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What You Need to Know About GIRD: What It Is and What it Isn’t

GIRD Mike ReinoldGlenohumeral internal rotation deficit, or GIRD, continues to be one of the most polarizing topics in baseball sports medicine.  It has become so popular that even athletes and the general public know about GIRD, often exhibiting fear and anxiety with just the mention of GIRD.

How many times has a baseball player come back from the doctor with their head down saying, “I have GIRD,” as if the world has just ended?

I do not feel that everyone truly understands GIRD, how to assess GIRD, or how to treat GIRD.  There are a lot of theories and assumptions out there that may or may not be true.

Here is my take on GIRD, and it is not exactly how everyone would describe GIRD.

 

What is normal range of motion in an overhead athlete?

Before we can have any discussion on what is considered abnormal range of motion in the thrower’s shoulder, we should make sure we understand what is considered “normal” in overhead athletes.

Throwers have very unique adaptations from the demands of throwing. Numerous articles over the past 15 years have consistently shown that the dominant shoulder in overhead athletes exhibits an increase of external rotation and a subsequent decrease in internal rotation.  However, if you take the total rotation motion and combine ER and IR measurements the numbers are almost identical.

I remember when we first started discovering this phenomenon many years ago and it is uncanny how you find essentially the exact same total motion arc on both sides.

Here is an illustration of what this looks like.  In this figure.  You see the nondominant shoulder on the left and the dominant shoulder on the right.  You see the shift in the arc of total rotational motion, however if you break down the components of ER and IR, you see that both sides total 180 degrees.

GIRD glenohumeral internal rotation deficit

This adaptation has been shown in too many publications to list here, but I’ll add a few:

GIRD total rotational motion

This is a brief list but you can see that the total rotation motion on both the dominant and nondominant shoulders is almost identical in every study.  Statistical analysis revealed no significant differences in range of motion side to side.

 

Why the Adaptation in Shoulder Range of Motion?

Since the first discovery of this loss of internal rotation on the throwing arm, there have been several theories as to the specific reason for the adaptation.

The first theory centered around the fact that since there was a loss of internal rotation, there must be a subsequent tightness of the posterior capsule.  In actuality, this is really a long shot of being the isolated reason for the loss of IR, assuming a very specific cause for GIRD.

With so many potential factors contributing to the altered range of motion, it is surprising to me how popular this theory became.  If IR is less on the thrower shoulder, we now jump straight to recommending aggressive internal rotation and posterior capsular stretching.  I guess whatever theory comes out first gets the most traction and popularity!

The major flaw of the posterior capsule tightness theory is that it does not take into consideration the very specific increase in ER that is also seen in overhead athletes, let alone the fact that total rotational motion is still the same side-to-side.  If the posterior capsule was the cause of the loss of IR, would we then assume that the anterior capsule has loosened precisely the exact same amount to allow the exact same increase in ER as the posterior capsule does to restrict IR?

That sounds pretty unrealistic to me.

Shortly after the posterior capsule tightness theory was presented, many researchers took a more scientific look at what could be causing this very precise shift in the arc of motion in baseball pitchers and other overhead athletes. Several studies have now been published that have assessed boney changes that could be associated with GIRD.  Using both MRI and CT scans, it is now well documented that the humerus of the throwing arm is more retroverted than the nondominant arm.

What this means is that the actual bone of your upper arm torques and adapts.

Imagine twisting and wringing out a towel.  This is exactly what happens to the humerus during throwing while your growth plates are open.  The body, bones especially, do a great job of adapting to stress.  Essentially, the humerus bone of your upper arm twists at the growth plate and causes permanent adaptations to your bones.  Newer research is also now showing that the other end of the socket, the glenoid, also shows retroversion.

Based on these studies, the exact amount of retroversion observed appears to be approximately 10 degrees on average.  Now go back up and look at the table above.  Notice how the loss of IR is approximately 10 degrees and the gain of ER is approximately 10 degrees?  This boney adaptation makes the very specific shift in range of motion make more sense.  I have shown a simple and fairly effective way of measuring humeral retroversion in the clinic.  Try it in your throwers and you’ll see.

