The Relationship Between Maximum Shoulder Horizontal Abduction and Adduction on Peak Shoulder Kinetics in Professional Pitchers

BACKGROUND: Repetitive horizontal shoulder abduction during pitching can cause increased contact between the posterosuperior aspect of the glenoid and the greater tuberosity of the humeral head, theoretically putting baseball pitchers at increased risk of shoulder internal impingement and other shoulder pathologies. HYPOTHESIS: Increased shoulder horizontal abduction is associated with increased shoulder anterior force, while increased horizontal adduction is associated with increased shoulder distraction force. STUDY DESIGN: Descriptive laboratory study. LEVEL OF EVIDENCE: Level 4. METHODS: A total of 339 professional baseball pitchers threw 8 to 10 fastball pitches using 3D motion capture (480 Hz). Pitchers were divided into 2 sets of quartiles based on maximum shoulder horizontal abduction and adduction. Elbow flexion, shoulder external rotation, and peak shoulder kinetics were compared between quartiles with post hoc linear regressions conducted for the entire cohort. RESULTS: At maximum shoulder horizontal abduction, there was no difference in ball velocity between quartiles ( = 0.76). For every 10º increase in maximum shoulder horizontal abduction, shoulder anterior force decreased by 2.2% body weight (BW) ( \u3c 0.01, B = -0.22, β = -0.38), shoulder adduction torque decreased by 0.5%BW × body height (BH) ( \u3c 0.01, B = -0.05, β = -0.19), and shoulder horizontal adduction torque decreased by 0.4%BW × BH ( \u3c 0.01, B = -0.04, β = -0.48). For every 10º increase in maximum shoulder horizontal adduction, shoulder anterior force increased by 2%BW and ball velocity decreased by 1.2 m/s (2.7 MPH). CONCLUSION: Professional pitchers with the least amount of maximum horizontal adduction had faster ball velocity and decreased shoulder anterior force. Pitchers with greater maximum shoulder horizontal abduction had decreased shoulder anterior force, shoulder adduction torque, and shoulder horizontal adduction torque. To maximize ball velocity as a performance metric while minimizing shoulder anterior force, pitchers can consider decreasing maximum shoulder adduction angles at later stages of the pitch. CLINICAL RELEVANCE: Identifying risk factors for increased throwing shoulder kinetics (ie, shoulder anterior force, shoulder adduction torque) has potential implications in injury prevention. Specifically, mitigating shoulder anterior forces may be beneficial in reducing risk of injury