Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Health Care Sciences - Physical Therapy Department

First Advisor

Fernandez-Fernandez, Alicia

Publication Date / Copyright Date

12-2015

Publisher

Nova Southeastern University

Abstract

Background: Baseball players exhibit a more posteriorly oriented humeral head or humeral retrotorsion (HRT) in the dominant arm, likely representing an adaptive response to the stress of throwing. This adaptation is thought to occur while skeletally immature, however there is limited research detailing how throwing while young influences the development HRT. In addition, it is currently unclear how this changing osseous orientation influences shoulder motion within young athletes. Purpose: To determine the influence of throwing and age on the development of asymmetry in HRT and shoulder range of motion (ROM); and analyze the relationship between HRT and ROM. Study Design: Cross-sectional age matched study Methods: Healthy athletes (8-14 years-old) were categorized into two groups based upon sports participation; throwing group (n=85) and non-throwing group (n=68). Bilateral measurements of HRT, shoulder external (ER), internal rotation (IR) and total range of motion (TROM) at 90° were performed using diagnostic ultrasound and digital inclinometer. A two-way analysis of variance was performed with throwing status (yes/no) and age group (youth (8-10.5), junior (10.51-12) and senior (12.01-13.99)) as primary factors. Dependent variables were asymmetry (dominant-non-dominant) in HRT,ER, IR and TROM. The relationship between ROM and HRT was analyzed using Pearson correlation coefficients. Results: Throwing athletes demonstrated a larger degree of HRT on the dominant side, resulting in greater asymmetry (8.7° versus 4.6°). Throwing athletes demonstrated a gain of ER (5.2°), a loss of IR (6.0°) and no change in TROM when compared to the non-dominant shoulder. Pairwise comparisons identified altered HRT and shoulder ROM in all age groups of throwers. A significant but weak relationship between HRT and shoulder ROM existed. Conclusion: Throwing causes adaptive changes in HRT and shoulder ROM in youth baseball players at a very young age. Other factors in addition to HRT influence shoulder motion within this population. Clinical Relevance: In baseball players, an altered arc of motion can be expected at a young age. This adaptation is in part due to changes in osseous structures, however a larger component of change is likely due to other factors.

Disciplines

Physical Therapy

Keywords

Health and environmental sciences, Baseball, Humeral retrotorsion, Humeral torsion, Pediatrics, Range of motion Shoulder

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