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Descriptive Profile of Hip Rotation Range of Motion in Elite Tennis Players and Professional Baseball Pitchers

Todd S. Ellenbecker, DPT, MS, SCS, OCS, CSCS^,*, Gail A. Ellenbecker, MS, E. Paul Roetert, PhD, Rogerio Teixeira Silva, MD^||, Greg Keuter, ATC^¶ and Fabio Sperling, PT^#

From Physiotherapy Associates Scottsdale Sports Clinic, Clinical Research Physiotherapy Associates, Scottsdale, Arizona, Scottsdale, Arizona, United States Tennis Association, Key Biscayne, Florida, ^|| Department of Orthopaedics, Federal University of São Paulo, Brazilian Tennis Federation, São Paulo, Brazil, ^¶ Chicago Cubs, Scottsdale, Arizona, and ^# NEO Sports Medicine Clinic, São Paulo, Brazil

^* Address correspondence to Todd S. Ellenbecker, Physiotherapy Associates Scottsdale Sports Clinic, 9917 N. 95th Street, Scottsdale, AZ 85258 (e-mail: ellenbeckerpt{at}cox.net).

Background: Repetitive loading to the hip joint in athletes has been reported as a factor in the development of degenerative joint disease and intra-articular injury. Little information is available on the bilateral symmetry of hip rotational measures in unilaterally dominant upper extremity athletes.

Hypothesis: Side-to-side differences in hip joint range of motion may be present because of asymmetrical loading in the lower extremities of elite tennis players and professional baseball pitchers.

Study Design: Cohort (cross-sectional) study (prevalence); Level of evidence, 1.

Methods: Descriptive measures of hip internal and external rotation active range of motion were taken in the prone position of 64 male and 83 female elite tennis players and 101 male professional baseball pitchers using digital photos and computerized angle calculation software. Bilateral differences in active range of motion between the dominant and nondominant hip were compared using paired t tests and Bonferroni correction for hip internal, external, and total rotation range of motion. A Pearson correlation test was used to test the relationship between years of competition and hip rotation active range of motion.

Results: No significant bilateral difference (P > .005) was measured for mean hip internal or external rotation for the elite tennis players or the professional baseball pitchers. An analysis of the number of subjects in each group with a bilateral difference in hip rotation greater than 10° identified 17% of the professional baseball pitchers with internal rotation differences and 42% with external rotation differences. Differences in the elite male tennis players occurred in only 15% of the players for internal rotation and 9% in external rotation. Female subjects had differences in 8% and 12% of the players for internal and external rotation, respectively. Statistical differences were found between the mean total arc of hip range of internal and external rotation in the elite tennis players with the dominant side being greater by a clinically insignificant mean value of 2.5°. Significantly less (P < .005) dominant hip internal rotation and less dominant and nondominant hip total rotation range of motion were found in the professional baseball pitchers compared with the elite male tennis players.

Conclusion: This study established typical range of motion patterns and identified bilaterally symmetric hip active range of motion rotation values in elite tennis players and professional baseball pitchers. Asymmetric hip joint rotational active range of motion encountered during clinical examination and screening may indicate abnormalities and would indicate the application of flexibility training, rehabilitation, and further evaluation.

Key Words: hip • range of motion • baseball • tennis

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