Glenohumeral Internal Rotation Deficit on Pitching Biomechanics and
                    Muscle Activity

Yi-Hsuan Weng; Tsun-Shun Huang; Cheng-Ya Huang; Hsing-Yu Chen; Yung-Shen Tsai; Jiu-Jenq Lin

doi:10.1055/a-1667-6080

International Journal of Sports Medicine, Table of Contents

Int J Sports Med
DOI: 10.1055/a-1667-6080

Orthopedics & Biomechanics

Glenohumeral Internal Rotation Deficit on Pitching Biomechanics and Muscle Activity

Authors

Yi-Hsuan Weng

¹School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
Tsun-Shun Huang

²Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
Cheng-Ya Huang

¹School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
Hsing-Yu Chen

³Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
Yung-Shen Tsai

⁴Graduate Institute of Sports Sciences, University of Taipei, Taipei, Taiwan
Jiu-Jenq Lin

¹School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

³Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan

Abstract

To characterize the scapular pitching biomechanics in symptomatic GIRD pitchers (SG) compared to asymptomatic GIRD (ASG) and healthy pitchers. The scapular kinematics and associated muscle activities during pitching were recorded in 33 high school pitchers. Compared to healthy, GIRD pitchers had less scapular posterior tilt in each pitching event (average difference, AD=14.4°, p<0.01) and ASG demonstrated less scapular upward rotation at ball release (AD=12.8°, p<0.01) and greater muscle activity in the triceps brachii in the early-cocking phase (AD=9.9%, p=0.015) and in the serratus anterior in the late-cocking phase (AD=30.8%, p<0.01). Additionally, SG had less muscular activity on triceps brachii in the acceleration phase and serratus anterior in the cocking phase (AD=37.8%, p=0.016; AD=15.5%, p<0.01, respectively) compared to ASG. GIRD pitchers exhibited less scapular posterior tilt during pitching, which may cause impingement. Since tightness of the anterior shoulder is a common cause of inadequacy of posterior tilt during arm elevation, stretching exercise of the anterior shoulder is recommended. Given the inadequate recruitment during pitching in the GIRD pitchers, symptoms may develop following potential impingement.

Key words

scapular kinematics - triceps brachii - serratus anterior - cocking phase - acceleration phase