Pretty cool, right?  Still think the posterior capsule is the cause of loss of IR?

I was also a part of two studies that looked at glenohumeral translation in the baseball pitcher that both showed that posterior translation was twice that of anterior translation.  This was even present in baseball pitchers with as little as 10 degrees of IR.  They still had a large amount of posterior translation, not posterior capsular tightness.

Taking all of this into consideration, if there is one thing you take away from this article, it should be:

[quote]The thrower’s shoulder is supposed to have less IR on the dominant side.  This is normal.[/quote]

 

Determining What is Clinically Significant GIRD

A threshold to determine what can be considered a clinically significant loss of IR is vitally important to the implementation of programs designed to prevent and treat GIRD.  As previously discussed, a loss of IR itself can be considered a normal anatomical variation observed in overhead athletes.

Despite this finding, the term GIRD has continued to have a negative connotation, implying that any side-to-side loss of IR may be pathological.  This has resulted in a trend towards assuming many of the hypothesized theories of why loss of IR occurs are present in each person.

This unfortunately leads to a standardized prescription of stretches and exercises based on assumption and not a thorough assessment.

After reviewing the literature, it appears that most authors have been arbitrarily defining GIRD as a loss of IR greater than 15-20 degrees in comparison to the nonthrowing arm.  Some authors have even published studies showing that your chance of getting injured is increased if you have GIRD of more than 15-20 degrees.

Correlating GIRD to injury is too simplistic at best and again has too many flaws to consider this valid.

You can not accurately state why an increase in injury was observed.  Was it the loss of 17 degrees of IR?  Or perhaps the subsequent gain of 17 degrees of ER?  You can’t make a definitive conclusion either way.

[quote]Perhaps the increase of injuries in baseball pitchers is due to the gain in shoulder ER, not GIRD and the loss of IR?[/quote]

I am thinking this more and more everyday.

Another major flaw with defining GIRD using an arbitrary number is that the published amounts of range of motion have a very large standard deviation.  If you look through the published studies on GIRD, you’ll see that the standard deviation of measurements is large, ranging from 8 degrees to over 15 degrees.  That means the “normal” amount of internal rotation on a shoulder is approximately 50 degrees, but plus or minus 15 degrees.  Thus both 35 degrees and 65 degrees of internal rotation should be considered “normal.”

I can say that I have observed this first hand in professional baseball pitchers.  I have seen just as many players with 140 degrees of total rotational motion than I have with 200 degrees of total rotational motion.  Sure, this averages out to 170 degrees.  But not all baseball pitchers have 170 degrees of total rotational motion.

With such a large standard deviation and variability in measurements, assigning an arbitrary number to define GIRD is too simplistic.

 

A New Definition of GIRD

These findings have caused me to alter the way I define GIRD and stimulated me to propose a new definition of GIRD based on total rotational motion.

Previous definitions of GIRD based on arbitrary numbers have resulted in generalized treatment programs that are not specific or individualized enough to be utilized in clinical practice.

I propose that a loss of side-to-side IR is actually a normal anatomical variation in overhead athletes and should not be considered pathological GIRD unless there is a subsequent loss of total rotational motion in the dominant arm as well.  

This definition essentially takes the large variability in ROM that has been observed in athletes into consideration and allows for a more individualized approach to treating GIRD. So:

[quote]GIRD is a loss of internal rotation range of motion in the presence of a loss of total rotational motion.[/quote]

In this new definition of GIRD, a pathological condition of GIRD is defined as a loss of IR in the presence of loss of total rotational motion.

