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04 Jun2014

04 June 2014.

Written by Willem-Paul Wiertz
Posted in Shoulder

04-06-2014 08:30:00
Rotational ROM can adapt considerably to repetitive overhead throwing (Image by: bigleaguesacademy.com)

Glenohumeral motion deficits: friend or foe?

A GIRD has long been pointed to as a common cause of throwing injuries – in recent literature however, this concept has been challenged and further refined. Other additional measures may help provide a more accurate representation of alterations in ROM that may occur.

Although the rotational arc can differ between the dominant and non-dominant shoulder, a side to side difference in TROM of >5 degrees in either direction contributes to a greater risk for sustaining a throwing injury. Moreover, a Glenohumeral External Rotation Gain of more than 5 degrees is normal – a gain of < 5 degrees in the dominant shoulder is pointed to as an External Rotation Deficit (ERD).

If a GIRD is present, and there is an accessory loss in TROM or an increase in ERD, the condition is pathologic. There is no definitive consensus yet on the threshold value: relative (>20% loss of internal rotation or >10% loss of TROM) and absolute measures (>18 degrees loss of internal rotation), as well as ratios (the side to side difference in internal rotation divided by external rotation) are used. > From: Manske et al., Int J Sports Phys Ther 8 (2013) 537-553. All rights reserved to The Author(s). 

Visit the Pubmed summary or see a few of our earlier posts for more information. Want to read more? Click here for the free full text version!

Measurement of the rotational ROM of the shoulder
(Image by: topvelocity.net)

Tags: Shoulder, pathology, GIRD, Overhead throwing, TROMD, Throwing injuries

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About the Author
Willem-Paul Wiertz

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