NMM/OMTBRIEF REPORT
Abstract
Context: Previous studies have sought to improve pitch performance and shoulder function utilizing the Muscle Energy Technique (MET) or Spencer’s technique. The results of these studies have been mixed. Some found immediate, but short-lived, improvement to different planes of the range of motion (ROM) of the throwing shoulder. None found improved velocity or investigated further pitch metrics, such as spin rate.
Objectives: This study is the first to measure the effects of osteopathic manipulative treatment (OMT) among key points of the kinetic chain, measuring ROM of the shoulder and the hip, as well as pitch metrics beyond release velocity.
Methods: Baseball pitchers from a local collegiate baseball team were offered participation in this study. Pitchers had to be medically cleared for participation as members of the team and had to be given permission by the coach to join the study. Sixteen pitchers were assessed for inclusion, and 13 of the 16 were randomized into OMT and control groups for a prospective cohort study. One dropped out of the control group upon randomization, and one member of the control broke baseline protocol, leaving six members in the experimental group, and five members in the control group. Data, including pitch metrics, active ROM, and demographics were collected at three time points with statistical analyses comparing data between groups. Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC-SES) was collected twice. After the third time point, the control group was crossed over to receive the OMT protocol also. Data were analyzed utilizing paired t-tests and Fisher’s exact test.
Results: Six pitchers received intervention (OMT), and five pitchers received no intervention (control). Overuse injuries developed in the control group only, preventing two of the five members of the control group from throwing further pitches for data collection at 5 weeks. When analyzed by Fisher’s exact test, those in the control group were 9.29 times more likely to develop an injury than those receiving a single application of OMT. The only significant difference in pitch performance was an immediate 0.74 mph reduction in effective velocity in the OMT group (p=0.048), not sustained at the 5-week follow-up. Immediately posttreatment, the intervention group appreciated a 7.16° advantage in shoulder internal rotation over the control group (p=0.017). Five weeks posttreatment, the intervention group appreciated a 9.44° advantage in shoulder external rotation (p=0.047). Bilateral hip extension was immediately significantly improved in the treatment group (p<0.001). Left hip flexion was significantly improved in the treatment group when compared against the control group both immediately by 6.76° (p<0.011) and at 5-week follow-up by 12.87° (p<0.001). An advantage in right hip flexion was significant only at 5 weeks by 5.89° (p<0.02).
Conclusions: A single application of OMT is a low-risk intervention to prevent overuse injuries in the elite overhead athlete. While this study found differences in velocity, ROM, and injury risk, this study was limited by the sample size (n=11). A larger sample group is needed both for reproducibility and for assessment of other pitch parameters such as horizontal break, vertical break, and pitch extension.