Lets looks at this as both an illustration and an equation.  In the figure below, you see the normal arc of motion in an overhead athlete, and to the right, an altered total rotational range of motion due to a loss of IR.

a new definition of GIRD

You can observe this yourself by assessing the specific range of motion measurements.  To calculate GIRD, use this equation:

GIRD = (Side-to-side difference in ER) + (Side-to-side difference in IR)

Here is an example of two baseball pitchers with a loss of IR:

  • Player 1 = (D ER 120 deg – ND ER 100 deg = +20 deg ER) + (D IR 60 deg – ND IR 80 deg = -20 deg IR) = 0 deg – Despite a loss of 20 degrees this is not pathological GIRD because total motion is the same bilaterally
  • Player 2 = (D ER 120 deg – ND ER 100 deg = +20 deg ER) + (D IR 35  deg – ND IR 80 deg = -45 deg IR) = -25 deg GIRD – This represents a pathological GIRD because both IR and total rotational motion are limited

I would suggest that the first player above should not be considered or even called GIRD, despite the fact that there is 20 degrees less IR on the throwing shoulder.  Because the total motion is the same, this is a normal adaptation in this athlete.

In fact, I would comfortably say in my experience that if you tried to reduce that 20 degrees loss of IR when total motion is symmetrical, you would essentially be increasing the total rotation motion and creating instability in an already vulnerable joint.

I believe this causes more injuries than it helps.

Because of the negative association that we have established with the word GIRD, I would propose that we stop calling everything GIRD and reserve GIRD for when it is truly pathological.  This helps clear up confusion.

I strongly feel that this new definition of GIRD takes the individual variability of range of motion as well as the total rotation motion into consideration and is a much more accurate calculation to base treatment recommendations.

 

Why is this important?

The goal of this article is to share my experience treating baseball pitchers.  I have rehabilitated 1000’s of injured baseball pitchers and managed 1000’s of healthy baseball pitchers.  This unique experience really opened my eyes to what is “normal” in baseball players.

When I first started working in Major League Baseball, I quickly found out that much of what I believe to be “facts” were not always accurate.  I’ll be the first to admit this.  If you only treat injured baseball pitchers, you start to assume that some normal adaptations may be pathological.

While my experience has been with baseball pitchers, this information can be extrapolated to all overhead athletes as these findings have all been established in other sports, such as tennis and handball.

There are far too many people who see a loss of IR and immediately label it GIRD.  Furthermore, there are far too many people who label any loss of IR as GIRD and blindly treat the posterior capsule.  I’m not saying that posterior capsular tightness does not exist, I am just saying it exists far less than we are diagnosing it and there are many other reasons that we need to consider before we start challenging the integrity of the stabilizing structures of the thrower’s shoulder.  I even dedicated an entire webinar to showing you 5 ways to gain IR without stretching the posterior capsule.

Blindly assuming GIRD is pathological, stretching the heck out of IR, and treating the posterior capsule is harmful.

 

Assess, Don’t Assume

Even with a pathological GIRD using the above equation, you can not assume you know why they have a loss of IR.

I have previously published a study showing that there is an immediate loss of IR after pitching.  We theorized that this was too acute to represent any changes in the capsule and most likely represented muscular stiffness from the eccentric trauma associated with pitching.  This was even more apparent when we also noticed that there was a loss of elbow extension, which is also subject to extreme eccentric forces during throwing.

You can’t assume they need to be stretched to gain more IR or that the posterior capsule is tight.  Maybe it is.  Maybe it isn’t.  Regardless:

Assess, don’t assume.

There is a specific way to assess the posterior capsule, which I will share in an upcoming post.  In fact I am going to write a series on how to more accurately assess GIRD, internal rotation, and the posterior capsule.

By changing the way we assess and define GIRD, we can start to more accurately understand what is happening to these overhead athletes and provide the best care possible.

Teres Major: An Important Muscle that is Often Overlooked in Throwers

There is no doubt that baseball pitchers and other overhead athletes get tight from throwing.  We originally showed this in my study published in AJSM, pitchers had an immediate loss of shoulder internal rotation after 45 pitches on the mound.

I often say that this loss of motion can easily become cumulative if not addressed, and unfortunately, the majority of baseball pitchers I see tend to need work on their soft tissue mobility.  I believe this is directly related to the cumulative trauma to the muscles that has been left unaddressed for some time.

I am a firm believer that regular soft tissue maintenance work is important for baseball pitchers, but I also understand that having access someone like me isn’t very realistic for many athletes.

