How To Relieve Pain From Throwing Injuries
While the best strategy for reducing pain from throwing injuries is a proactive injury prevention plan, there are plenty of effective throwing injury treatments. Catching a throwing injury early is key to limiting the overall damage it causes, so be sure to seek medical attention as soon as you experience symptoms such as a limited range of motion, a pop or tearing sensation.
Rehabilitation and preparation for the next practice or competition should begin immediately after a practice session ends. Managing the physical stress brought on by a pitching session or other intense throwing practice through stretching, icing and other treatments can help reduce the chances of injury. By being proactive and addressing minor pains early, athletes can avoid more serious injuries.
In the case of more persistent elbow pain, the first step is to rest from throwing and allow the elbow or shoulder to recover from inflammation. For more severe throwing-related injuries, an involved treatment option may be necessary. The following are your three main options for treating throwing injuries:
Conditions Related To Shoulder Pain
The shoulder is a complex joint built to allow movement in many directions: forward, backward, around in a circle, and away from the body. Muscles and ligaments help keep the shoulder stable and secure in your socket. We depend on our shoulders to support many of our most basic motions, including pushing, pulling, lifting, and throwing.
Because the shoulder is a very flexible joint, it is highly vulnerable to injury. Whether youre a competitive athlete or an active elder suffering from years of repetitive motion, our specialists are here to treat a wide variety of shoulder pain and conditions. Learn more about the conditions we treat below.
What Are Symptoms Of Shoulder Pain
Symptoms that may accompany shoulder pain can vary depending on the cause and may include:
- Difficulty doing activities that place the arm behind the back, such as buttoning or zippering
- Fever, if there is an infection, such as with infected bursitis
- Loss of appetite and decreased energy, such as with rheumatoid arthritis
- Signs of a heart attack may also include: chest discomfort, discomfort in other areas of the upper body, shortness of breath, breaking out in a cold sweat, nausea, or lightheadedness
- A heart attack is a medical emergency
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Exercise Dos And Donts
During your recovery from shoulder impingement, you should avoid any activities that involve throwing, especially with your arms overheard, such as tennis, baseball, and softball. You should also avoid certain types of weightlifting, such as overhead presses or pull downs. If youre a swimmer, you should take some time off from training to allow the recovery process to progress.
While its important to rest your shoulder, you can do some light exercising to strengthen your rotator cuff and stretch the muscles in your arm, shoulder, and chest.
Try these exercises:
- Stand with your arms at your sides and your palms facing forward. Squeeze your shoulder blades together and hold for five to ten seconds. Repeat a few times.
- Stretch your arm straight in front of you and move it forward using only your shoulder. Then move your shoulder as far back as you can without moving your neck or back, or bending your arm.
- Lie on your unaffected side and bend your top arm in a 90-degree angle. Keep your elbow on your hip and rotate your lower arm up toward the ceiling. Repeat 10 to 20 times.
- Stand in a doorway, holding the side of the frame with your arm slightly below shoulder height. Turn your upper body away from that arm until you feel a slight stretch, and hold.
If any of these exercises cause pain, stop doing them or try holding them for a shorter period of time.
When Should You Have Surgery
In the vast majority of cases the decision to have surgery is made because nothing else works. In most instances it is difficult to know before surgery if the shoulder is really unstable or not. It is generally good policy to try all possible nonoperative techniques prior to having surgery. Occasionally cortisone shots may be effective, although their use is controversial. Certainly a thrower should not have more than a couple of shots since they may weaken the tendons if many more than that are given.
There are other factors that should be considered before having shoulder surgery. One is the severity of the symptoms. Another is whether the player thinks they can make it to the end of the season for a much-needed rest. Another is whether the player has a future in the sport. If one is thinking of leaving the game anyway, then a big operation is probably a “long run, short slide.” Another consideration is the level of play, since a second stringer on the fraternity team is probably not going to need an operation to further their career.
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Corrective Exercises And Stretches To Fix Shoulder Impingement
Seeing a physical therapist, chiropractor, physician or other professional is ideal when you have a condition like shoulder impingement, but in most cases, it can be healed at home by doing the right exercises.
Therapeutic exercises that correct muscle imbalances and release tight, inflamed muscles, tendons and fascia heal and restore normal function in your shoulders.
To fix shoulder impingement the goal is to correct the muscle imbalances in a three-step process of release, stretching and strengthening.
- Start with myofascial release techniques for your shoulders, which breaks up tightness, promotes tissue healing and should give you some pain relief.
- Then, do strength training exercises that target your lower trapezius and serratus anterior to strengthen the weak muscles. The strengthening of these muscles will help pull the shoulder into the right alignment.
