What is Throwing Shoulder?
Shoulder injuries are very common in the throwing athlete. The use of high speed video technology has shown that pitching a baseball requires the arm to accelerate at a speed of 7,000 degrees per second. Larger muscles surrounding the shoulder are most active during the acceleration of the throw, whereas the smaller more delicate rotator cuff muscles are most active during the deceleration phase.
Our specialists will evaluate the throwing athlete by obtaining a thorough history and physical exam. A series of tests will be performed on both shoulders to compare range of motion, strength, and evaluate maneuvers that elicit pain. Radiographic imaging and MRIs will be obtained when necessary for diagnosing the patient’s problem. Microtrauma injuries to the rotator cuff muscles are common and can cause pain while throwing while more significant tears may cause night pain. Instability may cause pain or give the sensation of subluxation especially during the follow through phase of throwing. Athletes that are experiencing decreased range of motion, particularly internal rotation, may have contracture of the posterior capsule.
Treatment for shoulder injuries in the throwing athlete will be focused on the patient’s specific issue. There are many different issues in the shoulder that can cause pain and dysfunction. Our shoulder specialists focus on conservative management initially which usually requires physical therapy directed toward strengthening the shoulder girdle, stretching, and decreasing pain. If no improvement is seen over 3-6 months surgical treatment may be considered.
Shoulder arthroscopy involves introducing a small camera and instruments into the shoulder joint to examine different parts of the shoulder. This may often times be both therapeutic and diagnostic. Arthroscopy allows the surgeon to visualize the labrum, biceps tendon, capsular ligaments, undersurface and superior surface of rotator cuff, the glenoid, humeral head, and subacromial space. Debridement and repair of injured structures can be done when necessary through the small portals made in the shoulder. The overall goal is to restore normal function and stability while eliminating pain.