Sports and Throwing Injury
Does your shoulder hurt when you throw a ball overhand or when you engage in activities that require overhead arm movements? If so, you may have a throwing injury.
Your shoulder can sustain a variety of injuries as the result of overuse. Throwing injuries can irritate and inflame muscles and tendons, lead to tissue tears, and can even cause you to “throw out” your shoulder. When you throw out your shoulder, it means your upper arm bone has come partially or completely out of its socket in the shoulder.
Who Is at Risk?
Throwing injuries are particularly common among athletes who engage in repetitive overhead arm movements. This includes those who enjoy baseball (especially pitchers), volleyball, tennis, and even some track and field events. Throwing injuries are also prevalent among nonathletes who engage in the same type of arm motions on a regular basis, such as construction workers, painters, and others.
How Throwing Injuries Occur
To better understand the mechanics of throwing, let’s break down the distinct motions involved in pitching a baseball. A baseball pitcher will begin by bringing the ball down and back, toward the hip area. The arm holding the ball will rotate outwardly and rise upward, so the arm is now overhead, palm forward. The arm is then propelled forward while rotating inwardly, the ball is released, and the arm continues the motion, swinging out and down toward the left hip area during follow-through.
The shoulder is particularly vulnerable to injury as the arm is rotated and brought overhead – and again after the ball is released. That’s because the greatest force impacts the shoulder joint during these phases of throwing.
In the former (as the arm is raised and turned outward), the top of the upper arm bone is pushed forward, straining ligaments at the front of the shoulder. In the latter (after the ball is released), ligaments and rotator cuff tendons at the back of the shoulder bear the brunt of force required to stop the arm movement and keep the joint intact.
This stress on the shoulder, when repeated enough, can cause ligaments to loosen and your shoulder to become unstable.
Types of Throwing Injuries
Repetitive stress involved in the act of throwing can lead to a variety of shoulder conditions, including:
The muscles and tendons of the rotator cuff help control your arm movements. With repeated stress, tendons usually stretch and fray before resulting in a rotator cuff tear. In a throwing injury, a tendon may become entirely detached from the upper arm bone.
The type of labrum damage that occurs in a SLAP tear – along the top edge of the shoulder socket – is common during throwing, because it is where the biceps tendon attaches to the labrum. If you feel an ache deep in your shoulder or your shoulder seems to lock up, it could indicate a SLAP tear.
The upper biceps tendon can become irritated and inflamed (tendonitis) with repetitive throwing movements. Over time, or during a moment of significant impact or strain, you may hear a snap and feel a sharp pain in the upper arm, indicating a bicep tear.
Years of repetitive throwing can loosen the ligaments that hold the bones of your shoulder together, leading to chronic shoulder instability.
The extreme flexibility caused by shoulder instability can lead to the upper arm bone become partially or completely dislocated from the shoulder socket. If your shoulder becomes dislocated, you should seek immediate medical attention.
Diagnosis & Treatment of a Throwing Injury
In most cases, the best way to pinpoint the cause of your shoulder pain is through magnetic resonance imaging (MRI) or CT scan. These diagnostic imaging tools can provide a clearer and more detailed picture of soft tissue injuries than X-rays – although X-rays may be used to rule out other conditions such as a bone fracture.
Physical therapy is often crucial with any type of shoulder injury, especially if you want to be able to regain the shoulder strength and flexibility you had prior to the throwing injury. Your PT may focus on a return-to-throwing program, which strengthens the shoulder, trunk, and core to improve your shoulder’s position during throwing.
In addition to physical therapy, cortisone injections may offer some relief from shoulder pain. If these more conservative treatments fail to resolve your symptoms, you may need shoulder surgery. The type of surgical procedure you will need depends on the type of throwing injury you’ve sustained. At The Shoulder Institute at ORTHOKnox, our goal is to get athletes or anyone who has suffered a throwing injury back to their sport or other physical activity at the level they were at prior to their injury.
Preventing Throwing Injuries
If you engage in throwing-type movements on a regular basis, it’s never too early to address the potential of a throwing injury. Preventing an injury is always easier than treating it once it’s occurred.
Call us to schedule your consultation with Dr. Hovis. He will work with you to develop a prevention-based program to help you avoid a future throwing injury. This will involve a close look at your body mechanics (how you’re moving) to help you achieve your best strength and core stability – which will put you in the best position to prevent future throwing injuries.
Throwing Injury Treatment in Knoxville and Athens, TN
Have you suffered a throwing injury to your shoulder? Dr. David Hovis at The Shoulder Institute at ORTHOKnox can help. Call (865) 251-3030 to schedule your consultation or simply request an appointment now.