{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:01:25Z","timestamp":1792130485634,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T00:00:00Z","timestamp":1504224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T00:00:00Z","timestamp":1504224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T00:00:00Z","timestamp":1504224000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","arthroscopyjournal.org","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The primary aims of this work were to (1) describe normal range of motion (ROM) profiles for elite pitchers, (2)\u00a0describe the characteristics of shoulder and elbow injuries in professional pitchers over a 6\u2010year period in one Major League Baseball organization, and (3) identify ROM measures that were independently associated with a future shoulder or elbow injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Over 6 seasons (2010\u20102015), a preseason assessment was performed on all pitchers invited to Major League Baseball Spring Training for a single organization. ROM measures included shoulder flexion, horizontal adduction, external rotation (ER), internal rotation, as well as elbow flexion and extension, were measured for both the dominant and nondominant arm, and total range of motion and deficits were calculated. All noncontact shoulder and elbow injuries were identified. Using multivariate binomial logistic regression analysis to control for age, height, weight, and all other ROM measures, the factors associated with an increased risk of subsequent shoulder or elbow injury were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 53 shoulder (n\u00a0= 25) and elbow (n\u00a0= 28) injuries occurred during 132 pitcher seasons (n\u00a0=\u00a081 pitchers). The most significant categorical risk factor associated with increased elbow injury rates was the presence of a shoulder flexion deficit &gt;5\u00b0 (odds ratio [OR] 2.83;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .042). For continuous variables, the risk of elbow injury increased by 7% for each degree of increased shoulder ER deficit (OR 1.07;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .030) and 9% for each degree of decreased\u00a0shoulder flexion (OR 1.09;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .017). None of the measures significantly correlated with shoulder injuries.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preseason shoulder ER and flexion deficits are independent risk factors for the development of elbow injuries during the upcoming season. Although prior work has supported the importance of reducing glenohumeral internal rotation deficits in pitchers, this study demonstrates that deficits in shoulder ER and flexion are more significant predictors of subsequent elbow injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2017.03.025","type":"journal-article","created":{"date-parts":[[2017,8,31]],"date-time":"2017-08-31T14:02:14Z","timestamp":1504188134000},"page":"1629-1636","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":81,"title":["Decreased Shoulder External Rotation and Flexion Are Greater Predictors of Injury Than Internal Rotation Deficits: Analysis of 132 Pitcher\u2010Seasons in Professional Baseball"],"prefix":"10.1002","volume":"33","author":[{"given":"Christopher L.","family":"Camp","sequence":"first","affiliation":[{"name":"Mayo Clinic Department of Orthopedics Sports Medicine Center Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Zajac","sequence":"additional","affiliation":[{"name":"New York Mets Baseball Club New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Pearson","sequence":"additional","affiliation":[{"name":"New York Mets Baseball Club New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alec M.","family":"Sinatro","sequence":"additional","affiliation":[{"name":"Sports Medicine and Shoulder Service Hospital for Special Surgery New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M.","family":"Spiker","sequence":"additional","affiliation":[{"name":"Sports Medicine and Shoulder Service Hospital for Special Surgery New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Werner","sequence":"additional","affiliation":[{"name":"Sports Medicine and Shoulder Service Hospital for Special Surgery New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Altchek","sequence":"additional","affiliation":[{"name":"Sports Medicine and Shoulder Service Hospital for Special Surgery New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Struan H.","family":"Coleman","sequence":"additional","affiliation":[{"name":"Sports Medicine and Shoulder Service Hospital for Special Surgery New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua S.","family":"Dines","sequence":"additional","affiliation":[{"name":"Sports Medicine and Shoulder Service Hospital for Special Surgery New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,1]]},"reference":[{"key":"e_1_2_2_2_2","first-page":"116","article-title":"Injury trends in Major League Baseball over 18 seasons: 1998\u20102015","volume":"45","author":"Conte S.","year":"2016","journal-title":"Am J Orthop"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465010290040801"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511411700"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510384223"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515594380"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514538391"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546505279921"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513493249"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508326712"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2015.12.519"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2011.11.035"},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-15-00292"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-44.6.611"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511408876"},{"key":"e_1_2_2_16_2","unstructured":"Shitara H Kobayashi T Yamamoto A et al. 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