Comparison of Peak Shoulder Distraction Forces Between Pain and Pain-Free Youth Baseball Pitchers

BACKGROUND: Increased shoulder distraction force during a baseball pitch may make a pitcher susceptible to rotator cuff or glenohumeral labral injuries. A precursor to a pitching injury may be pain experienced in the throwing arm. PURPOSE: To (1) compare peak shoulder distraction (PSD) forces in youth baseball pitchers with and without upper extremity pain when throwing a fastball and (2) assess if PSD forces across trials differ between pain and pain-free groups. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 38 male baseball pitchers aged 11 to 18 years were separated into a pain-free group (n = 19; mean age, 13.2 ± 1.7 years; mean height, 163.9 ± 13.5 cm; mean weight, 57.4 ± 13.5 kg) and a pain group (n = 19; mean age, 13.3 ± 1.8 years; mean height, 164.9 ± 12.5 cm; mean weight, 56.7 ± 14.0 kg). Pitchers in the pain group indicated that they experienced pain in their upper extremity while throwing a baseball. Pitching mechanical data from 3 fastballs per pitcher were recorded with an electromagnetic tracking system and motion capture software. The mean PSD (mPSD) was calculated as the mean PSD of 3 pitches per pitcher, the trial with the highest recorded PSD was determined as the maximum-effort PSD (PSDmax), and the PSD range (rPSD) was defined as the difference of the PSD force of the trial with the highest PSD and the lowest PSD for each pitcher. The PSD force was normalized to the pitcher’s body weight (%BW). Pitch velocity was also recorded. RESULTS: The mPSD force was 114%BW ± 36%BW for the pain group and 89%BW ± 21%BW for the pain-free group. Pitchers in the pain group exhibited a significantly higher PSDmax force (t(30.548) = 2.894; P = .007) and mPSD force (t(29.231) = 2.709; P = .009) compared with those in the pain-free group. There were no significant between-group differences in the rPSD force or pitch velocity. CONCLUSION: The normalized PSDmax force was higher in pitchers who experienced pain while throwing fastballs compared with pitchers who were pain-free while throwing. CLINICAL RELEVANCE: Baseball pitchers who experience pain in their throwing arm are likely to have higher shoulder distraction forces. Improvement in pitching biomechanics and corrective exercises may assist in the mitigation of pain while pitching.