Sports Injuries: Throwing injuries

Frequent overhead motion can cause injuries. The act of throwing a baseball or swinging a racket puts extreme force on the shoulder and elbow, the areas most commonly hurt.

Throwing can be broken down into six phases: wind-up, early cocking, late cocking, acceleration, deceleration and follow-through. Pain can occur at any phase.

Patients with a throwing injury may experience discomfort through the arms and upper body, including the elbow and shoulder. Sometimes it’s a dull ache, but often it’s a sharp, progressive pain.

Young athletes are particularly vulnerable – indeed one condition is called Little League Elbow. But anyone can be affected — and debilitated — by a throwing injury. Throwing athletes are also at risk for tendonitis and ligament tears.

Physical therapy can both treat throwing injuries and help prevent re-injury by teaching patients safe techniques and practices. That is the key to enjoying decades of trouble-free throwing.

Common throwing injuries include: 

Tendonitis occurs when excessive repetitive throwing motions lead to inflammation of a tendon, often in the rotator cuff or elbow.

The rotator cuff, a group of muscles and tendons that act together to stabilize the shoulder, can develop tendonitis due to repetitive throwing or overhead movements. It’s one of the most common conditions affecting the shoulder.

Physical therapy can reduce the pain and allow most patients to resume previous sports activities. Exercises help strengthen the rotator cuff and help the shoulder move more efficiently. Often healing comes quickly, after perhaps just a half-dozen to a dozen sessions.

Internal impingement, or labrum tear, another rotator cuff injury, occurs when part of the cuff itself gets pinched inside the shoulder, sometimes when cocking back the elbow too far. It also can develop over time due to wear and tear.

This can cause partial tearing of the cartilage, a flexible connective tissue found in many areas in the body, including the shoulder joint. The condition requires medical treatment and will worsen if not addressed.

A physical therapist can introduce stretches to ease movement and exercises to strengthen the muscles outside the joint that help rotate the shoulder. Often therapy can allow a patient to avoid surgery.

Shoulder blade or scapular pain is also a frequent injury caused by abnormal movement and damage to the tissue around the scapula. It can lead to decreased motion, sometimes called dead-arm syndrome.

Treatment involved muscle strengthening through exercise and conditioning. Your physical therapist may initially prescribe rest, pain relievers and other drugs.

Little League Elbow, also known as medial epicondyle apophysitis, occurs frequently among young baseball players. Caused by the forceful and repetitive nature of overhand throwing, it’s marked by pain and swelling inside of the elbow, and can limit range of motion.

Physical therapists teach young athletes individualized stretching and strengthening exercises. Following this regimen, patients can regain range of motion, flexibility and strength.

To prevent recurrence, a physical therapist typically also educates a player about proper throwing techniques, the need for rest, and the importance of keeping a count (and limiting the number) of pitches thrown during a game or practice.

Patients will also learn about safe throws and working up to more advanced one. For example, a frequent source of injury is throwing sliders or curve balls at an early age.