The Effect of In-Game Cervical Exercises on Shoulder Internal Rotation Range of Motion and External Rotator Strength in Baseball Pitchers.
Vincent Ceasrine, Christine Ferraro, Jason Grimes
Cervical retraction exercises done between innings preserved shoulder internal rotation range of motion after a simulated pitching game (mean difference 16.1 degrees, p<0.001), but did not significantly reduce the loss of external rotator strength.
Key findings
1After the simulated game, the group doing cervical exercises between innings had a mean post-game internal rotation of 57.0 degrees versus 48.1 degrees in the resting group (mean difference 8.9 degrees, p=0.024, Cohen's d=1.10). The between-group difference in change from pre- to post-game was 16.1 degrees (p<0.001, Cohen's d=3.18).
2External rotator strength showed no significant between-group difference after the game: the experimental group lost 0.5 kg versus 1.0 kg in the control group (mean difference 0.49 kg, p=0.399, Cohen's d=0.39). Controlling for body weight did not change this result (p=0.928).
3Every pitcher in the experimental group gained internal rotation range of motion after the game, while every pitcher in the control group lost range of motion.
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What it does not show
Only 20 pitchers, all aged 15–24, so the finding may not generalise to older or more experienced throwers. Outcomes were measured only once, immediately after a single simulated game; there is no information on whether the effect lasts, accumulates, or translates to lower injury risk over a season. A single measurement per time point increases measurement error and may have masked a real but small strength effect; the authors note the study was underpowered for the strength outcome. No sham-exercise group was included, so it is impossible to separate a true cervical effect from placebo or attention effects. The control group was significantly heavier than the experimental group (197.3 vs 172.1 lb, p=0.045), which the authors addressed with an ANCOVA but which introduces a baseline imbalance. The game was simulated in a controlled indoor setting during the off-season with a fixed 60-pitch count; real-game conditions, higher workloads, or different demographics may produce different results.
The easy way to misread this
Do not read the 16.1-degree internal rotation difference as proof that cervical exercises treat glenohumeral internal rotation deficit or prevent shoulder injury — the study had only 20 pitchers, measured range of motion a single time immediately after one simulated game, included no sham-exercise group, and was underpowered for the strength outcome. The external rotator strength result was null, and the authors themselves state that cause and effect cannot be assumed from these findings.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →