Sports Medicine

Insufficient shoulder external rotation increases shoulder injury, surgery in pitchers

By Casey Tingle

The likelihood of shoulder injury and shoulder surgery was increased when professional baseball players had insufficient shoulder external rotation on the throwing side, according to study results.

“In the past, clinicians and people dealing with individuals with shoulder injuries related to baseball and overhead sports have often looked at the loss of internal rotation, commonly referred to as GIRD [glenohumeral internal rotation deficit], as a reason for shoulder injuries and this paper portrays it as the complete opposite: do not worry so much about the loss of internal rotation, but the loss of external rotation seems to correlate more so with injuries,” Kevin E. Wilk, PT, DPT, FAPTA, associate clinical director at Champion Sports Medicine in Birmingham, Ala., told Orthopedics Today.

Passive range of motion

Wilk and his colleagues assessed passive range of motion of the glenohumeral joint during spring training among 296 professional pitchers between 2005 and 2012. Overall, 505 examinations were performed, with researchers recording passive range of motion data for external and internal rotation in 288 pitchers. Researchers also measured external and internal rotation, as well as forward shoulder flexion, in 287 pitchers.


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