An athlete performs their best when their body is at its best. Therefore, protecting the athlete from overuse injury is (or should be) a primary concern in sports. For baseball players, monitoring the arm is a big deal. Baseball players, especially pitchers, can put their arms through the ringer with repetitive and forceful throwing motions. The stress of repeated throwing can cause microtrauma in soft-tissue structures. This puts players at risk for chronic injury (1-4) and excessive stretching of the soft-tissue. Chronic stretching of the anterior capsule and tightening of the posterior capsule can lead to trauma creating instability and impingement (1, 10). Due to stressful overhead throwing, baseball players can experience glenohumeral internal rotation deficits (GIRD) in the dominant arm. GIRD is a condition resulting in the loss of internal rotation of the glenohumeral joint as compared to the contralateral side (1, 5, 6, 8, 9).

Therefore, full body assessments, as well as gauging multi-joint movement quality, are popular and common practice among sports medicine (1, 7). These evaluations provide an athlete, as well as coaches and trainers, with an idea of how their body is handling play. Common screening assessments used are the Functional Movement Screen (FMS) and Selective Functional Movement Screen (SFMA). FMS is used to determine stability and identify imbalances in a player’s movement (1). Whereas, SFMA can be used to diagnose musculoskeletal dysfunction (1). The question is, how reliable are these tools in identifying risk of overuse in baseball players? A group of scientists decided to investigate and come up with a potential answer – looking to see if pre-season scores for FMS or SFMA could provide accurate information on risk for in-season overuse symptoms.

Let’s take a look at the science

The 2017 study, assessed 60 male NCAA Division III collegiate baseball players during pre- and competitive season. Screenings were done during a 2-week period before the start of official team practices. FMS and SFMA scores were divided into ratings of “good” and “poor”. To track overuse symptoms and pain severity, weekly questionnaires were provided to each player throughout pre- and competitive season. (1) All scores were tallied and assessed at the end of the study and here is what they found:

FINDINGS

During preseason, poor FMS and SFMA scores showed a statistically significant relationship to an increased probability of experiencing at least one overuse symptom. However, during competitive season, only poor SFMA scores showed the same statistically significant relationship. The study noted a player’s position and year in college did not influence score results. (1)

So, what does this mean?

This study suggests players scoring poorly on FMS and SFMA screens are more likely to report symptoms (such as pain) of overuse during preseason. Additionally, this study suggests SFMA screens may be better to use when evaluating during competitive season; Players scoring poor in SFMA screens are suggested to experience at least one overuse symptoms during competitive season. (1) The study’s findings highlight the importance of upper extremity movement screens to help detect increasing risk of overuse symptoms in baseball players during pre- and competitive season. These results can help formulate a treatment plan for players to recover pain-free movement and function.

Now, all that being said, we must remember scientific reports can be very informative, but scientific studies cannot be perfect. Meaning, one study cannot account for everything. For example, this study had a very focused cohort: college male athletes. So if women, middle aged people, or amateur athletes were included, concluding results may have varied. This study also used questionnaires, and as subjective the subjects may have tried to be, everyone can be a bit bias or experience pain differently. Therefore, questionnaire reports may not be 100% accurate.  This was also a limited study, only evaluating players during a single season. In addition, factors such as fatigue, conditioning level, pitch counts and throwing velocities were not considered in the study. This does not mean we should discount what this study has suggested, but simply consider how we apply their conclusions to our own athletic lifestyle.

What can I do?

What this study shows us is it important to utilize the tools we have – such as functional testing – to protect athletes. Yes, one such tool can be simply asking – “Hey do you have any pain?”. However, not every athlete will answer that question the same. Knowing someone feels pain, lets us know something is wrong, but it is a vague understanding. We need to know what the body is experiencing. So, what you can do, is use all the tools available to understand what is happening on the inside. There are many testing options to choose from, all providing excellent information on the functionality and risk factor a person’s body is experiencing. Keeping yourself or your team off the bench doesn’t need to be a guessing game. If we monitor the health and function of our athletes, we can keep them on the field.

Thank you for reading! I hope you feel more informed. If you have any questions or concerns, please feel free to leave a shout out!

 

 

REFERENCES

  1. Busch, A. M., Clifton, D. R., Onate, J. A., Ramsey, V. K., & Cromartie, F. (2017). RELATIONSHIP OF PRESEASON MOVEMENT SCREENS WITH OVERUSE SYMPTOMS IN COLLEGIATE BASEBALL PLAYERS. International journal of sports physical therapy, 12(6), 960–966.
  2. Byram I Bushnell B Dugger K, et al. Preseason shoulder strength measurements in professional baseball pitchers: Identifying players at risk for injury. Am J Sports Med. 2010;38(7): 1375-1382.
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  4. Vogelpohl RE Kollock RO. Isokinetic rotator cuff functional ratios and the development of shoulder injury in collegiate baseball pitchers. Intl J Ath Ther & Train. 2015; 20(3): 46-52.
  5. Magnusson S Gleim G Nicholas J. Shoulder weakness in professional baseball pitchers. Med Sci Sports Ex. 1994;26(1): 5-9.
  6. Escamilla RF Andrews JR. Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports. Sports Med. 2009:39(7), 569-590.
  7. Kiesel KB Butler RJ Plisky PJ. Prediction of injury by limited and asymmetrical fundamental movement patterns in American football players. J Sport Rehab. 2014;23(2): 88-94.
  8. Crockett H Gross L Wilk K, et al. Osseous adaptation and range of motion at the glenohumeral joint in professional baseball pitchers. Am J Sports Med, 2002;30(1):20-26.
  9. Park S Loebenberg M Rokito A, et al. The shoulder in baseball pitching. Biomechanics and related injuries. Part 1. Bulletin NYU Hosp Jt Dis. 2002;61(1/2): 68-79.
  10. Myers JB Laudner KG Pasquale MR, et al. Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. Am J Sports Med. 2006;34 (3): 385-391.