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The American Journal of Sports Medicine 30:20-26 (2002)
© 2002 American Orthopaedic Society for Sports Medicine

Osseous Adaptation and Range of Motion at the Glenohumeral Joint in Professional Baseball Pitchers

Heber C. Crockett, MD{dagger},{ddagger}, Lyndon B. Gross, MD, PhD§, Kevin E. Wilk, PT§, Martin L. Schwartz, MD§, Jamie Reed, ATC||, Jay O’Mara, MD§, Michael T. Reilly, MD||, Jeffery R. Dugas, MD§, Keith Meister, MDa, Stephen Lyman, PhD|| and James R. Andrews, MD§

{dagger} Trailswest Sportsmedicine, Kearney, Nebraska, § American Sports Medicine Institute, Birmingham, Alabama, || Tampa Bay Devil Rays Baseball Club, Tampa Bay, Florida, a University of Florida Shands Clinic, Gainesville, Florida

Presented at the 26th annual meeting of the AOSSM, Sun Valley, Idaho, June 2000.

{ddagger} Address correspondence and reprint requests to Heber C. Crockett, MD, 2 Rolling Hills Road, Kearney, NE 68845

The throwing shoulder in pitchers frequently exhibits a paradox of glenohumeral joint motion, in which excessive external rotation is present at the expense of decreased internal rotation. The object of this study was to determine the role of humeral head retroversion in relation to increased glenohumeral external rotation. Glenohumeral joint range of motion and laxity along with humeral head and glenoid version of the dominant versus nondominant shoulders were studied in 25 professional pitchers and 25 nonthrowing subjects. Each subject underwent a computed tomography scan to determine bilateral humeral head and glenoid version. The throwing group demonstrated a significant increase in the dominant shoulder versus the nondominant shoulder in humeral head retroversion, glenoid retroversion, external rotation at 90°, and external rotation in the scapular plane. Internal rotation was decreased in the dominant shoulder. Total range of motion, anterior glenohumeral laxity, and posterior glenohumeral laxity were found to be equal bilaterally. The nonthrowing group demonstrated no significant difference in humeral head retroversion, glenoid retroversion, external rotation at 90° or external rotation in the scapular plane between shoulders, and no difference in internal rotation at 90°, total motion, or laxity. A comparison of the dominant shoulders of the two groups indicated that both external rotation at 90° and humeral head retroversion were significantly greater in the throwing group.




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