Researchers at Hospital for Special Surgery Receive Grant to Study Shoulder Rehabilitation for Pitchers

New York, NY—August 1, 2016

A team led by Stephen Fealy, MD, and Hospital for Special Surgery (HSS) has been awarded the Orthopaedic Research and Education Foundation (OREF) Prevention of Youth Sports Injuries Grant in honor of Dr. James Andrews. The $138,500 grant will go towards gaining a better understanding of structural and functional changes that occur during rehabilitation in order to reduce the risk of injuries in young adolescent baseball pitchers.

Over half of pitchers suffer from shoulder injuries during a given season, leading to pain, disability and loss of time from baseball. Shoulder pain typically stems from the overuse motion of throwing overhand.

"There is very little known about how rehabilitation affects scapula (shoulder) motion during pitching and if pitch count can increase the risk of re-injury," said principle investigator of the study Stephen Fealy, MD, sports medicine surgeon at HSS. "Our goal is to collect data to help inform sports medicine physicians about the effectiveness of rehabilitation in young athletes who haven’t undergone surgery in order to help decrease the risk of re-injury."

Current MLB Pitch Smart guidelines1 state that adolescent pitchers (aged 15-18) should not exceed 100 innings in any 12-month period. The recommended daily pitch limit for 15-16 year olds is 95 per game and 105 for 17-18 year olds. Additionally, players should take at least two to three continuous months off from all overhead throwing each year.

The investigational team developed a unique light-weight scapula tracker to measure scapulothoracic (ST) kinematics during pitching.

"Past studies on baseball pitching kinematics have primarily focused on 2D data such as video or simply the relationship between pitching and ball velocity," added Dr. Fealy, also a consultant for the MLB Players Association and co-founder of MLB Pitch Smart. "In our study, we are utilizing our custom scapula tracker to gather more comprehensive data as we know the 3D motion of the scapula during pitching is a key contributor to shoulder pain."

The HSS researchers developed this novel protocol to measure the effect of pitch count on shoulder function, rotational strength and performance in healthy adolescent pitchers in a simulated game. The investigators recruited 12 baseball pitchers aged 15 to 18 years with no history of shoulder pain for the pilot study. Each participant in the control group threw 90 pitches and was evaluated for possible fatigue and change in ball velocity.

The objective is to apply this protocol to a group of young baseball pitchers with a loss of internal rotation of shoulders (glenohumoral internal rotation deficit, or GIRD) who have undergone rehabilitation and compare 3D functional, performance and strength measures. For this next phase of the study, investigators will recruit 20 symptomatic GIRD high school male baseball pitchers between 15 and 18 years of age.

Upon recruitment, participants will be evaluated on structural and strength measures, kinematic assessment of the scapula coupling, and physical therapy rehabilitation. After the therapy team approves the participant’s return to sport (typically 14-32 weeks later), the participant will return to the HSS Motion Analysis Lab to perform the full pitching protocol.

While geared around baseball pitchers, the findings could also be applied to other overhead athletes such as tennis players and football quarterbacks.

The other investigators include Andreas Kontaxis, PhD, and Howard Hillstrom, PhD.