Change in Glenohumeral Rotation and Scapular Position After Competitive High School Baseball

in Journal of Sport Rehabilitation
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Context:

Pathologies such as anterior instability and impingement are common in baseball and have been linked to decreases in internal rotation (IR) and concurrent increases in external rotation (ER). In addition, alterations to scapular position have been identified in this population, but the chronology of these adaptations is uncertain.

Objectives:

To determine whether there is a change in range of motion and scapular position after a single baseball season.

Design:

Prospective cohort.

Setting:

High school.

Participants:

19 high school baseball players (age 16.6 ± 0.8 y, mass 78.6 ± 12.0 kg, height 180.3 ± 6.2 cm).

Interventions:

Subjects were measured for all dependent variables at preseason and postseason.

Main Outcome Measures:

Participants were measured for glenohumeral (GH) IR and ER with the scapula stabilized. Total GH range of motion was calculated as the sum of IR and ER. Scapular upward rotation was measured at 0°, 60°, 90°, and 120° of GH abduction in the scapular plane, and scapular protraction, at 0°, hands on hips, and 90° of GH abduction.

Results:

Overall, the dominant arm had significantly less GH IR (11.4°, P = .005) and significantly more ER (4.7°, P = .001) than the nondominant arm. Total motion in the dominant arm was significantly less than in the nondominant arm (6.7°, P = .001). Scapular upward rotation in the dominant arm significantly increased at 0° (2.4°, P = .002) and significantly decreased at 90° (3.2°, P = .001) and 120° (3.2°, P < .001) of abduction from preseason to postseason. Scapular protraction in the nondominant arm significantly decreased at 45° (0.32 cm, P = .017) and 90° (0.33 cm, P = .006) from preseason to postseason.

Conclusion:

These data suggest that scapular adaptations may be acquired over a relatively short period (12 wk) in a competitive baseball season. Competitive high school baseball players also presented with significant GH motion differences between their dominant and nondominant arms. Total motion was also significantly less in the dominant arm than in the nondominant arm.

Thomas is with the McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA. K. Swanik is with the Dept of Nursing and Health Science, Neumann University, Aston, PA. C. Swanik is with the Dept of Health, Nutrition and Exercise Sciences, University of Delaware, Newark, DE. Huxel is with Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ. Kelly is with the Dept of Orthopaedic Surgery, University of Pennsylvania Hospital, Philadelphia, PA.