We have come a long way with tools to work on your own soft tissue, like foam rolling, massage sticks, and trigger point balls.  For throwers, we have been recommending the use of these tools for some time and you often see people focused on a few key areas like the posterior rotator cuff, lats, and pecs.  This is for good reason!

But there is another spot that I bet you are missing that I think is pretty important and will help you feel better quickly.

 

Teres Major

The teres major just doesn’t get enough respect.  It’s not lucky enough to be included as one of the “rotator cuff” muscles.  It’s not a big guy that you can read how to strengthen in Men’s Health, like the pecs or lats.  Sometimes I think it is forgotten!

The teres major is a pretty important muscle to focus on.

The teres major acts as an internal rotator and adductor of the arm.  Guess what the arm does as you accelerate through your mechanics to generate velocity on the ball?  That is right, you internally rotate and adduct the arm!

But unlike the pec and the lat, who also contribute to the same motion, the teres major has a more intimate relationship with the scapula and humerus.  When you look at baseball pitchers, you tend to see a large, overdeveloped, hypertrophied teres major.  This again tells me it is an important muscle for throwing.  (photo from wikipedia)

teres major tightness

As the teres major gets tight and shortened from overuse and throwing.  you can start to see changes in scapulohumeral motion.  When assessing someone, you may see that the scapula looks like it wants to upwardly rotate more on the throwing side, which I often attribute to the teres major shortening not allowing proper separation of scapula and humeral arm movement.  Essentially the tight teres major drags the scapula up with the arm because the two can’t separate

It looks like the person is achieving good arm elevation but realistically they are just compensating with more scapular upward rotation.  If you look closely, you’ll even notice that they are elevating the arm less and upwardly rotating their scapula more.  This is probably going to cause some impingement and irritation to the shoulder.  Here is a great example:

teres major tightness

 

Self-Myofascial Release and Soft Tissue Work for the Teres Major

So as much as I want to help you and work with you, I also want you to be able to manage this yourself a little bit.  Remember, we said earlier that you will lose motion after throwing, it’s all about managing this as best as you can.

A simple way to work on the teres major is to perform self-myofascial release to the muscle with a trigger point or lacrosse ball.  We often recommend you roll the back of the shoulder or posterior rotator cuff, but in my experience, we do not emphasize the teres major enough.  To do this you simply need to understand the anatomy of the muscle and adjust the placement of the ball.

I should note that I do not think foam rolling your lats will get your teres major very well.  The muscle is too short and situated up towards your armpit that it just doesn’t work well.  You need to get in there more focal with a smaller trigger point ball.

You can also read my article and video demonstration on self myofascial release for the teres major.

Self-myofascial release teres major

 

What Trigger Point Ball to Buy?

I typically use a couple of different trigger point balls, depending on how firm I want the ball to be.  I would recommend the softer balls for beginners and firmer for advanced users.  Here is what I recommend:

  • For Beginners: Trigger Point Therapy Massage Ball.  These are a little more expensive than lacrosse balls at about $15, but they are softer and have a little nub than you can wedge into different areas, which I like.  This is a good starting point, but the newer Trigger Point Therapy X-Factor Ball is a little larger and more firm.  I use these a lot.
  • For Advanced Users: SKLZ Reaction Ball.  You know those little yellow reaction balls that you drop and bounce all over the place?  A friend just recently turned me on to these as trigger point tools!  They work great!  They are firm and have great little nubs to really get in to the tissue.  Plus you can usually find them for under $10.
  • You can always just go with a simple lacrosse ball as well.  I think lacrosse balls are great, but they are pretty firm and don’t have a small nub to use, making them less than ideal for some areas.  That being said they are under $2!

 

Try working on the teres major or recommending this to your athletes, I bet you see improvement pretty quickly.  Working on the teres major soft tissue with some self-myofascial release techniques is an important, yet often overlooked, area to emphasize in baseball pitchers and other overhead athletes.

