Shoulder Injuries in Throwing Athletes

Understanding Shoulder Injuries in Throwing Athletes

Throwing places extreme stress on the shoulder. The arm moves at very high speed, and the muscles, tendons, ligaments and labrum must stretch enough to allow motion while still keeping the joint stable. Over time, repetitive throwing can lead to a group of overuse injuries seen in baseball pitchers, quarterbacks, tennis and volleyball players and swimmers.

Common problems include SLAP tears, biceps tendinitis, rotator cuff tendinitis and partial tears, internal impingement where the rotator cuff is pinched against the back of the socket, subtle instability, glenohumeral internal rotation deficit (GIRD), and abnormal shoulder blade motion. Athletes often notice pain, a "dead arm" feeling or loss of velocity and control.

Most throwing injuries respond to rest from throwing, physical therapy focused on flexibility, core and scapular strength, and an interval throwing program. Surgery is considered when a structural injury prevents return to sport despite good rehabilitation.

Causes & Risk Factors

• High pitch counts and year-round throwing
• Poor throwing mechanics
• Loss of internal rotation (GIRD) and tight posterior capsule
• Weak core, hip and shoulder-blade muscles
• Fatigue and inadequate rest

Symptoms

Common signs and symptoms of Throwing Shoulder Injuries include:

• Pain at the back or front of the shoulder when throwing
• Loss of velocity, accuracy or endurance
• A "dead arm" feeling
• Stiffness or slow warm-up
• Clicking, catching or a feeling of looseness

Treatment Options

Treatment for Throwing Shoulder Injuries depends on the severity of your condition and may include:

• Rest from throwing and activity modification
• Physical therapy for posterior capsule stretching, rotator cuff and scapular strength
• Core and lower-body conditioning and mechanics evaluation
• An interval throwing program
• Arthroscopic surgery for SLAP tears, labral tears or rotator cuff injuries that do not respond