{"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":1792130485098,"version":"4.4.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2015,3,25]],"date-time":"2015-03-25T00:00:00Z","timestamp":1427241600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Dominant shoulder glenohumeral internal rotation deficit (GIRD) has been associated with pitching arm injuries. The relationship of humeral torsion on development of GIRD is not clear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>Pitchers displaying GIRD will display greater humeral retrotorsion when compared with those without GIRD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cross-sectional study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Humeral torsion and shoulder range of motion (ROM) were measured in 222 professional pitchers before spring training from 2009 to 2012. Shoulder external rotation (ER) and internal rotation (IR) ROM were assessed in 90\u00b0 of abduction with the scapula stabilized. Humeral torsion was measured via ultrasound using previously described and validated methods. Side-to-side differences in total arc of motion (ER + IR), ER, and IR ROM and humeral torsion were calculated as nondominant minus dominant arm measures for analysis. Pitchers were classified as having GIRD if their dominant arm displayed an IR deficit \u226515\u00b0 concomitant with a total arc of motion deficit \u226510\u00b0 compared with their nondominant arm. A mixed-model analysis of variance (side \u00d7 GIRD) was used to compare dominant and nondominant humeral torsion between pitchers with GIRD (n = 60) and those without GIRD (n = 162). Independent t tests were used to compare the side-to-side difference in humeral torsion between pitchers with GIRD and those without GIRD (\u03b1 = 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Pitchers with GIRD displayed significantly less humeral torsion (ie, greater retrotorsion) in their dominant arm as compared with those without GIRD (GIRD = 4.5\u00b0 \u00b1 11.8\u00b0, no GIRD = 10.4\u00b0 \u00b1 11.7\u00b0; P = .002). Pitchers with GIRD also displayed a greater side-to-side difference in humeral torsion (GIRD = 19.5\u00b0 \u00b1 11.9\u00b0, no GIRD = 12.3\u00b0 \u00b1 12.4\u00b0; P = .001). However, pitchers with GIRD did not display an increase in dominant ER ROM (dominant ER = 131.8\u00b0 \u00b1 14.3\u00b0, nondominant ER 126.6\u00b0 \u00b1 13.1\u00b0) when compared with those without GIRD (dominant ER = 132.0\u00b0 \u00b1 14.2\u00b0, nondominant ER 122.6\u00b0 \u00b1 13.1\u00b0; P = .03). Pitchers with GIRD displayed expected alterations in ROM (IR = 28.8\u00b0 \u00b1 9.6\u00b0, total arc = 160.6\u00b0 \u00b1 15.4\u00b0; P &lt; .01 for both) when compared with those without GIRD (IR = 39.9\u00b0 \u00b1 9.9\u00b0, total arc = 171.2\u00b0 \u00b1 15.5\u00b0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Pitchers with GIRD displayed greater side-to-side differences and dominant humeral retrotorsion as compared with those without GIRD. The greater humeral retrotorsion may place greater stress on the posterior shoulder resulting in ROM deficits. Pitchers with greater humeral retrotorsion appear to be more susceptible to developing ROM deficits associated with injury and may need increased monitoring and customized treatment programs to mitigate their increased injury risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0363546515575020","type":"journal-article","created":{"date-parts":[[2015,3,26]],"date-time":"2015-03-26T06:07:29Z","timestamp":1427350049000},"page":"1448-1454","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":76,"title":["Professional Pitchers With Glenohumeral Internal Rotation Deficit (GIRD) Display Greater Humeral Retrotorsion Than Pitchers Without GIRD"],"prefix":"10.1177","volume":"43","author":[{"given":"Thomas J.","family":"Noonan","sequence":"first","affiliation":[{"name":"Steadman Hawkins Clinic Denver, Greenwood Village, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Shanley","sequence":"additional","affiliation":[{"name":"Proaxis Therapy, Greenville, South Carolina, USA"},{"name":"South Carolina Center for Rehabilitation and Reconstruction Science, Greenville, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lane B.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Memorial Hermann Ironman Sports Medicine Institute, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas J.","family":"Wyland","sequence":"additional","affiliation":[{"name":"Steadman Hawkins Clinic of the Carolinas, Greenville, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Kissenberth","sequence":"additional","affiliation":[{"name":"Steadman Hawkins Clinic of the Carolinas, Greenville, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Steadman Hawkins Clinic of the Carolinas, Greenville, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles A.","family":"Thigpen","sequence":"additional","affiliation":[{"name":"Proaxis Therapy, Greenville, South Carolina, USA"},{"name":"South Carolina Center for Rehabilitation and Reconstruction Science, Greenville, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,3,25]]},"reference":[{"key":"bibr1-0363546515575020","doi-asserted-by":"publisher","DOI":"10.1177\/036354659702500504"},{"key":"bibr2-0363546515575020","doi-asserted-by":"publisher","DOI":"10.1249\/01.mss.0000180890.69932.15"},{"key":"bibr3-0363546515575020","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2011.3357"},{"key":"bibr4-0363546515575020","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2003.50128"},{"key":"bibr5-0363546515575020","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2007.2449"},{"key":"bibr6-0363546515575020","doi-asserted-by":"publisher","DOI":"10.1123\/jsr.16.1.41"},{"key":"bibr7-0363546515575020","doi-asserted-by":"publisher","DOI":"10.1177\/03635465020300011701"},{"issue":"7","key":"bibr8-0363546515575020","first-page":"340","volume":"39","author":"Drakos MC","year":"2010","journal-title":"Am J Orthop (Belle Mead 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