 

 

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Why and How to Stretch Before You Throw

Why and How to Stretch Before You ThrowAs baseball and softball season approaches, I wanted to address a few things that I think could really help your performance.  Today, we’ll discuss why you should be stretching before you throw, and more importantly, how to stretch before you throw.

 

If You Throw a Ball, You Will Get Tight

That is just a simple fact.  We actually proved this several years ago in an article in the American Journal of Sports Medicine.  We found that immediately after throwing a bullpen, pitchers lost 10 degrees of internal rotation of their shoulder.  The eccentric nature of decelerating after you throw produces damage to the muscles much like after what you feel when you get a good lift in, and are tight the next couple of days.

In a nutshell, your rotator cuff and other posterior shoulder muscles get tight from the trauma of throwing.  If this isn’t addressed, it is cumulative and will get tighter and tighter over time.

So what do we do about it?  I always recommend some good manual therapy, massage work, and “smart” stretching prior to throwing.  What if you don’t have someone to work with?  There are some stretches that I would recommend, and not recommend.

 

I Don’t Recommend the Sleeper Stretch

The sleeper stretch has become a very popularly recommended stretch for throwers.  I’ve discussed what I don’t like about the sleeper stretch in the past, but essentially, I feel like it was developed for inaccurate reasons as a tool to help with GIRD (glenohumeral internal rotation deficit) before we really understood that the answer the GIRD wasn’t to torque your shoulder into internal rotation

In the 1000’s of baseball pitchers I have worked with, I don’t use the sleeper stretch, aggressively stretch into internal rotation, or routinely mobilize the posterior capsule.  Honestly.  In fact, I have seen more people do more harm than good by overusing the sleeper stretch

In my experience, GIRD has more to do with muscular tightness and alignment than anything else.  Addressing these with good manual therapy is more successful and less stressful on the shoulder.

Here are some interesting related links to read:

I should say that I do think there is a time and place for the sleeper stretch, but it isn’t my first line of defense.  If you don’t have someone to work with that can help, try the below two warm up stretches prior to throwing instead of the sleeper stretch and see if it they help.

 

How to Stretch Before You Throw

Remember earlier I mentioned that the rotator cuff and posterior shoulder get tight from decelerating the arm when you throw?  That is what the focus of stretch it going to be on.  Here are two ways to work on this area, one a simple stretch, and the other a self-myofascial release technique.

 

The Genie Stretch

The first stretch is called the Genie Stretch.  Russ Paine, a great PT and friend in Houston showed me this one and wrote about it in his chapter in my book The Athlete’s Shoulder.  It is essentially a cross body stretch of the back of your arm.  However, you use the opposite arm to enhance the stretch and stabilize the arm.  Studies have shown that cross body stretching is more effective than the sleeper stretch at restoring your shoulder internal rotation (your GIRD).

To perform the exercise, cross your arms out in front of you with your throwing arm on the bottom.   In this position you’ll look like a genie (or at least the Genie from “I Dream of Genie,” not really the he genie from Aladdin…).   Grasp the back of your throwing elbow with your other hand and stretch across your body.  Your other arm pulls the arm across for the stretch and prevents the shoulder from rotating into external rotation.  Hold this stretch from 5-10 seconds and repeat 3-5 times.

YouTube Preview Image

Notice if you don’t stabilize the arm, your hand will want to drift up into external rotation as you come across the body.

 

The Trigger Point Stretch

Trigger Point Massage Ball

The next stretch is similar, however the focus is more on digging into the tissue with a trigger point ball than it is stabilizing the arm.  For this stretch you can use any type of ball.  Lacrosse balls and tennis balls work fine with varying amount of pressure.  But I do prefer either the Trigger Point Ball or one of the reaction balls with the nubs on them.

Skilz Reaction Ball

To perform this stretch, place the trigger point ball on the back of the shoulder and lean against a wall.  With the ball in place, perform the cross body stretch.  The trigger point ball acts as a deep tissue massage as you stretch the muscles.  You can play around with the position of both the ball and your arm to get a great trigger point release.  I like to find a good spot, hold for about 10 seconds, then perform the cross body stretch a few times with the ball in the same spot.  Do this in a few different spots.

