Physical findings associated with pain in professional baseball pitchers

Abstract

Introduction: Medical checkups were performed in professional baseball pitchers to identify physical findings associated with pain during assessment of pain reproducibility.

Subjects and methods: The study was conducted in 191 professional baseball pitchers not complaining of throwing pain, who underwent medical checkups after the play season during the 13 years from 2004 to 2016. Eleven test items of physical findings of throwing shoulder used at our hospital were assessed. Subjects whose pain could and could not be reproduced in the impingement test and hyper-external rotation test (HERT), which are used to assess pain reproducibility, were grouped into a pain group and non-pain group, respectively. The proportion of subjects with abnormalities in each test was compared between the two groups.

Results: The proportion of subjects with abnormalities in the following tests was significantly higher in the pain group than in the non-pain group: loosening test (LOOSE), which is used to assesses joint instability, elbow extension test (EET) and elbow push test (EPT), which are used to assess scapular function, and external rotation (ER) test and supraspinatus (SSP) test, which are used to assess rotator cuff function. In addition, the proportion of subjects with abnormalities in the combined abduction test (CAT) and horizontal flexion test (HFT), which are used to assess the range of motion of the shoulder joint, was high in both groups, with no significant difference.

Discussion: In professional baseball pitchers, limited range of motion of the shoulder joint was common, regardless of the presence or absence of pain in the assessment of pain reproducibility, and findings of pain reproduction are considered to be caused by increased findings of joint instability, scapular dysfunction and rotator cuff dysfunction based on the limited range of motion of the shoulder joint.