Biomechanical characteristics of scapula and glenohumeral movements during pitching motion in injury-prone college baseball pitchers

Coordination of glenohumeral and scapular movements plays an important role in the injury prevention of baseball pitchers. However, there is no objective data establishing the direct relationship between pitching injuries and associated glenohumeral and scapular movements. Therefore, the objectives of the present study were to demonstrate biomechanical differences in scapular and glenohumeral movements during pitching between injury-prone pitchers and healthy college baseball pitchers. Thirty collegiate baseball pitchers were classified into two groups according to their injury status: injury-prone group (N=15, 20.7{+/-}1.4 years, 180.1{+/-}6.5 cm, 78.9{+/-}5.4 kg) and control group (N=15, 20.9{+/-}1.1 years, 177.1{+/-}6.6 cm, 72.3{+/-}6.7 kg). We obtained the pitching motion data using the three-dimensional motion analysis technique with four high-speed cameras. The horizontal abduction angles of the glenohumeral joint during cocking and acceleration phases were significantly greater in injury-prone pitchers [19.0{degrees} (95% CI: 14.4-23.6) at foot contact, -4.0{degrees} (95% CI: -7.7 to -0.2) at maximum external rotation (MER), and -0.3{degrees} (95% CI: -4.8 to -4.2) at ball release] than in healthy controls [11.7 {degrees}(95%CI:7.1 to 16.3) at foot contact, -10.0{degrees}(95%CI: -13.7 to -6.3) at MER, and -6.9{degrees}(95%CI: -11.4 to -2.4)](p<0.01). In addition, the external rotation angle (ER) of the scapula at MER was significantly greater in the injury-prone group [-0.1{degrees} (95% CI: -5.0 to 4.8)] than in the control group [-12.3{degrees} (95% CI: -17.2 to -7.4)] (p<0.01), but there was no difference in the scapular ER during foot contact between the two groups. These results suggests that injury-prone pitchers have less internal rotation of the scapula and more horizontal abduction of the glenohumeral joint during cocking and acceleration phases. Therefore, sports medicine practitioners may need to pay more attention to coordination of scapular and glenohumeral movements during the cocking and acceleration phases of pitching for prevention of shoulder injuries.