The Effect Of Straight-Line Long-Toss Versus Ultra-Long-Toss Throwing On Passive Glenohumeral Range Of Motion Recovery After Pitching

Background: Repetitive throwing in baseball pitchers can lead to pathologic changes in shoulder anatomy, range of motion (notably glenohumeral internal rotation deficit), and subsequent injury; however, the ideal strengthening, recovery, and maintenance protocol of the throwing shoulder in baseball remains unclear. Two strategies for throwing shoulder recovery from pitching are straight-line long-toss (SLT) throwing and ultra-long-toss (ULT) throwing, although neither is preferentially supported by empirical data.Hypothesis: ULT will be more effective in returning baseline internal rotation as compared with SLT in collegiate pitchers after a pitching session.Study Design: Cohort study.Methods: A total of 24 National Collegiate Athletic Association Division I baseball pitchers with mean age 20.0 +/- 1.1 years were randomized to either the ULT group (n = 13; 9 right-hand dominant, 4 left-hand dominant) or SLT group (n = 11; 10 right-hand dominant, 1 left-hand dominant). Measurements (dominant and nondominant, 90 degrees abducted external rotation [ER], internal rotation [IR], and total range of motion [TROM]) were taken at 5 time points across 3 days: before and immediately after a standardized bullpen session on day 1; before and immediately after a randomized standardized ULT or SLT session on day 2; and before practice on Day 3.Results: ULT demonstrated significantly greater final ER compared with baseline (+10 degrees; P = 0.05), but did not demonstrate significant IR changes. Similarly, SLT demonstrated significantly greater post-SLT ER (+12 degrees; P = 0.02) and TROM (+12 degrees;P = 0.01) compared with baseline, but no significant IR changes. Final ER measurements were similar between ULT (135 degrees +/- 14 degrees) and SLT (138 degrees +/- 10 degrees) (P = 0.59). There was also no statistically significant difference in final IR between ULT (51 degrees +/- 14 degrees) and SLT (56 degrees +/- 8 degrees) (P = 0.27).Conclusion: The routine use of postperformance, ULT throwing to recover from range of motion alterations, specifically IR loss, after a pitching session is not superior to standard, SLT throwing. Based on these findings, the choice of postpitching recovery throwing could be player specific based on experience and comfort.