Understanding Common Shoulder Injuries in Throwers: Symptoms, Self-Management, and When to Seek Professional Help

As a physical therapist and sports medicine doctor, I frequently see athletes who engage in throwing sports—such as baseball, softball, tennis, and even track and field events—struggling with shoulder pain. The shoulder is a highly mobile joint that allows for a wide range of motion, making it susceptible to various injuries, especially for those who repetitively use it. Understanding these common shoulder injuries, recognizing their symptoms, and knowing how to manage them can help prevent more serious damage.

Common Shoulder Injuries in Throwers

1. Rotator Cuff Tendinitis or Tear

Symptoms: Pain during overhead activities, weakness in the shoulder, difficulty lifting the arm, and a dull ache deep in the shoulder.

Description: The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint. Repetitive overhead throwing can cause inflammation (tendinitis) or even tears in these tendons.

2. Shoulder Impingement Syndrome

Symptoms: Sharp pain when lifting the arm, especially above shoulder height, pain when lying on the affected side, and a feeling of weakness in the arm.

Description: This occurs when the tendons of the rotator cuff become compressed or "impinged" between the bones in the shoulder, leading to inflammation and pain.

3. SLAP Tear (Superior Labrum Anterior and Posterior) or Generalized Labral Tears

Symptoms: Deep shoulder pain, a sense of instability, clicking or catching sensations in the shoulder, and loss of strength.

Description: The labrum is a ring of cartilage that surrounds the shoulder socket and helps keep the shoulder stable. Repetitive throwing motions can cause tears in the labrum, leading to instability and pain.

4. Biceps Tendinitis

Symptoms: Pain in the front of the shoulder, tenderness over the biceps tendon, pain that worsens with overhead activity, and sometimes a snapping sound or sensation in the shoulder.

Description: The biceps tendon attaches the biceps muscle to the shoulder and can become inflamed from overuse, particularly with repetitive throwing motions.

Self-Treatment Tactics

While some shoulder injuries may require professional treatment, there are several strategies that throwers can use to manage their symptoms at home:

1. Rest and Modify Activities

Resting the shoulder and avoiding activities that aggravate the pain is crucial. Modify your throwing technique or reduce the intensity and volume of your workouts.

2. Ice Therapy

Apply ice to the shoulder for 15-20 minutes several times a day, especially after activity, to reduce inflammation and pain.

3. Stretching and Strengthening Exercises

Gentle stretches for the shoulder muscles, such as the cross-body stretch and doorway stretch, can help maintain flexibility. Strengthening exercises like external rotations and scapular retractions can enhance shoulder stability.

When to See a Physical Therapist

While self-treatment can be effective for mild cases, certain signs indicate the need for professional intervention:

Persistent Pain: If pain continues despite rest and self-treatment, it’s important to see a physical therapist. Chronic pain can indicate a more serious injury that requires targeted therapy.

Loss of Strength or Range of Motion: Difficulty lifting your arm, weakness, or a noticeable reduction in your shoulder’s range of motion should not be ignored. These symptoms may indicate a tear or significant injury that needs specialized care.

Instability or Dislocation: If your shoulder feels unstable or has a tendency to dislocate, a physical therapist can help you regain strength and stability through a structured rehabilitation program.

Numbness or Tingling: Any numbness or tingling sensations in the arm or hand may suggest nerve involvement, which requires immediate attention.

Failure to Improve with Self-Treatment: If there’s no noticeable improvement within a week or two of self-care, it’s time to consult a physical therapist who can assess the injury and develop a customized treatment plan.

Conclusion

Shoulder injuries are common in throwers, but with the right knowledge and approach, they can often be managed effectively. Understanding the symptoms and causes of these injuries allows athletes to take proactive steps toward recovery. However, when pain persists or other concerning symptoms arise, seeking the guidance of a physical therapist is crucial for a safe and successful return to your sport.

If you’re experiencing shoulder pain or any of the symptoms mentioned above, don’t hesitate to reach out to Dr. Cousin. Early intervention can prevent more serious issues and help you get back to doing what you love with strength and confidence.

FAQs

1. What are the common causes of shoulder injuries in throwers?

Repetitive overhead motions in sports like baseball or tennis often cause shoulder injuries due to strain on the rotator cuff, labrum, and other shoulder structures.

2. What are the signs of a rotator cuff injury?

Common signs include pain when lifting the arm, shoulder weakness, and a dull ache deep in the shoulder.

3. Can shoulder injuries heal on their own?

Mild injuries may improve with rest, ice, and modified activity, but persistent pain or loss of function may require professional treatment.

4. How long should I rest a shoulder injury before seeking help?

If there’s no improvement after a week or two of self-care, it's time to consult a physical therapist for further evaluation.

5. What is a SLAP tear, and how does it affect throwing athletes?

A SLAP tear is a tear of the cartilage around the shoulder socket, often causing pain, instability, and difficulty throwing with power.

6. How can I prevent shoulder injuries from recurring?

Proper warm-ups, strengthening exercises, and avoiding overuse can help prevent recurring shoulder injuries.

7. Are there specific exercises to strengthen the shoulder?

Yes, exercises like external rotations and scapular retractions can help build shoulder stability and strength.

8. When should I apply ice to a shoulder injury?

Ice should be applied for 15-20 minutes after activity to reduce inflammation and pain.

9. What should I do if my shoulder feels unstable?

If your shoulder feels unstable, it's important to see a physical therapist who can guide you through a targeted rehabilitation program.

10. Can biceps tendinitis be treated at home?

Mild cases of biceps tendinitis can often be managed with rest, ice, and modified activity, but severe cases may require professional treatment.