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Shoulder News

Using Preseason Strength Values to Predict In-Season Shoulder Injuries

The front page of a newspaper may have all the local and world news but for millions of sports fans, it's the sports page that gets attention over breakfast or morning coffee. Wins, losses, records, and placement in the standings are carefully reviewed. Newspaper, television, and radio all report on the health and any injuries of key players.

During baseball season, major and minor league pitchers have a special place in the news. A shoulder or elbow injury (the two most common types of injuries in these players) can put a pitcher out of the game. The loss of a pitcher can put the team at a disadvantage that can affect the win/loss ratio for the entire season.

The fans are disappointed, the team is distressed, and the owners stand to lose money if the team doesn't do well. That's why the results of this study may be very important for baseball fans, team players, and owners alike. What was the study? Sports orthopedic surgeons investigated the effect of preseason shoulder strength on the risk of in-season throwing-related injuries.

After looking over what's already known about shoulder (throwing or pitching) injuries, they decided to see if weak shoulder muscles during preseason are linked with in-season problems. To test their ideas out, they measured the shoulder range-of-motion of 144 baseball pitchers.

All measurements were taken before the season began for five years in a row (2001-2005). Then they compared strength data with in-season injuries to see if there was a link between the two. Baseball pitchers from both major and minor leagues were included. Anyone who had a previous shoulder injury requiring surgery was followed closely to see if having shoulder surgery once before resulted in more shoulder injuries later.

As it turns out, a history of shoulder surgery did not mean the pitcher was more likely to reinjure that arm. But preseason muscle weakness in any player does point to the potential for increased risk of in-play shoulder injuries. The shoulder muscles that were important included muscles of the rotator cuff that externally rotate the arm (the cocked-back position needed to throw the ball forward).

Only injuries that occurred during pitching were included in this study. Injuries were not counted if a player ran into someone else or hurt himself while running or by falling. Players were divided into three groups: 1) those who had no injury, 2) pitchers who had an injury that could be treated conservatively, and 3) injuries that required surgery.

They found that shoulder injuries requiring surgery were more likely to occur when muscles used to externally rotate the shoulder (cock the arm back to throw) were weak. An imbalance between internal and external rotator muscle strength (one group stronger or weaker than the other) was a red flag that weakness could lead to injury. This finding has been reported in many other studies as well.

Professional baseball pitchers also end up in surgery when the supraspinatus muscle is weak. The supraspinatus muscle is one of the four muscles of the rotator cuff. Its major function is to abduct the arm. Abduct means the arm moves away from the body.

It's no surprise that pitchers who repeatedly throw the ball in an overhead motion suffer from shoulder and/or elbow injuries. The authors of this study are among many sports health care specialists who are trying to find ways to reduce those injuries and keep the players in the game.

Preseason strengthening of the rotator cuff and muscles of the elbow/forearm may be the answer. Strong muscles help reduce the force and load placed on the joints during overhead throwing activities. Since all players normally participate in a strengthening and conditioning program, the next task is to find out what type of preseason exercise works best. Identifying players with weakness is the first step towards targeting those pitchers who might be at increased risk for injury.


Ian R. Byram, MD, et al. Preseason Shoulder Strength Measurements in Professional Baseball Pitchers. Identifying Players at Risk for Injury. In The American Journal of Sports Medicine. July 2010. Vol. 38. No. 7. Pp. 1375-1382.


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*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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