Comparison of the effects of two recovery methods after collegiate baseball pitching
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Context: The localized muscular fatigue, acute loss of glenohumeral strength and passive range of motion (PROM), and delayed onset muscle soreness (DOMS) that intercollegiate and professional baseball pitchers experience following a game must be minimized or eliminated before they can safely pitch in their next outing. The combination of light shoulder exercise, stretching, and cryotherapy is commonly used after baseball pitching as the recovery method to hasten the restoration of shoulder muscular strength and PROM, and reduce the symptoms of DOMS. However, the effectiveness of the light shoulder exercise program for recovery after baseball pitching remains unclear. Objective: To compare the effectiveness of two recovery methods, stretch and cryotherapy (SC), and a light shoulder exercise program, stretch and cryotherapy (LSC), after simulated game pitching by collegiate baseball pitchers. Design: Repeated measures cross-over design. Setting: Research laboratory. Participants: 20 healthy male collegiate baseball pitchers (mean age 21.7 yrs 1.41) were recruited to participate in this study; 18 pitchers completed all aspects of the study. Interventions: Each participant threw 3 innings of a simulated game (a total of 45 pitches) and then was randomly assigned to receive either the SC or LSC post-pitching treatment method. The participants returned to the laboratory at 24 and 48 hour intervals after the simulated game pitching to provide follow-up measures of glenohumeral joint strength and PROM, and patient-oriented measures of functional ability and pain. Two weeks later, each participant repeated an identical bout of simulated game pitching, was treated with the alternate recovery method, and returned to the lab for follow-up data collection at 24 and 48 hours intervals. Main Outcome Measures: Isometric glenohumeral internal and external rotation strength and PROM measurements were obtained on four occasions with each treatment regimen. The velocity of every pitch thrown was measured with a radar gun, and later evaluated for accuracy via video analysis. A QuickDASH™ Sport questionnaire and a 100-mm visual analog pain scale (VAS) were also completed at 24 and 48 hour intervals post-pitching. Results: The LSC protocol produced significantly better patient outcomes than the SC protocol for 6 of the 9 objective and subjective measures, specifically, glenohumeral isometric strength, shoulder internal rotation PROM, total rotation PROM, pitching velocity, QuickDASH™ Sport score and VAS pain score (p < 0.05). Conclusions: The results of this study indicate that the LSC active recovery treatment regimen was more effective than the passive recovery SC method for post- pitching restoration of glenohumeral joint strength and PROM. Light shoulder exercise after pitching was found to be a superior post-pitching protocol for a more complete and rapid recovery of shoulder strength, PROM and pitching velocity in collegiate pitchers.