Review of Shoulder Range of Motion in the Throwing Athlete: Distinguishing Normal Adaptations from Pathologic Deficits

Purpose of Review: Overhand (OH) throwers demonstrate a unique motion profile of the shoulder joint complex. This manuscript reviews normal adaptations in the OH thrower and contrast findings with pathologic motion deficits. Recent Findings: Multiple adaptations in range of motion have been associated with increased risk for arm injury. The use of a more conservative cutoff value for glenohumeral internal rotation deficit and horizontal adduction in younger throwers may help reduce injury risk. Deficits in glenohumeral internal rotation, total range of motion, shoulder flexion, and external rotation insufficiency have all been proposed as means to identify OH throwers at risk for arm injury, but conflicting evidence exists. Summary: Understanding normal adaptation due to repetitive stress of throwing is essential to effective management of these athletes. Adaptive change in bone and soft tissues is normal and contributes to the unique motion profiles expected in throwers. The causative link between normal adaptation and shoulder and elbow injury remains uncertain.