The Effect of a High Pitch Volume on Musculoskeletal Adaptations in High School Baseball Pitchers

Abstract

Background: Shoulder range of motion and strength adaptations occur at an early age in baseball pitchers. Purpose/Hypothesis: The purpose of this study was to examine the effect of pitch volume on in-season and year-to-year range of motion (ROM) and strength adaptations in high school baseball pitchers. The hypothesis was that a high pitch volume will not affect range of motion asymmetries but will impair supraspinatus strength. Study Design: Cohort study; Level of evidence, 2. Methods: Pre- and postseason ROM and strength measures were performed on pitchers from 3 high schools for 4 consecutive seasons, for a total of 95 player-seasons (mean ± SD participant age, 16 ± 1 years). Preseason measures were repeated the next year on players returning to the teams, for a total of 71 consecutive player-seasons. ROM tests included internal-external rotation and posterior shoulder flexibility. Strength tests (hand-held dynamometer) included internal-external rotation, supraspinatus, and scapular retraction. Pitchers were categorized by pitch count for the season (high, >400; moderate, 180-400; low, <180). ROM and strength changes in the dominant versus nondominant arm were assessed by analysis of variance. Results: Dominant versus nondominant ROM differences did not change from pre- to postseason (P = .36-.99) or from one year to the next (P = .46-.86), with no effect of pitch volume (P = .23-.87). Supraspinatus strength decreased in the dominant arm during the season, with 13% loss in high-volume pitchers (P < .001) and insignificant losses in moderate- (6%) and low-volume pitchers (2%). Strength in other tests was unaffected by pitch volume. Consistent with physical development, strength increased bilaterally from one year to the next (supraspinatus, 12%; external rotation, 15%; internal rotation, 14%; scapular retraction, 23%; P < .001). Supraspinatus strength gain in the dominant arm was affected by prior pitch volume (P = .02): 24% in low-volume pitchers (P < .01), with no significant change in moderate-volume (0%; P = .99) or high-volume (5%; P = .99) pitchers. Conclusion: Dominant versus nondominant ROM differences did not progress during the season, or from one year to the next, and were unaffected by pitch volume. A high pitch volume was associated with in-season supraspinatus weakness and diminished strength gains from one year to the next. In conclusion, a high pitch volume appeared to have a catabolic effect on supraspinatus strength.