Usefulness of release push test in physical examination for throwing shoulder injury

Abstract

We aimed to determine the usefulness of release push test (RPT) in detecting shoulder pain in baseball players with throwing shoulder injury. Fifty-five baseball players with throwing shoulder injury were recruited. RPT entailed pushing the examinerʼs hand while simulating the hand position of releasing the ball during throwing. Full can, empty can test, hyper-external rotation test (HERT), Neer impingement sign, Hawkins impingement sign, and OʼBrien test were also performed. All tests were considered positive if shoulder pain was provoked during the test. The RPT positivity rate was 51%, which was the highest among all the tests. Ten patients had only RPT positive during the examination; it had the highest single positivity which was also seen with HERT. The players with RPT positivity reported significantly more shoulder pain after the cocking phase of throwing compared to players with HERT positivity who reported more shoulder pain in the cocking phase. This study suggested that RPT may be a useful pain provocation test to assess the start or change in strength of throwing because it showed high positivity rate and could detect specific pain in players with throwing shoulder injury.