Shoulder Injuries

“Put me in coach, I’m ready to play, today.”

Some of you might recognize the lyrics from an old John Fogerty classic about baseball called Centerfield. The question is, are you really ready to play? The start of May usually brings with it the start of another baseball season accompanied by the smell of the fresh cut grass, the crack of the bat, the call of the umpire and the inevitable ache in the shoulder of your throwing arm.

Throwing, especially overhand throwing is a very hard activity on the shoulder joint. It particularly stresses something called the rotator cuff which is a group of four muscles that are responsible for controlling shoulder movement. Classically, shoulder injuries from throwing include pain during the throwing motion especially at the point of release, a pinching feeling at the top of the shoulder especially when raising the arm above shoulder height and general stiffness and loss of range of motion in the shoulder.

Throwing often leads to a strain of the important rotator cuff muscles at the back of the shoulder referred to as the external rotators. These muscles are the “braking mechanism” which slows your arm down after the acceleration phase and then the release phase of throwing. That’s why it seems to hurt more once you release the ball. These muscles are also responsible for holding the top of the arm in the proper position with arm movements. When these muscles are injured they shut down and the top of the arm jams up into the shoulder socket pinching the soft tissues and creating pain. This condition is called impingement syndrome.

Typically, for many ball players the last time they threw a ball was probably the last game at the end of the previous season. They haven’t thrown all winter and then jump right into the activity without any appropriate preparation. One of the best ways to avoid this type of injury is to begin in early April. Start gradually and gently by playing catch or if no partner is available start by throwing an appropriately weighted sponge or rubber ball against a wall to slowly work the muscles involved in throwing back into shape.

A key factor is proper preparation but if you are reading this now with a sore shoulder then the time for proper preparation has probably passed. So now it’s time to try to treat the injury that you have already created. Please take heed because ignoring it and trying to play through it will inevitably lead to a progressively deteriorating condition with possibly serious complications including tendonitis or a rotator cuff tear.

Although regrettable, if you haven’t done the appropriate pre-season preparation and are now experiencing shoulder pain you may have to take a few weeks off to allow the shoulder to heal properly. You should have the shoulder properly assessed by a chiropractor or physiotherapist to determine the exact cause of your shoulder pain. Often muscular imbalances and weakness in the external rotators may be a big factor in the re-occurrence of the injury and need to be addressed with specific exercises.

Initial treatment includes the use of ice, ultrasound, laser or perhaps even acupuncture to reduce the acute pain and inflammation. The next step is to gradually increase the range of motion of the joint to help restore function as well as avoiding secondary complications like frozen shoulder from developing. Once the pain and inflammation are under control and the range of motion is beginning to improve the next step is to address strength and length imbalances in the muscles involved.

Ultimately, seeking the advice of a qualified professional that knows how to properly treat and rehabilitate these kinds of injuries will not only allow you to play pain free but may also increase your throwing ability. More importantly however, it may help you to avoid a potentially debilitating injury.