of shoulder MSI prospectively and prevalence of shoulder pain at the initial evaluation.
Baseball and softball athletes demonstrated significantly less IR ROM in the dominant shoulder (50.6° ± 9.4°) compared with the nondominant shoulder (59.1° ± 8.6°; < 0.01) and significantly more ER ROM (dominant, 104.6° ± 12.1°; nondominant, 97.7° ± 12.0°; < 0.01). Incidence of shoulder MSI was 15% but was not significantly related to any shoulder adaptations. No significant relationship was found between prevalence of pain and any shoulder adaptations in the 27% of athletes with pain.
Increased ER and decreased IR ROM adaptations in intercollegiate overhead throwing athletes do not appear to be correlated to risk of shoulder MSI or pain.
The findings of this level 3 prospective study provide clinicians working with overhead athletes information regarding shoulder MSI risk and pain. It is recommended that clinicians should not use ROM adaptations exclusively to determine increased risk of shoulder MSI.
棒球和垒球运动员的过顶投掷会引起肩部适应，据推测，这会增加肩部肌肉骨骼损伤（MSI）和/或因运动范围（ROM）不足而引起疼痛的风险。
肩部 ROM 适应性与发生肩部 MSI 和疼痛的风险较高相关。
前瞻性队列研究。
3 级。
共有 60 名美国大学生体育协会一级运动员通过全面运动参与和在过去 4 周内无上肢 MSI 筛查（年龄，19.0 ± 1.2 岁；体重，82.1 ± 13.7 公斤；身高，178.6 ± 11.2 厘米；垒球，n = 23；棒球，n = 37）。在肩胛稳定的情况下测量被动盂肱关节内旋（IR）、外旋（ER）和水平内收（HA）ROM，并在竞争赛季前使用这些 ROM 来对伴有/不伴有外旋增加（ERG）、外旋不足（ERI）、盂肱关节内旋不足（GIRD）、病理性 GIRD 和后肩紧张（PST）的运动员进行分类。然后对各组进行比较，以前瞻性评估肩部 MSI 的发生率和肩部疼痛的患病率。
棒球和垒球运动员的优势肩的 IR ROM 明显小于非优势肩（优势肩 50.6°±9.4°，非优势肩 59.1°±8.6°；<0.01），而 ER ROM 明显较大（优势肩 104.6°±12.1°，非优势肩 97.7°±12.0°；<0.01）。肩部 MSI 的发生率为 15%，但与任何肩部适应均无显著相关性。在有 27%疼痛的运动员中，疼痛的患病率与任何肩部适应均无显著关系。
大学生过顶投掷运动员的 ER 增加和 IR 减少的 ROM 适应性似乎与肩部 MSI 或疼痛的风险无关。
这项 3 级前瞻性研究的结果为从事过顶运动的运动员提供了有关肩部 MSI 风险和疼痛的信息。建议临床医生不应仅使用 ROM 适应性来确定肩部 MSI 风险增加。
