The Effect of Glenohumeral Internal Rotation Deficit Improving Rehabilitation Program in the Male High-School Baseball Players

Jin Young Lee; Li Na Kim; Hong Sun Song; Sung Hwan Kim; Myung Sup Choi; Seung Seok Woo

doi:10.5763/kjsm.2014.32.2.105

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Lee, Kim, Song, Kim, Choi, and Woo: The Effect of Glenohumeral Internal Rotation Deficit Improving Rehabilitation Program in the Male High-School Baseball Players

Clinical Article

Korean J Sports Med 2014;32(2):105-111.

Published online: 17 January 2014

DOI: https://doi.org/10.5763/kjsm.2014.32.2.105

The Effect of Glenohumeral Internal Rotation Deficit Improving Rehabilitation Program in the Male High-School Baseball Players

Jin Young Lee¹, Li Na Kim¹, Hong Sun Song², Sung Hwan Kim¹, Myung Sup Choi³, Seung Seok Woo⁴

¹ Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul

²Korea Institute of Sports Science, Seoul

³Environment and Occupational Medicine, Sahmyook Medical Center, Seoul

⁴Institute of Sports Science Health and Exercise, Seoul National University, Seoul, Korea

Correspondence: Li Na Kim Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, 82 Mangu-ro, Dongdaemun-gu, Seoul 130-711, Korea Tel: +82-2-2210-3134, Fax: +82-2-2210-3133 E-mail: magiclina@naver.com This work was done with the sports promotion fund from Korea Institute of Sport Science, Korea Sports Promotion Foundation (KISS-2012-15).

Received 22 July 2014 Revised 10 October 2014 Accepted 6 November 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

To investigate the effect of the glenohumeral internal rotation deficit (GIRD) improving rehabilitation program in high school baseball players on the change in muscle strength balance and pain of their shoulders. Seventy-six players (35 control group, 41 experimental group) participated in this 6-month study, from April, 2012 to September, 2012. The rehabilitation program (sleeper stretch) was carried out by coaches of experimental group. The experimental group showed a significant decrease, while the control group didn't show significant change in GIRD. The shoulder flexion-extension isokinetic strength ratio of experimental group changed only slightly, while that of control group experienced a bigger change. Experimental group players initially had high frequency of shoulder pain, but decreased to 53% at the end. Also, the Short Form-36 Health Survey showed the increase of total score. GIRD improving rehabilitation program helps to maintain the balance of shoulder extension-flexion strength ratio and relieve shoulder pain in the baseball players.

Keywords: Glenohumeral joint, Shoulder joint, Baseball, Shoulder pain, Quality of life

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Fig. 1.

Sleeper stretch exercise. The players lie on the throwing shoulder side with glenohumeral joint flexed at 90^o, with a 90^o internal rotation, and the elbow was flexed at 90^o. They hold their wrist with the opposite hand and slowly push the forearm towards the floor.

Fig. 2.

The frequency of pain location in the experimental group was assessed through a survey, conducted at the commencement of the rehabilitation program, and after 6 months. The incidence of shoulder pain decreased from 15 to 8 cases (a 53% decrease) after 6 months.

Table 1.

Demographic characteristics of subjects

Variable	Experimental group (n=41)	Control group (n=35)
Age (y)	16.62±0.94	17.0±1.06
Height (cm)	176.0±6.41	177.4±5.19
Weight (kg)	72.34±13.01	71.84±8.17
Body mass index (kg/cm²)	23.17±3.89	22.81±2.19
Years in baseball (y)	6.54±1.22	6.27±1.75

Values are presented as mean±standard deviation.

Table 2.

Initial shoulder ROM of internal rotation and external rotation

Group	Internal rotation (^o)		External rotation (^o)
Group	T-shoulder	NT-shoulder	T-shoulder	NT-shoulder
Experimental group	40.97±17.90^∗	47.53±14.63^∗	107.56±10.45^∗	98.76±10.48^∗
Control group	37.68±11.90^∗	47.66±11.91^∗	107.18±9.29^∗	100.03±8.67∗

Values are presented as mean±standrad deviation. ROM: range of motion, T-shoulder: throwing shoulder, NT-shoulder: non-throwing shoulder.∗p＜0.05 comparison between T-shoulder and NT-shoulder by paired t-test.

Table 3.

The glenohumeral internal rotation deficit (GIRD)

Group	GIRD (^o)
Group	Initial	After (°)
Experimental group	15.5±2.34	7.14±2.60∗
Control group	12.94±2.06	11.94±4.75

Values are presented as mean±standard deviation.

GIRD(°)=Non-throwing shoulder ROM of IR– Throwing shoulder ROM of IR, (GIRD>0°)

ROM: range of motion, IR: internal rotation.∗p＜0.05 comparison between initial and after 6 months by paired t-test.

Table 4.

The flexion-to-extension isokinetic strength ratio in throwing shoulder

Group	60 ^o/s angular velocity		180 ^o/s angular velocity
Group	Initial	After 6 mo	Initial	After 6 mo
Experimental group	0.87±0.11	0.79±0.13	0.79±0.07	0.73±0.11
Control group	0.81±0.12	0.66±0.29^∗	0.75±0.09	0.65±0.18^∗

Values are presented as mean±standard deviation.

^∗ p＜0.05 comparison between initial and after 6 months by paired t-test.

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