About the test

Externall Rotation Range of Motion

The shoulder external rotation range of motion test is performed in the kneeling position and measures how far you can rotate your hand backward towards the wall behind you. This is similar to your range of motion when in your layback during throwing.

About the test

External Rotation Range of Motion

The shoulder external rotation range of motion test is performed in the kneeling position and measures how far you can rotate your hand backward towards the wall behind you. This is similar to your range of motion when in your layback during throwing.

Why it matters

Baseball players often have greater external rotation range of motion on their throwing arm. These are often normal adaptations to throwing, but significant changes following an outing or a progressive loss throughout a season may be early signs of an injury, fatigue, or a response to muscle soreness. Research shows that these changes can affect performance and increase the risk of both shoulder and elbow injuries.

In addition to the normal increase in external rotation on the throwing arm, it’s usually paired with a decrease in internal rotation as well. For that reason, it’s common to look at the total arc of motion (external rotation + internal rotation = total arc motion) rather than movement in just one direction. The total arc should remain within 5-10 degrees between the throwing and non-throwing sides.

Analyzing Internal

Rotation Strength

There are two ways that we look
at external rotation ROM:

1. Symmetry

Symmetry compares your throwing arm external rotation range against your non-throwing shoulder. Most players have more external rotation range in their throwing arm than their non-throwing arm.

2. Trend

Trend looks at how your range changes when compared to previous tests. Players range will fluctuate throughout the season, but if there is a loss of 10% or more, the app will optimize the arm care to a more recovery based program that focuses on mobility.

Summary of Research

Pitchers usually have greater external rotation and less internal rotation of their throwing arm due to bone and soft-tissue adaptations to the throwing motion (Hellem, 2019).

Pitchers with an external rotation deficit of more than 5 degrees on their throwing arm compared to the non-throwing arm were 2.2x more likely to be placed on the disabled list for a shoulder injury and were 4x more likely to require shoulder surgery (Wilk, 2015).

The risk of elbow injury increased by 7% for each degree of external rotation deficit in the throwing arm (Camp, 2017).

Research

Hellem A, Shirley M, Schilaty N, Dahm D. Review of Shoulder Range of Motion in the Throwing Athlete: Distinguishing Normal Adaptations from Pathologic Deficits [published online ahead of print, 2019 Jul 1]. Curr Rev Musculoskelet Med.

Wilk KE, Macrina LC, Fleisig GS, et al. Deficits in Glenohumeral Passive Range of Motion Increase Risk of Shoulder Injury in Professional Baseball Pitchers: A Prospective Study. Am J Sports Med. 2015;43(10):2379–2385.

Camp CL, Zajac JM, Pearson DB, et al. Decreased Shoulder External Rotation and Flexion Are Greater Predictors of Injury Than Internal Rotation Deficits: Analysis of 132 Pitcher-Seasons in Professional Baseball. Arthroscopy. 2017;33(9):1629–1636.