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  • Title: Estimation of Shoulder Behavior From the Viewpoint of Minimized Shoulder Joint Load Among Adolescent Baseball Pitchers.
    Author: Tanaka H, Hayashi T, Inui H, Muto T, Ninomiya H, Nakamura Y, Yoshiya S, Nobuhara K.
    Journal: Am J Sports Med; 2018 Oct; 46(12):3007-3013. PubMed ID: 30095975.
    Abstract:
    BACKGROUND: During pitching, an overloaded joint reaction force exerted on the shoulder and excessive shoulder horizontal abduction at ball release are considered risk factors causing anterior shoulder pain for young baseball pitchers. Hypothesis/Purpose: The first aim was to examine the relationship between shoulder horizontal abduction position and force on the shoulder at ball release. The second was to identify the relative rotational position of the shoulder and the range of shoulder motion at ball release that minimize force on the shoulder. It was hypothesized that the amount of force on the shoulder would be exacerbated by excessive shoulder horizontal abduction. STUDY DESIGN: Descriptive laboratory study. METHODS: Participants were 183 adolescent baseball pitchers (mean ± SD age, 15.5 ± 1.2 years) without shoulder/elbow problems. Each pitcher threw 5 fastballs to a catcher behind a home plate. The kinematics and kinetics of the throwing shoulder during fastball pitching were calculated with 3-dimensional measurements from 36 reflective markers. In data analysis, the correlations were calculated between the relative rotational positions of the shoulder (abduction, horizontal adduction-abduction) and the forces on the shoulder (anterior-posterior, proximal, and superior-inferior) at ball release. Subsequently, the specific rotational position and range of motion of the shoulder at ball release that minimized forces on the shoulder were determined. RESULTS: Statistically significant correlations were identified between the magnitude of superior-inferior force on the shoulder and shoulder abduction position ( R2 = 0.44, P < .001) as well as between the magnitude of anterior-posterior force on the shoulder and shoulder horizontal adduction-abduction position ( R2 = 0.72, P < .001). Minimal anterior-posterior and superior-inferior forces were obtained with a combination of 80.6° of shoulder abduction and 10.7° of shoulder horizontal adduction. Any deviation >5° from this position significantly increased the anterior-posterior and superior-inferior forces on the shoulder. CONCLUSION: Increasing shoulder horizontal abduction position significantly increased the magnitude of anterior force on the shoulder at ball release. The combination of 80.6° of shoulder abduction and 10.7° of horizontal shoulder adduction minimized the shear forces on the shoulder at this point. CLINICAL RELEVANCE: The present data can be useful for screening pitching technique to prevent shoulder pain and injury with motion capture assessment.
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