YouTube Preview Image

That’s really it.  Try these two stretches before you throw instead of the sleeper stretch and see how you feel throwing.  If you are super tight and feel like you need to also do the sleeper stretch, that is fine, but if that is the case, you should probably seek some skilled help in working on your soft tissue.

 

 

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Shoulder Adaptations Over the Course of a Baseball Season

Today’s guest post by Chris Beardsley is a review of a recent study looking at the changes in shoulder joint range-of-motion that baseball players experience over the course of a season.  A timely post as the MLB season winds down.

 

The Study

Shoulder Adaptations Among Pitchers and Position Players Over the Course of a Competitive Baseball Season, by Laudner, Lynall and Meister, in Clinical Journal of Sports Medicine, 2012 [Pubmed]

 

Background

Baseball position players typically play daily during game season and while pitchers throw in games less frequently, they often throw on their rest days. Consequently, upper extremity injuries are common in baseball players, particularly among pitchers. And despite advances in both rehabilitation knowledge and surgical technology, the trend for such injuries appears to be increasing.

Researchers investigating upper extremity injuries in baseball players have previously reported alterations in shoulder function such as posterior shoulder tightness and scapular dyskinesis, both of which have been associated with a variety of shoulder pathologies.

 

What did the researchers do?

The researchers wanted to investigate whether posterior shoulder tightness and scapular position change over the course of a competitive baseball season in both baseball pitchers and in position players. So they recruited 16 asymptomatic, professional baseball pitchers and 16 asymptomatic, professional baseball position players. Neither group had any history of upper extremity injury in the last 6 months nor any history of upper extremity surgery.

The researchers measured scapular upward rotation and glenohumeral range of motion (ROM) using a digital inclinometer. They measured glenohumeral horizontal adduction ROM with the subjects supine on a table and the shoulder in 90 degrees of abduction and flexion with the scapula stabilized using a posterior force into the table. They measured bilateral glenohumeral internal rotation ROM in a similar set-up: in the supine position with the shoulder in 90 degrees of abduction and flexion and the scapula stabilized using a posterior force into the table.

The researchers measured bilateral forward scapular posture with the subjects standing against a wall and used the double-square method to establish the distance between the wall and the acromion of the scapula. They recorded the difference between the throwing and non-throwing arms for analysis. Finally, they measured scapular upward rotation of the throwing arm in a resting position as well as in the scapular plane at 60, 90, and 120 degrees of humeral elevation.

The researchers performed these measurements at two points in time: at the baseball players’ initial physical examination during spring training and within the final week of their competitive season.

 

What happened?

Glenohumeral horizontal adduction ROM

The researchers found that were no significant differences in the changes to glenohumeral horizontal adduction ROM between pitchers and position players over the course of the season. However, there was a trend for the pitchers to start the season with a greater ROM than position players, while the ROM at the end of the season was similar in both groups of players. This was caused by a reduction in the ROM of the pitchers.

 Glenohumeral adduction ROM

 

Bilateral internal rotation ROM

The researchers found that were no significant differences in the changes in bilateral internal rotation ROM between the pitchers and the position players over the course of the season. However, there was again a trend for the pitchers to start the season with a greater ROM than position players, while the ROM at the end of the season was similar in both groups of players. This was caused by a reduction in the ROM of the pitchers.

Bilateral glenohumeral internal rotation

 

Bilateral difference in forward scapular posture

The researchers did not note any significant differences in the changes to the bilateral difference of forward scapular posture between the pitchers and the position players over the course of the season. However, there was a trend for the pitchers to start the season with a greater ROM than position players, while the ROM at the end of the season was similar in both groups of players. This was caused by an increase in the ROM of the position players.

Bilateral difference in forward scapular posture

 

Scapular upward rotation

The researchers found that the pitchers displayed significantly lower increases in scapular upward rotation at 60 and 90 degrees of humeral elevation compared with the position players as a result of the baseball season. However, this appeared to result from the pitchers starting the season with a higher level of upward rotation and both groups finishing the season with similar degrees of upward rotation.