Full Text

References

References
1 Olsen SJ, Fleisig GS, Dun S. et al. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am J Sports Med 2006; 34: 905-912
2 Saper MG, Pierpoint LA, Liu W. et al. Epidemiology of shoulder and elbow injuries among United States High School Baseball Players: School years 2005–2006 through 2014–2015. Am J Sports Med 2018; 46: 37-43
3 Kibler WB, Sciascia A. Evaluation and management of scapular dyskinesis in overhead athletes. Curr Rev Musculoskelet Med 2019; 12: 515-526
4 Lin DJ, Wong TT, Kazam JK. Shoulder injuries in the overhead-throwing athlete: epidemiology, mechanisms of injury, and imaging findings. Radiology 2018; 286: 370-387
5 Oyama S. Baseball pitching kinematics, joint loads, and injury prevention. J Sport Health Sci 2012; 1: 80-91
6 Seroyer ST, Nho SJ, Bach BR. et al. The kinetic chain in overhand pitching: its potential role for performance enhancement and injury prevention. Sports health 2010; 2: 135-146
7 Astolfi MM, Struminger AH, Royer TD. et al. Adaptations of the shoulder to overhead throwing in youth athletes. J Athl Train 2015; 50: 726-732
8 Freehill MT, Archer KR, Diffenderfer BW. et al. Changes in collegiate starting pitchers’ range of motion after single game and season. Phys Sportsmed 2014; 42: 69-74
9 Meister K, Day T, Horodyski M. et al. Rotational motion changes in the glenohumeral joint of the adolescent/Little League baseball player. Am J Sports Med 2005; 33: 693-698
10 Oyama S, Hibberd EE, Myers JB. Changes in humeral torsion and shoulder rotation range of motion in high school baseball players over a 1-year period. Clin Biomech (Bristol, Avon) 2013; 28: 268-272
11 Reinold MM, Wilk KE, Macrina LC. et al. Changes in shoulder and elbow passive range of motion after pitching in professional baseball players. Am J Sports Med 2008; 36: 523-527
12 Shanley E, Thigpen CA, Clark JC. et al. Changes in passive range of motion and development of glenohumeral internal rotation deficit (GIRD) in the professional pitching shoulder between spring training in two consecutive years. J Shoulder Elbow Surg 2012; 21: 1605-1612
13 Thomas SJ, Swanik CB, Swanik K. et al. Change in glenohumeral rotation and scapular position after a Division I collegiate baseball season. J Sport Rehabil 2013; 22: 115-121
14 Thomas SJ, Swanik KA, Swanik C. et al. Change in glenohumeral rotation and scapular position after competitive high school baseball. J Sport Rehabil 2010; 19: 125-135
15 Thomas SJ, Swanik KA, Swanik CB. et al. Internal rotation deficits affect scapular positioning in baseball players. Clin Orthop Relat Res 2010; 468: 1551-1557
16 Wilk KE, Macrina LC, Fleisig GS. et al. Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers. Am J Sports Med 2011; 39: 329-335
17 Wilk KE, Reinold MM, Macrina LC. et al. Glenohumeral internal rotation measurements differ depending on stabilization techniques. Sports Health 2009; 1: 131-136
18 McClure P, Balaicuis J, Heiland D. et al. A randomized controlled comparison of stretching procedures for posterior shoulder tightness. J Orthop Sport Phys Ther 2007; 37: 108-114
19 Tyler TF, Nicholas SJ, Lee SJ. et al. Correction of posterior shoulder tightness is associated with symptom resolution in patients with internal impingement. Am J Sports Med 2010; 38: 114-119
20 Harryman DT, Sidles JA, Clark JM. et al. Translation of the humeral head on the glenoid with passive glenohumeral motion. J Bone Joint Surg Am 1990; 72: 1334-1343
21 Borich MR, Bright JM, Lorello DJ. et al. Scapular angular positioning at end range internal rotation in cases of glenohumeral internal rotation deficit. J Orthop Sport Phys Ther 2006; 36: 926-934
22 Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther 2000; 80: 276-291
23 Escamilla RF, Andrews JR. Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports. Sports Med 2009; 39: 569-590
24 Alberta FG, ElAttrache NS, Bissell S. et al. The development and validation of a functional assessment tool for the upper extremity in the overhead athlete. Am J Sports Med 2010; 38: 903-911
25 Du WY, Huang TS, Chiu YC. et al. Single-Session video and electromyography feedback in overhead athletes with scapular dyskinesis and impingement syndrome. J Athl Train 2020; 55: 265-273
26 Schüldt K, Harms-Ringdahl K. Activity levels during isometric test contractions of neck and shoulder muscles. Scand J Rehabil Med 1988; 20: 117-127
27 Kendall FP, McCreary EK, Provance PG. Muscles: Testing and Function with Posture and Pain. Lippincott Williams & Wilkins; 2010
28 Wu G, van der Helm FC, Veeger HE. et al. ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion–Part II: shoulder, elbow, wrist and hand. J Biomech 2005; 38: 981-992
29 Oliver G, Weimar W. Scapula Kinematics of Youth Baseball Players. J Hum Kinet 2015; 49: 47-54
30 Dillman CJ, Fleisig GS, Andrews JR. Biomechanics of pitching with emphasis upon shoulder kinematics. J Orthop Sport Phys Ther 1993; 18: 402-408
31 Lin HT, Lin YC, Chou YL. et al. Effect of Glenohumeral internal rotation deficit on shoulder in baseball pitchers during fastball pitching. Int J Environ Res Public Health 2020; 8211
32 Lin JJ, Hanten WP, Olson SL. et al. Functional activity characteristics of individuals with shoulder dysfunctions. J Electromyogr Kinesiol 2005; 15: 576-586
33 Faherty MS, Plata A, Chasse P. et al. Upper extremity musculoskeletal characteristics and the kerlan-jobe orthopaedic clinic questionnaire score in collegiate baseball athletes. J Athl Train 2019; 54: 945-952
34 Fronek J, Yang JG, Osbahr DC. et al. Shoulder functional performance status of Minor League professional baseball pitchers. J Shoulder Elbow Surg 2015; 24: 17-23
35 Henning L, Plummer H, Oliver GD. Comparison of scapular muscle activations during three overhead throwing exercises. Int J Sports Phys Ther 2016; 11: 108-114
36 Oliver GD, Plummer H, Henning L. et al. Effects of a simulated game on upper extremity pitching mechanics and muscle activations among various pitch types in youth baseball pitchers. J Pediatr Orthop 2019; 39: 387-393
37 Oliver GD, Weimar WH, Plummer HA. Gluteus medius and scapula muscle activations in youth baseball pitchers. J Strength Cond Res 2015; 29: 1494-1499
38 Shin YA, Choi WH. Effects of weighted baseball throwing during warm-up on ball velocity and upper extremity muscle activation in baseball pitchers. J Exerc Rehabil 2018; 14: 436-444
39 Digiovine NM, Jobe FW, Pink M. et al. An electromyographic analysis of the upper extremity in pitching. J Shoulder Elbow Surg 1992; 1: 15-25
40 Gowan ID, Jobe FW, Tibone JE. et al. A comparative electromyographic analysis of the shoulder during pitching. Professional versus amateur pitchers. Am J Sports Med 1987; 15: 586-590
41 Jobe FW, Moynes DR, Tibone JE. et al. An EMG analysis of the shoulder in pitching. A second report. Am J Sports Med 1984; 12: 218-220