## 4 Discussion  
The objective of this study was to determine if elite HB athletes with GIRD presented changes in the TS in maximal isometric strength, posterior stiffness, and mechanical properties in the teres major muscle compared to the non-TS and to non-HB healthy athletes. The results of the study confirmed the hypotheses: HB athletes presented lower ER isometric strength, a lack of extensibility in the tissues of the posterior part, and an increased tone and stiffness in the teres major muscle. Shoulder ROM was assessed mainly for inclusion criteria. The mean value of IR ROM in the TS was 17.57\({}^{\circ}\) and in the non-TS was 41.30\({}^{\circ}\), and the mean difference between them was 23.58\({}^{\circ}\). These data are similar to other studies that included elite HB athletes [19]. The role of GIRD was investigated as a primary risk factor for shoulder injury in HB athletes, establishing the mean value between 12.9\({}^{\circ}\) to 15\({}^{\circ}\)[8]. The reduction of tROM in the TS compared to the non-TS has been also described as a risk factor for shoulder injury [20]. Deficits greater than 10\({}^{\circ}\) are needed to be considered as a contributing factor [5]. The HB athletes included in this study presented a mean difference between shoulders of 30.00\({}^{\circ}\). [PERSON] et al. [5] concluded that elite athletes with GIRD and tROM reduction presented at least twice the risk of suffering shoulder injuries than those without GIRD and tROM differences. Therefore, the HB athletes included in the study presented the biomechanical adaptations described for this type of patient, which makes an adequate sample to assess other variables such as strength, extensibility, and mechanical properties. No differences were found for IR or ER isometric strength between shoulders or between both groups. However, the ER/IR ratio in the HB group showed that the IR strength was greater than the ER strength and was statistically significant different from the control group. The optimal balance between IR and ER muscle strength allow one to stabilize the glenohumeral joint and maintain the correct position of the humeral head [36]. ER weakness may alter the stability and position of the humeral head. These results are similar to the results obtained by [PERSON] et al. [17], that found that isometric ER weakness in elite HB athletes increased the probability of shoulder injuries during the season. \begin{table}
\begin{tabular}{l l l l l l} \hline \hline  & \multicolumn{2}{l}{**HB Group**} & \multicolumn{2}{l}{**Control Group**} & \\ \cline{2-5}
**Outcomes** & \multicolumn{2}{l}{**Differences**} & \multicolumn{2}{l}{**Differences**} & \multicolumn{2}{l}{**Between-Groups**} \\  & \multicolumn{2}{l}{**(\(p\)-Value)**} & \multicolumn{2}{l}{**(\(p\)-Value)**} & \multicolumn{2}{l}{**Differences \(p\)-Value**} \\ \hline Stiffness (N/m) & & & & & \\ TS & 173.34 (25.57) & 30.86 (23.04; 38.68); 0.001 & 147.93 (19.22) & 4.39 (\(-\)0.16; 8.94); 0.060 & 27.03 (15.24; 38.83) \\ Non-TS & 142.48 (18.73) & & 143.54 (19.94) & 0.060 & \(p\) \(<\) 0.001 \\ Elasticity & & & & & \(-\)0.28 (\(-\)10.62; 10.05) \\ TS & 1.08 (0.21) & 0.05 (\(-\)0.01; 0.12); 0.106 & 1.10 (0.14) & 0.02 (\(-\)0.04; 0.08); 0.515 & \(p\) \(=\) 0.806 \\ Non-TS & 1.03 (0.15) & & 1.08(0.14) & 0.05 (\(-\)0.05 (\(-\)0.13; 0.01) \\ Relaxation time (ms) & & & & \(p\) \(=\) 0.120 \\ TS & 25.56 (1.67) & \(-\)0.69 (\(-\)1.15; \(-\)0.24); 0.004 & 26.78 (2.40) & \(-\)0.16 (\(-\)0.67; 0.33); 0.501 & \(-\)1.37 (\(-\)2.44; \(-\)0.29) \\ Non-TS & 26.26 (1.79) & & 26.95 (2.19) & 0.501 & \(p\) \(=\) 0.013 \\ Creep (D) & & & & & \(-\)0.80 (\(-\)1.86; \(-\)0.25) \\ TS & 1.33 (0.11) & 0.01 (\(-\)0.02; 0.03); 0.764 & 1.37 (0.13) & 0.01 (\(-\)0.01; 0.03); 0.535 & \(p\) \(=\) 0.222 \\ Non-TS & 1.33 (0.12) & & 1.36 (0.11) & 0.03 (\(-\)0.09; 0.02) & \(p\) \(=\) 0.149 \\ \hline \hline \end{tabular}
\end{table} 
Table 4: _Cont._Both groups showed a statistically significant decrease of the extensibility of the tissues of the posterior part of the TS compared to the non-TS.