Throwing and the Shoulder
Forces on the shoulder during throwing are very high. In fact, rotational speeds can exceed 7500 degrees per second. It is for this reason that most throwing injuries involve the shoulder. The labrum (cartilage) and rotator cuff musculature are most often injured. It is important to know how the shoulder works to know how to prevent injury.
The shoulder is a unique joint, similar to a golf ball on a tee, or a ball and socket joint. The ball is the head of the arm, medically termed as the humerus bone. The socket (or tee) is called the glenoid fossa. The design of the shoulder joint allows the least amount of restriction to movement, which enables the use of arms with greater freedom than legs. However, this makes the shoulder relatively unstable and prone to injury. A group of four muscles, called the rotator cuff, are involved with fine movement of the shoulder. The muscles that comprise the rotator cuff help to correctly position the humerus in the glenoid fossa.
There are numerous causes of shoulder injuries from throwing: overuse, lack of preparation for the upcoming season, altered mechanics, and throwing through pain and fatigue. Strict pitch counts should be monitored by the coaches for each player. Pitch counts vary depending on the age of the player. Type of pitch is also very important. Breaking balls should be limited or restricted for younger throwers. Baseball players should take the time in the off-season to properly rest, stretch, strengthen and throw. The off-season is the most important time to prepare for the season. Altered mechanics are another reason for injury. Most mechanical faults involve the arm path and follow through. Most players reach too far behind the body and abbreviate their follow through. Small mechanical faults add up over the course of a season that can include thousands of throws. Poor core trunk strength and not using the legs properly during throwing also can contribute to injuries of the shoulder. A physical therapist can evaluate and even video tape the player's throwing motion to identify mechanical faults.
Proper strengthening of the rotator cuff and the muscles that surround the scapula (shoulder blade) is an important step to preventing injury. Seated rows and lat pull downs are examples of exercises that target the scapula stabilizers. Rotator cuff strengthening should be done with light weights or resistance bands since these muscles are small and fatigue easily. Examples of these exercises should include internal and external rotation of the shoulder. Strength training should be done separately from your specific sport training since the muscles will be too fatigued if performed in conjunction. Although we typically think throwing only involves the arm, the legs and core are essential to not only throwing hard but to staying healthy. The better shape your whole body is in the less likely injury will occur.
The most important thing to remember is to always train properly. It is necessary to perform a warm up and cool down, stretch, and correctly strengthen your shoulder. Never attempt to work through the pain or ignore early warning of injury such as fatigue, loss of control and stiffness. Let your coach or parents know if you have an injury and seek proper treatment to avoid further, more serious problems. If you have questions or problems, contact an Excel Physical Therapy location closest to you or visit our website at excelpt.com.