Scapular upward rotation

 

What did the researchers conclude?

The researchers concluded that pitchers developed significantly less scapular upward rotation at 60 and 90 degrees of humeral elevation over the course of a competitive baseball season compared with position players. The researchers propose that the increase in scapular upward rotation displayed by the position players may be a beneficial adaptation geared towards reducing their injury risk.

The researchers suggest that the absence of a similar increase in pitchers may make them more susceptible to shoulder injuries. However, it is important to note that the pitchers started the season displaying significantly greater levels of scapular upward rotation and the season only serves to bring the position players up to a similar level. An alternative interpretation of the results is therefore that the pitchers already have such adaptations, beneficial or not, and that the season’s activities bring the position players up to a similar level. Whether these adaptations are genetically determined or acquired over time is unclear.

Indeed, the researchers note that since posterior shoulder tightness causes the humerus to translate upwards into the subacromial space, it is possible that athletes perform increased scapular upward rotation in order to elevate the acromion and increase the available subacromial space. Therefore, it is possible that the adaptive process that was observed in this study in the position players was done for this reason and it is also possible that the pitchers did not require this adaptation, having sufficient subacromial space already.

 

Limitations

This study was clearly limited by the small sample size that precluded the observation of several large differences in the measured variables between position players and pitchers over the course of the season.

 

Key Points

Pitchers develop significantly less scapular upward rotation at 60 and 90 degrees of humeral elevation over the course of a competitive baseball season compared with position players. However, the increase in scapular upward rotation observed in the position players only brings their total amount of movement in line with the pitchers, who begin the season with a greater degree of upward rotation.

 

Mike’s Thoughts

Thanks Chris, I thought you did a great job summarizing this nice article.  Studies like this are extremely challenging to perform, more so than you would think.  There is inherently an issue with control over the course of a season.  Did every pitch the exact same amount of innings and games?  Did they all throw with the same velocity?  Since this is a ROM study, did they all stretch exactly the same and with the same exact frequency all season?

The answer to all of these questions is, “of course not.”  This is what makes this so challenging, we can only take the means of a large group and try to draw conclusions.  I do caution readers to take information like this with a grain of salt.

As my readers know, I work in baseball everyday, yet I seldom discuss baseball on this website.  I am not in a position that I can share all I have learned (yet at least!), but I can tell you that we have studied very similar trends as this study.  Players will loose motion over the course of a season, similar to what we showed acutely after one outing (see here and here).  The acute ROM changes can become cumulative over the course of a season.  However, a proper stretching program can maintain normal ROM over the course of a season.

 

About the author

Chris BeardsleyChris Beardsley is a co-founder of Strength and Conditioning Research, a monthly publication that summarizes the latest fitness research for strength and sports coaches, personal trainers, and physical therapists. Chris also writes a regular blog in which he reviews some of the latest developments in biomechanics.

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If you enjoyed this post, then you’ll love Strength and Conditioning Research, a monthly publication that summarizes recent journal publications just like this post.  Don’t let the name fool you, there are a ton of research reviews for rehabilitation as well.  Chris does an awesome job summarizing a ton of great articles every month.  I am a proud subscriber because it helps me stay current and I can read it on my iPad when I am on the go.  Learn more about Strength and Conditioning Research.

 

 

 

 

 

 

3 Ways to Gain Shoulder Internal Rotation – Without Stretching Into IR or the Posterior Capsule!

Inner Circle Premium Content

The latest webinar recording for Inner Circle members is now available below.

 

3 Ways to Gain Shoulder Internal Rotation – Without Stretching Into IR or the Posterior Capsule!

The below webinar will help you understand:

  • How to assess loss of internal rotation and if it is pathological
  • Why loss of IR motion occurs in overhead athletes
  • Why you don’t want to torque the shoulder into IR if you don’t have to
  • GIRD doesn’t always mean posterior capsular tightness
  • How posture impacts shoulder motion
  • Techniques to immediately gain internal rotation

 

To access the webinar, please be sure you are logged in and are a member of the Inner Circle program.