What specific shoulder movements were found to be most predictive of injury risk, and why are they so important?

The research highlighted that deficits in shoulder external rotation (ER) and shoulder flexion were particularly significant predictors of injury risk. Increased elbow injury rates were observed in pitchers with shoulder ER deficits greater than 5° and shoulder flexion deficits greater than 5°. These movements are crucial because they reflect the shoulder's ability to withstand the extreme forces involved in throwing. Proper shoulder rotation and flexion ensure the shoulder joint has the necessary flexibility and stability to handle the stress, thus preventing injuries.

How can preseason shoulder assessments help reduce injury rates, and what specific parameters should be measured?

Preseason shoulder assessments can significantly reduce injury rates by identifying modifiable risk factors early on. The study suggests measuring total range of motion (TROM) in the shoulder and elbow. Specifically, assessing shoulder external rotation (ER) and shoulder flexion deficits is crucial. By identifying these deficits before the season begins, athletes and trainers can implement targeted interventions such as stretching and strengthening exercises to mitigate the risk of injury.

Beyond shoulder rotation and flexion, what other factors were identified as contributors to injury risk in baseball pitchers?

Besides shoulder rotation and flexion, the study also identified other contributing factors to injury risk in baseball pitchers. Increased internal rotation (IR) deficit, higher weight, and decreased shoulder ER were also found to play a role in predicting injury risk. These factors, when combined with deficits in ER and flexion, paint a more complete picture of the factors that can contribute to injury.

What is the significance of Glenohumeral Internal Rotation Deficits (GIRD) in the context of shoulder health and injury prevention, and how does it relate to the other findings of the study?

While the study focused on shoulder rotation and flexion, it's important to understand GIRD, as it is a well-known risk factor. GIRD refers to a loss of internal rotation in the shoulder. It's often seen in baseball pitchers due to the repetitive throwing motion, which can tighten the posterior capsule of the shoulder. GIRD can lead to increased stress on the shoulder joint, potentially increasing the risk of injury. The findings of this study complement the understanding of GIRD by highlighting the importance of a balanced approach to shoulder health, which includes assessing both ER and flexion along with addressing potential deficits in IR.

How can athletes and trainers take actionable steps based on the study's findings to improve shoulder health and optimize performance in baseball?

Based on the study's findings, athletes and trainers can take several actionable steps. First, implement regular preseason ROM assessments, focusing on shoulder ER and flexion. Second, develop targeted stretching and strengthening programs to address any identified deficits. Third, adopt a holistic approach to player wellness, including proper warm-up and cool-down routines, adequate rest and recovery, and attention to overall physical conditioning. By proactively addressing these factors, athletes and trainers can significantly reduce injury risk and optimize performance, leading to healthier and more successful seasons.

Surreal image of a pitcher's arm transforming into a healthy tree branch, representing shoulder health and flexibility.

Unlocking Peak Performance: How Shoulder Health Predicts Injury Risk in Baseball

Beau Callahan in Health & Wellness December 2025 • 4 min read.

"New research reveals the critical role of shoulder rotation and flexion in preventing injuries, offering insights for athletes and trainers."

In the high-stakes world of professional baseball, even the slightest physical advantage can be the difference between a winning season and a career setback. For pitchers, the intricate mechanics of throwing place immense stress on the shoulder and elbow, making them particularly vulnerable to injuries. Recognizing and addressing modifiable risk factors is crucial for preventing these injuries and ensuring players remain at the top of their game.

While much attention has been given to Glenohumeral Internal Rotation Deficits (GIRD), a new study published in The Orthopaedic Journal of Sports Medicine sheds light on the broader impact of shoulder range of motion (ROM) on injury risk. The research delves into the predictive capacity of shoulder and elbow ROM, offering valuable insights for trainers, coaches, and athletes alike.

This article explores the key findings of the study, translating complex research into practical advice for maintaining shoulder health and optimizing performance. Whether you're a seasoned athlete, a dedicated coach, or simply a baseball enthusiast, understanding these principles can help you play smarter and stay healthier.

Why Shoulder Rotation and Flexion Matter for Injury Prevention

Surreal image of a pitcher's arm transforming into a healthy tree branch, representing shoulder health and flexibility.

The study, conducted over six seasons (2010-2015), involved a comprehensive preseason assessment of ROM in 132 pitcher-seasons within a Major League Baseball (MLB) organization. Researchers meticulously measured total range of motion (TROM) and identified deficits, while also tracking non-traumatic shoulder and elbow injuries that resulted in time off the field. By using multivariate binomial logistic regression analysis, they were able to isolate the factors that significantly increased the risk of subsequent injuries, even when controlling for age, height, and weight.

The results revealed some compelling insights into the relationship between shoulder ROM and injury risk. Specifically, the study highlighted the following key findings:

Increased Elbow Injury Rates: Pitchers with a shoulder ER deficit greater than 5° (OR 2.40; p=0.069) and a shoulder flexion deficit greater than 5° (OR 2.83; p=0.042) showed a significant increase in elbow injury rates.
Impact of Shoulder ER Deficit: Increasing shoulder ER deficit (OR 1.07, p=0.030) was identified as a significant factor, indicating that the greater the deficit, the higher the risk.
The Role of Decreased Shoulder Flexion: Decreased shoulder flexion (OR 1.09, p=0.017) also emerged as a critical factor, underscoring the importance of maintaining flexibility in this movement.
Other Contributing Factors: Increased IR deficit (OR 1.04, p=0.068), weight (OR 1.10, p=0.012), and decreased shoulder ER (OR 1.06; p=0.076) also played roles in predicting injury risk.

These findings underscore the importance of a balanced and comprehensive approach to shoulder health, emphasizing that deficits in external rotation and flexion are particularly significant predictors of injury. It also highlights the role of simple preseason ROM assessments.

Taking Action: Protecting Your Shoulders and Enhancing Performance

The study's conclusion reinforces the idea that preseason ROM parameters are independent risk factors for shoulder and elbow injuries. By identifying and addressing deficits in shoulder ER and flexion, athletes and trainers can proactively mitigate these risks. Implementing regular ROM assessments, targeted stretching and strengthening exercises, and a holistic approach to player wellness can pave the way for healthier, more successful seasons. Prioritizing shoulder health isn't just about injury prevention; it's about unlocking peak performance and ensuring long-term success on the field.