- Finally, stretch and release your upper trapezius to help the muscle lengthen out and allow your shoulders to achieve proper alignment.
Issues like inward-turned shoulders and a rounding of the upper back contribute to the muscle imbalances seen in people with shoulder impingement.
With regular practice, youll start to see your chest lift, your shoulder blades rest down along your back, your shoulders relax downwards away from your ears, and your head move back into alignment.
In other words, you should begin to see an improvement in your overall posture which has many benefits.
What Are Common Elbow Injuries From Throwing
Here are three elbow injuries that can result from repetitive throwing:
- Ulnar collateral ligament injury: A UCL injury is the most common ligament injury for pitchers and throwers. UCL injuries usually start with pain on the inside of the elbow and can range from slight inflammation and minor damage to a complete UCL tear.
- Flexor tendinitis: Repeated overhand throwing can inflame the flexor and pronator tendons that attach to the humerus bone, resulting in tendinitis. Flexor tendonitis will cause pain on the inside of the elbow while throwing, and in severe cases, pain while at rest.
- Ulnar neuritis: When the elbow bends back to throw, the ulnar nerve stretches. Repetitive throwing can stretch the ulnar nerve to the point of slipping out of place, which causes painful snapping and irritation of the nerve that is known as ulnar neuritis. Ulnar neuritis can cause pain similar to the feeling of an electric shock, tingling, numbness, or pain in the fingers.
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What Are The Results Of Surgery
Generally most players can get back to their previous level of throwing, and it takes on average nine months for most players to be able to compete. Which type of rehabilitation in the first few weeks after surgery depends upon the type of procedure done, but by three months the player should have most of their range of motion back. A light throwing program can be started around four months, and it takes about three to four months to get all of the conditioning done to have the stamina to throw competitively.
There are not many scientific studies on the success of these operations. The more traditional operation, where an incision is made on the front of the shoulder, has been reported in the scientific literature. Two years after the surgery about 80 percent of players had returned to their previous level of throwing. What this means is that a majority of players get back to throwing, but even with surgery some may drop out of the game, sometimes for reasons other than their arm. However, we tell players that this operation will not make your arm bionic and it will not make up for poor mechanics. It takes hard work to recover from the surgery and there is a great chance that you can participate again.
Causes & Risk Factors
Shoulder or elbow pain is caused by excessive overhead movement of the arm, and often occurs while pitching a baseball. Overhead movement causes the muscles in the arm to pull on the growth plates. When this movement is repeated over and over, the space in the growth plates begins to widen. In some cases, the growth plates pull away from the bone.
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Symptoms Of A Slap Tear
SLAP tears are caused by stresses on the shoulder joint greater than what the labrum can withstand. This can happen when throwing a ball or making other overhead motions with your arms. Symptoms of a SLAP tear include:
- Pain when lifting objects
- Popping, locking, or catching sensations
- The feeling that your shoulder may pop out of the joint.
Athletes such as baseball pitchers may notice a decrease in throw velocity or the sensation of having a limp/dead arm after throwing.
What Causes Throwing Injuries
The most common elbow problems are usually caused by improper throwing mechanics. Throwers often develop muscle and tendon swelling and irritation on the inside of the elbow. This generally responds to rest, icing, and improved throwing mechanics. Occasionally, throwers tear this ligament, also known as the “Tommy John ligament,” which often requires reconstructive surgery using a tendon from the forearm or knee.
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What Every Baseball Player Should Know About Shoulder Injuries
When you think about sports injuries, football, basketball, or soccer probably come to mind. All three of these sports require that players put their bodies on the line play after play. Contact is common, and, in the case of football, tackling is an integral part of the sport.
But when you think of common sports injuries, only one sport has a repair surgery literally named after a player. Tommy John surgery, named after a Los Angeles Dodgers pitcher, is used to repair one the most common sports injuries a torn ulnar collateral ligament in the elbow..
And when baseball players arent getting their elbows repaired with Tommy John surgery, they’re usually hurting somewhere else. Soft tissue injuries are on the rise in the major leagues and show no sign of stopping. Baseball players put their bodies through a lot of sudden motion pitchers whip balls at 90+ miles an hour, and sluggers make huge swings for the fences. Its easy to see why shoulder injuries are so common.
Are you or someone in your family suffering from shoulder pain that may be related to baseball or another throwing sport? If so, come see our team at Steven E. Nolan, MD. Dr. Nolan is a board-certified orthopedic surgeon with over 20 years of experience and has received numerous top-surgeon awards during his career. Here, he highlights the most common shoulder injuries in baseball players and what they need to know.
