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Elbow Range of Motion in Professional Baseball Pitchers

Rick W. Wright, MD^*,, Karen Steger-May, MS, Brett L. Wasserlauf, MD, Mark E. O’Neal, ATC, Barry W. Weinberg, ATC^|| and George A. Paletta, MD

From the Department of Orthopaedics, the Division of Biostatistics, Washington University, St. Louis, Missouri, the Chicago Cubs Baseball Team, Chicago, Illinois, and the ^|| St. Louis Cardinals Baseball Team, St. Louis, Missouri

^* Address correspondence to Rick W. Wright, MD, Department of Orthopaedic Surgery, Washington University School of Medicine, One Barnes-Jewish Hospital Plaza, West Pavillion, Suite 11300, West Pavilion, St. Louis, MO 63110 (e-mail: rwwright1{at}aol.com).

Background: Physicians involved with the care of baseball players have noted elbow range of motion changes in pitchers. Objective data regarding the extent of these changes have rarely been documented.

Hypothesis: Dominant and nondominant elbow range of motion differences are common in baseball pitchers, and these differences are related to player age, amount and length of time professionally pitched, and history of surgical procedures on the dominant extremity.

Study Design: Cross-sectional study; Level of evidence, 4.

Methods: Thirty-three professional pitchers were evaluated for elbow range of motion during spring training preseason physical examination. Dominant and nondominant elbow range of motion including flexion, extension, supination, and pronation were measured with a goniometer. Range of motion measures from the dominant and nondominant sides were compared. Baseball records were reviewed for arm dominance, age, years of professional pitching, professional innings pitched, and history of elbow surgery. These factors were evaluated for their possible association with range of motion for each side and the difference between sides.

Results: Statistically significant differences between dominant and nondominant sides were noted for elbow extension (dominant decreased 7.9° ± 7.4°, P < .0001), flexion (dominant decreased 5.5° ± 7.8°, P = .0003), and total flexion-extension arc (dominant decreased 13.3° ± 13.7°, P < .0001). No significant difference between sides was found for the supination or pronation measures. No correlation was noted for age, pitching history, surgery, or arm dominance and the motion differences.

Conclusion: Professional pitchers demonstrate elbow flexion and extension differences between dominant and nondominant elbows. No correlation was found between motion differences and age, pitching history, surgery, or arm dominance.

Key Words: pitcher • elbow • range of motion

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