Pitching shoulder passive flexibility: torque-angle analysis for external rotation and internal rotation.

In this study, a custom device was developed to analyse the pitching shoulder's external rotation (ER) and internal rotation (IR) passive flexibility. We analysed three novel measures: the resistance onset angle (ROA = angle where the shoulder begins stretching), rotational stiffness, and torque at the end range of motion (ROM). The purpose was to conduct a bilateral analysis to determine if there are significant differences between the throwing and non-throwing shoulder. Participants were 30 upper level pitchers (13 division I, 17 minor league). During testing, pitchers laid supine on a treatment table and the arm was secured to a rotational wheel with the shoulder abducted 90° and elbow flexed 90°. Dependent t-tests revealed significant (p < 0.01) and relatively extreme bilateral differences for all three variables. The throwing shoulder had: increased ER ROA (9°), decreased IR ROA (5.3°), increased ER stiffness (17%), increased IR stiffness (34%), increased ER torque (21%), and increased IR torque (30%). Secondary correlation analysis was completed to determine if the torque-angle variables were good predictors of the end ROM. Stiffness correlations were weak for ER (r = 0.35, p = 0.048) and IR (r = 0.42, p = 0.017) but ROA correlations were strong for ER (r = 0.85, p < 0.001) and IR (r = 0.86, p < 0.001).

Developing reliable measures of the passive torque-angle relationship for shoulder internal and external rotation: Implications for overhead athletics.

OBJECTIVES: 1) Thoroughly assess shoulder flexibility by establishing the passive torque-angle relationship for internal and external rotation with the arm in an overhead athletics position (abducted 90°) and 2) test the reliability of four passive torque-angle measures. DESIGN: Reliability study. SETTING: Data were collected in a university biomechanics laboratory. PARTICIPANTS: Bilateral shoulder flexibility of 15 male college students (20.7 ±â€¯1.1 y) was evaluated twice in two sessions over 7-10 days. MAIN OUTCOME MEASURES: For both ER and IR, reliability was assessed bilaterally (intra-session, inter-session, and inter-tester) for the traditional range of motion measure and three novel kinetic measures: torque at end ROM, resistance onset angle, rotational stiffness. This resulted in 48 total assessments. RESULTS: Thirty-four assessments had good to excellent reliability (ICC ≥ 0.8), 10 had fair reliability (0.7 ≤ ICC < 0.8), and 4 had poor reliability (ICC< 0.7). Three of the four flexibility measures had a good overall ICC score: ROM (0.83), torque at end ROM (0.84), and resistance onset angle (0.81). The fourth, stiffness, had a fair overall reliability score (0.74). CONCLUSIONS: The passive torque-angle measures should be assimilated into clinical and research settings to determine the relevance to injury, rehabilitation, and performance.