Context: Shoulder injury in baseball pitchers is a very common problem and has been linked to an imbalance in rotator cuff strength. Recently, the use of functional shoulder strength ratios has become more popular because they more closely resemble the actions of the shoulder during the throwing motion. Objective: To investigate the link between preseason shoulder rotator cuff functional strength ratios and the development of shoulder pain and injury. Design: Prospective research design. Setting: University human performance laboratory. Patients: Fifteen collegiate baseball pitchers participated in this study. At the end of the baseball season, six (19.5 ± 1.8 years, 73.6 ± 2.8 inches, 198.7 ± 19.1 lbs) developed shoulder injury and were placed in the injured group, and nine (21.0 ± 1.7 years, 73.1 ± 2.3 inches, 207.9 ± 28.1 lbs) did not develop injury and were placed in the noninjured group. Interventions: Isokinetic peak torque was collected concentrically and eccentrically for both shoulder internal rotation (IR) and external rotation (ER) at 60°-s-1, 180°-s-1, and 300°-s-1. Main Outcome Measure: The following functional ratios were calculated from the peak torque measures: concentric ER: concentric IR; eccentric ER: eccentric IR; concentric ER: eccentric IR (cocking phase); and eccentric ER: concentric IR (acceleration phase). Analysis was conducted using an analysis of variance comparing the injured and noninjured groups. A secondary analysis was conducted using an analyses of variance on the concentric and eccentric peak torque for shoulder IR and ER between groups. Results: The acceleration phase functional shoulder ratio was significantly higher (p = .019) in the injured group and a concentric IR peak torque (p = .003) was significantly lower in the injured group compared with the noninjured group. conclusion: Increased acceleration phase ratios and decreased concentric IR peak torque may be linked to the development of shoulder injury during a baseball season.
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