Acute Decrease in Glenohumeral Internal Rotation During Repetitive Baseball Pitching Is Associated with Transient Structural Changes in Medial Longitudinal Arch of Stride Leg: Pilot Study Using Mixed Model.

Pitching requires effective transfer of ground reaction force (GRF), and structural breakdown of the medial longitudinal arch (MLA) may influence glenohumeral internal rotation (IR) deficits. This study investigated whether changes in foot morphology of the stride leg and soft tissue characteristics are associated with loss of IR during repeated pitching. Fifteen male college pitchers completed 60 pitches in a simulated game. IR range of motion (IRROM) was assessed before and after pitching. The navicular height, mechanical properties of the abductor hallucis (AbH) and plantar fascia, and GRF were measured at multiple time points. Correlation analysis and a linear mixed model were used to identify predictors of IRROM change. The mean change in shoulder IRROM during pitching was -21.9° ± 8.4°. IRROM and navicular height decreased significantly over time. The AbH elasticity increased throughout the pitching sequence. Greater reductions in IRROM appeared related to a higher vertical GRF (p = 0.021) and increased AbH elasticity (p = 0.046). Vertical GRF was unrelated to fastball velocity (p = 0.260), whereas anteroposterior GRF correlated with fastball velocity (p = 0.038). Morphological and mechanical changes in the stride leg, particularly within the support of the MLA, can influence IRROM. Reducing vertical GRF and stress on the AbH may help preserve the IRROM without compromising performance.