Throwers can be a challenging client for full return to sport. In order to facilitate your plan of care development, check out this complimentary video from TSPT Academy on advanced exercises for pitchers.
The Shoulder
Range of Motion
ROM Using a Goniometer (Norkin and White, 2006): Flexion: 180 degrees Extension: 50 degrees Abduction: 180 degrees Adduction: Not usually measured Internal Rotation in 90 degrees shoulder abduction: 50-65 GH External Rotation in 90 degrees shoulder abduction: 90 GH
Cluster for Patients with Shoulder Pain Likely to Benefit from Cervicothoracic Manipulation (Mintken et al, 2010): -Pain-free shoulder flexion <127 deg -Shoulder IR <53 deg at 90 deg abduction (-) Neer Test -Not taking medications for shoulder pain -Symptoms < 90 days
2 positive: Sn .9, Sp .61, +LR 2.3 3 positive: Sn .51, Sp .9, +LR 5.3 4 positive: Sn .27, Sp 1.0, +LR infinite
Reference: Mintken PE, et al. Some Factors Predict Successful Short-Term Outcomes in Individuals with Shoulder Pain Receiving Cervicothoracic Manipulation: A Single-Arm Trial. Phys Ther. 2010; 90(1):26-42.
Norkin and White, . Measurement of Joint Motion: A guide to goniometry. 4th. F.A. Davis Company, 2009. Print.
Park HB, et al. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am. 2005; 87(7): 1446-55.