High School Girls' Volleyball Athletes' Self-Reported Management of Pain, Intentions to Report Overuse Injuries, and Intentions to Adhere to Medical Advice for Treating Overuse Injuries.

CONTEXT: Girls' high school volleyball is a popular sport with a high rate of overuse injuries and sport specialization. Health professionals perceive that high school athletes are reluctant to follow treatment plans involving sport activity reduction. This study's purpose was to describe high school girls' volleyball athletes' self-reported shoulder and knee pain, the likelihood of adhering to medical advice, and the association of factors that influence the likelihood of reporting overuse injuries and sport specialization. STUDY DESIGN: Cross-sectional. METHODS: Participants completed an online survey (demographics, sport participation measures, shoulder and knee pain information, medical adherence likelihood [4-point Likert: not at all likely to extremely likely], and factors influencing overuse injury reporting intentions). A 2 × 2 chi-square analysis compared factors that influence athletes' intentions to "not report an overuse injury" (eg, I thought my coach would get mad; yes/no) and sport specialization (nonhighly specialized/highly specialized athletes). RESULTS: There were 150 participants (highly specialized = 56%, grade: ninth = 33%, 10th = 28%, 11th = 22%, 12th = 17%). At least 60% reported shoulder and knee pain related to an overuse mechanism. Most reportedly did not seek rehabilitation led by a medical provider (shoulder pain = 66%, knee pain = 60%). Only 11% of athletes reported they were "extremely likely" to rest from sporting activity during the regular season if advised by a medical professional. Highly specialized athletes were more likely to report the pursuit of a college scholarship as a factor that influences their intention to report an overuse injury compared to nonhighly specialized athletes (13% vs 3%, respectively, P = .04). CONCLUSIONS: Most girls' volleyball athletes did not treat their pain with guided rehabilitation, which may increase their risk of a worse overuse injury or even acute injury. Clinicians, athletes, parents, and coaches need to work together to create a sport culture that empowers athletes to discuss their pain and overuse injuries with medical professionals.

Functional hip characteristics of baseball pitchers and position players.

BACKGROUND: During the throwing motion, the lower extremity is responsible for creating power that is transmitted through the core to the upper extremity. Research has shown that good hip range of motion and strength in throwing athletes results in greater performance and decreased stress placed on the upper extremity. Although research has investigated bilateral differences in hip characteristics among baseball pitchers, little is known about differences between pitchers and position players. HYPOTHESIS: Pitchers will have decreased passive hip rotation range of motion and gluteus medius strength compared with position players. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Forty professional baseball pitchers and 40 position players with no recent history of lower extremity injury participated. Bilateral hip external and internal rotation range of motion, total arc of motion, and gluteus medius strength were measured with a digital inclinometer and handheld dynamometer. Results A Hotelling T(2) multivariate analysis of variance showed position players to have significantly more hip internal rotation range of motion (3.1 masculine, P = .01, effect size = .53) and abduction strength (3.5 kg, P =.04, effect size = .53) in the trail leg compared with the pitchers. There were no significant differences for any other hip characteristics between groups (P > .07). CONCLUSION: The results of this study indicate that baseball pitchers have significantly smaller amounts of hip internal rotation range of motion and abduction strength of the trail leg compared with position players. However, these differences may not be clinically significant. CLINICAL RELEVANCE: Position players may be able to develop more energy in the lower extremity, while pitchers may rely more on energy created in the core and upper extremity, potentially placing pitchers at an increased risk for upper extremity injury. These descriptive hip characteristics may help clinicians detect inadequacies and provide appropriate prevention, diagnostic, and treatment interventions for such athletes.

The acute effects of sleeper stretches on shoulder range of motion.

CONTEXT: The deceleration phase of the throwing motion creates large distraction forces at the shoulder, which may result in posterior shoulder tightness and ensuing alterations in shoulder range of motion (ROM) and may result in an increased risk of shoulder injury. Researchers have hypothesized that various stretching options increase this motion, but few data on the effectiveness of treating such tightness are available. OBJECTIVE: To evaluate the acute effects of "sleeper stretches" on shoulder ROM. DESIGN: Descriptive with repeated measures. SETTING: Biomechanics laboratory and 2 separate collegiate athletic training facilities. PATIENTS OR OTHER PARTICIPANTS: Thirty-three National Collegiate Athletic Association Division I baseball players (15 pitchers, 18 position players; age = 19.8 +/- 1.3 years, height = 184.7 +/- 6.4 cm, mass = 84.8 +/- 7.7 kg) and 33 physically active male college students (age = 20.1 +/- 0.6 years, height = 179.6 +/- 6.6 cm, mass = 83.4 +/- 11.3 kg) who reported no recent participation (within 5 years) in overhead athletic activities. INTERVENTION(S): Range-of-motion measurements of the dominant shoulder were assessed before and after completion of 3 sets of 30-second passive sleeper stretches among the baseball players. The ROM measurements in the nonthrower group were taken using identical methods as those in the baseball group, but this group did not perform any stretch or movement between measurements. MAIN OUTCOME MEASURE(S): Internal and external glenohumeral rotation ROM and posterior shoulder motion (glenohumeral horizontal adduction). RESULTS: In the baseball group, posterior shoulder tightness, internal rotation ROM, and external rotation ROM were -3.5 degrees +/- 7.7 degrees , 43.8 degrees +/- 9.5 degrees , and 118.6 degrees +/- 10.9 degrees , respectively, before the stretches and were -1.2 degrees +/- 8.8 degrees , 46.9 degrees +/- 9.8 degrees , and 119.2 degrees +/- 11.0 degrees , respectively, after the stretches. These data revealed increases in posterior shoulder motion (P = .01, effect size = 0.30) and in internal shoulder rotation (P = .003, effect size = 0.32) after application of the stretches. No other differences were observed in the baseball group, and no differences were noted in the nonthrower group. CONCLUSIONS: Based on our results, the sleeper stretches produced a statistically significant acute increase in posterior shoulder flexibility. However, this change in motion may not be clinically significant.