Rotational motion changes in the glenohumeral joint of the adolescent/little league baseball player

Background: Differences in range of motion and rotational motion between the dominant and nondominant shoulders in throwing athletes are well documented, although the age at which these changes begin to occur is not known. Hypothesis: Changes in glenohumeral rotational motion in the shoulder of the Little League/adolescent baseball player occur during the most formative years of physical development. Study Design: Cross-sectional study. Methods: Elevation, internal rotation at 90 degrees of abduction, and external rotation at 90 degrees of abduction were measured in the dominant and nondominant shoulders of 294 baseball players, aged 8 to 16 years. Results: Analysis of variance revealed 2-way interactions between arm dominance by age for elevation (P = .005) and internal rotation (P = .001). Significant differences were noted between dominant and nondominant arms for internal rotation at 90 degrees (P = .001) and external rotation at 90 degrees (P = .001). Elevation, internal rotation at 90 degrees external rotation at 90 degrees, and total range of motion varied significantly (P = .001) among age groups. Elevation in the dominant arms of 16-year-olds was on average 5.3 degrees less than in 8-year-olds (179.6 degrees vs 174.3 degrees). In the nondominant arms, mean elevation for 16-year-olds was 5.6 degrees less than in 8-year-olds (179.7 degrees vs 174.1 degrees). Internal rotation at 90 degrees for the dominant arms averaged 39.0 degrees at age 8 and only 21.3 degrees at age 16. In the nondominant arms, internal rotation for 8-year-olds averaged 42.2 degrees and only 33.1 degrees for 16-year-olds. Conclusions: Elevation and total range of motion decreased as age increased. These changes may be consequences of both bone and soft tissue adaptation. The most dramatic decline in total range of motion was seen between the 13-year-olds and 14-year-olds, in the year before peak incidence of Little Leaguer's shoulder. This decrease in rotational motion may cause increased stress at the physis during throwing.