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Glenohumeral Instability and Arm Pain in Overhead Throwing Athletes: A Correlational Study
Authors:Max Wardell  Doug Creighton  Carter Kovalcik
Affiliation:1. Overhead Athletic Institute ; 2. Physical Therapy Oakland University
Abstract:BackgroundThe overhead activity of throwing a baseball is arguably the most demanding athletic endeavor placed on the glenohumeral (GH) joint. Previous studies illustrate that 75-80% of baseball players will experience some degree of upper extremity (UE) pain. GH instability is thought to play a role.PurposeThe purpose of this study was to investigate the relationship between GH joint hypermobility and instability with measures of arm pain and performance in overhead throwing athletes.MethodsActively competing baseball pitchers were recruited and evaluated once with the anterior-posterior Load and Shift examination procedure, the Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow Questionnaire (KJOC), and the Functional Arm Scale for Throwers (FAST). Multivariate analysis was performed to identify correlation between severe GH capsular laxity (GH instability), mild capsular laxity (GH hypermobility), no capsular laxity (GH normal), and presence of shoulder pain when pitching.Study DesignCross-sectional Study.ResultsForty-five pitchers were evaluated, 62.2% of throwing shoulders were classified normal stability, 26.7% were classified hypermobile, and 11.1% were classified unstable. Average KJOC scores for pitchers with the three mobility categories were 66.1 (normal), 59.7 (hypermobile), and 45.0 (unstable). Average FAST scores among the pitchers were 19.9 (normal), 34.2 (hypermobile), and 32.2 (unstable). Pitchers with GH instability and GH hypermobility demonstrated increased arm pain compared to athletes with normal GH joints; KJOC scores of 3.2, 5.5, and 7.4 (p = 0.0007), respectively.ConclusionPitchers with GH instability and hypermobility demonstrated significantly increased ratings of arm pain compared to pitchers with no capsular laxity.Level of Evidence3b
Keywords:Glenohumeral   instability   hypermobility   overhead throwing athletes   baseball pitchers   Load and Shift Assessment   FAST   KJOC   pain
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