Throwing Injuries

There are some injuries that may occur in a thrower’s shoulder and elbow that simply do not occur in the shoulders and elbows of non-throwers. The constant, repetitive overhead throwing motion imparts high, outward, extension loads to the athlete’s shoulder and elbow. This can lead to either a progressive structural change, or a chronic or acute injury.

Common injuries that are usually encountered in the throwing elbow include ulnar neuritis, ulnar collateral ligament tears, flexor-pronator muscle strain or tendonitis, valgus extension overload syndrome with olecranon osteophytes, medial epicondyle apophysitis or avulsion, olecranon stress fractures, osteochondritis dissecans of the capitellum, and loose bodies. Understanding throwing biomechanics, along with a thorough knowledge of the anatomy and function of the shoulder and elbow is imperative to properly diagnose and treat the throwing athlete. Significant advantages in recent arthroscopic surgical techniques and ligament reconstruction have markedly improved the prognosis for a healthy return to competition for the extremely motivated athlete.

Likewise, common throwing shoulder injuries include labral tears, bursitis, tendonitis, rotator cuff tears,biceps tendon injuries, capsular contractures, and shoulder blade (scapula) dyskinesis (abnormal movement) or true winging. A common condition in which throwing athletes develop loss of internal rotation from scarring of the joint capsule, scapula dyskinesis, labral tears, and rotator cuff tears is known as GIRD or glenohumeral internal rotation deficit. It is the most common condition affecting the throwing shoulder.

The shoulder and elbow are inextricably intertwined with each other and to the joints and muscles of the trunk and lower extremities (hip, back, knee, ankle). Therefore, in order to maintain painfree throwing, potential causes of altered throwing kinematics must be prevented with a balanced training program and treated appropriately when identified.

It must be pointed out; however, that continuation of overhead throwing most often results in subsequent injury and symptom recurrence in the competitive athlete.