Tuesday, April 16, 2013

A Technique to Increase Internal Rotation Range of Motion in Baseball Players

This baseball season is in full swing including high school, college, and professional baseball. Only a few weeks into Major League season, there are quite a few players put on DL. Shoulder and elbow are among the most injured joints in baseball players especially pitchers. Many of those injuries are chronic in nature and, thanks to many research studies, we know more about what happens to throwing shoulders from repetitive stress and what risk factors may be. Many of baseball pitchers develop a loss of internal rotation (IR) range of motion (ROM) as a result of repetitive throwing. Studies suggest that GIRD (glenohumeral internal rotation deficit) of more than 5 degrees may put baseball pitchers in more risk of shoulder injury. GIRD is a loss of total shoulder ROM (IR + ER) compared to the non-throwing shoulder. What this tells us is that it is important to keep ROM in both shoulders relatively close and, in order to do so, it is necessary to keep stretching the external rotators and posterior capsule. There are some techniques to stretch. Sleeper stretch and passive internal rotation stretch are shown to be effective. Also cross arm stretch is another way to stretch posterior capsule. A study published in 2011 suggests that not only passive stretching the muscle energy technique may be effective in gaining shoulder IR and horizontal adduction ROM. According to this study, the muscle energy technique into horizontal abduction increases both shoulder IR and horizontal adduction ROM immediately. This does not mean that other stretching methods such as sleeper stretch and passive stretching are not good. However, the muscle energy technique can provide effective way to relieve a loss of ROM in baseball pitchers.