Asymptomatic Loss of Range of Motion in Junior Athletes

Loss of range of motion (ROM) after acute injury is very common primarily due to swelling and pain. And it usually returns back to normal when inflammation is relieved. For instance, an athlete with acute ankle sprain may display swelling and loss of immediate ROM and it will be to where it was before injury when swelling and pain are gone. However, loss of ROM due to chronic conditions such as frozen shoulder may be more difficult to relieve. One of the reason is that it is developed over a long time and there may be some changes in structure and properties of sift tissue.

But some athletes may display loss of ROM and may not have any symptoms. So, it this bad?? It is not necessarily bad if they do not complain any symptoms which may include pain, decreased performance level, stiffness, etc. However, some research has shown that loss of ROM in certain joint may be linked to possible risk of injury. In overhead athletes such as baseball, softball, and tennis, it is very common to have loss of range of shoulder internal rotation in the dominant shoulder. Instead, usually those athletes will have increased shoulder external rotation compared to the other shoulder. Looking at the total ROM from internal to external rotation end range, if one side has more than 15 degrees less motion than the other side, it is called GIRD (glenohumeral internal rotation deficit) and some research has shown that those athletes may be more prone to an shoulder injury.

Overhead athletes and some athletes like gymnasts may also display loss range of elbow extension compared to the other side. Elbow extension in the dominant arm in overhead athletes may be less than that of non-dominant arm. This may be due to joint capsule tightness and/or forearm muscle tightness (pronator-flexor mass) as a result of repetitive use of the elbow, which can be relieved by stretching exercise. At the same time, it could be as result of early stage of OCD, Panner's disease, bone spur in the olecranon (back of the elbow) which could develop from repetitive stress placed in the joint during overhead motion. Some gymnasts may display loss of elbow ROM without any symptoms probably from repetitive weight-bearing, which puts compressive stress on the outside of the elbow, distraction forces on the inside of the elbow, and overloads between olecranon and humerus. Loss of ROM without any symptoms may not mean that they will need an immediate medical attention but it may be something that needs an eye kept on especially loss of motion is significantly less than the other side. When it is symptomatic in young athletes or elbow does not fully extend (extension is less than 0), they should be seen by a health care provider to find out what is causing it and correct it. Symptomatic loss motion likely indicate some type of injury or condition that needs an attention.

Asymptomatic loss ROM is often ignored until it becomes symptomatic. This may not need an immediate attention as long as it is asymptomatic, however, some literature shows that ROM loss in certain joint may be linked to risk of injury. Loss of ROM in young athletes is certainly something that we need to keep an eye on even when it is asymptomatic.