The Best Exercises For Shoulder Impingement
Shoulder impingement is a fairly common source of shoulder pain, but few people know what to do about it.
Even if the pain is minor, if its constantly there or it flares up at night, you could be suffering from a preventable and treatable condition.
In this post, well talk about how you can tell you have a shoulder impingement and what the cause of it may be.
Well also give you the best exercises for shoulder impingement, as well as some stretches to help you eliminate pain and improve mobility in your shoulders.
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What Are Common Throwing Injuries
Two common shoulder problems are injury to the rotator cuff and injury causing shoulder instability. A little biology helps tell the story. The rotator cuff is composed of four large muscles that extend from the scapula to cover the shoulder joint. These muscles are extremely important for shoulder strength and for holding the shoulder joint in the correct position. Frequent throwing can irritate the rotator cuff or its bursa. A pinching of the bursa and rotator cuff can occur during throwing, especially if the cuff muscles are weak or tired, or if the shoulder has instability.
Shoulder Rotation With A Resistance Band
What it does: Strengthens the rotator-cuff muscles to improve shoulder function. This is the primary strength exercise for rotator-cuff strains.
How to do it:
Internal rotation with a low elbowTie one end of a resistance band to an anchor point at waist height, like a pole or doorknob. Grab the other end of the band, stand with the shoulder of that arm facing the anchor point, and step away to give tension to the band. Hold your arm by your side, with your elbow bent to 90 degrees and your hand aiming forward. Then engage your shoulder blade and rotate your arm toward your abdomen. Slowly reverse the movement for one repetition. Complete all reps, then switch to external rotation.
External rotation with a low elbowFrom the aforementioned position, rotate your body 180 degrees or switch arms, so the band now comes across your abdomen. Rotate your arm out to the side against the band , then slowly let it return to the starting position. Repeat.
If your sport involves overhead reaching, progress the exercise by performing it with your elbow at shoulder height, which better mimics the movement pattern.
External rotation with a high elbowKeep your arm in the air, and turn around to face the anchor point. Slowly rotate your arm to lower your forearm until its parallel to the floor, then pull against the band to return to the starting position . Repeat.
Volume: Three sets of ten reps for each internal and external rotation
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Pearls And Pitfalls Of Technique
Rotator cuff repair/debridement
Avoid repair of partial thickness rotator cuff tears. This can result in over constraint of the shoulder.
Concurrent procedures have a worse prognosis.
Superior labral lesions seen by MRI may not always be symptomatic in a throwing athlete and may be part of a spectrum of disease.
Posterior capsule release
Over release may result in glenohumeral instability.
Avoid axillary nerve injury inferiorly.
Manipulation under anesthesia prior to arthroscopy may lessen the need for surgical release, but also can obscure arthroscopic view due to bleeding.
Exercises To Fix Shoulder Pain
A holistic guide to strong, healthy shoulders
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As outdoor athletes, we abuse our shoulders, whether were climbing, pole planting, paddling, or doing anything that involves the risk of falling hard. The shoulder is the most mobile and least stable joint in the body, which means its highly prone to injury.
Shoulder injuries are one of the most common injuries that we see in our clinic, says Esther Smith, a physical therapist, climber, and owner of Grassroots Physical Therapy in Salt Lake City. Most of these cases are caused by misuse and overuse versus trauma, she says, which suggests theyre largely preventable. Injuries often begin as a dull ache or discomfort that may come and go but never seems to disappear completely. When you try to push through as most stubborn outdoor athletes tend to doit can develop into a sharp, debilitating pain that can be frustratingly difficult to shake.
People will oftentimes see a medical practitioner too late, and then those injuries become hard to treat, says Jared Vagy, a physical therapist, board-certified orthopedic clinical specialist, and the author of Climb Injury-Free. The best course of action is to address the nagging ache early on, before it becomes a full-blown injury. Below, Smith and Vagy explain the mechanism behind the three most common shoulder injuries and how to get on the road to recovery.
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What Are The Risk Factors For Throwing Injuries
When it comes to throwing-related injuries, there are certain factors that can put athletes at a greater risk of injury. Some of these factors are unavoidable, while others can be easily corrected with the right amount of practice. These are the main variables that affect an athlete’s likelihood of developing a pitcher’s elbow or another throwing-related injury:
Rotator Cuff Injuries And Irritations
Your rotator cuff is a group of muscles and tendons that help tether your shoulder into the socket and allow you to move it in a circular motion. Some two million people visit a doctor each year for rotator cuffrelated issues, according to the American Academy of Orthopedic Surgery . Most problems with the rotator cuff fall into two categories: tears or inflammation. Suspect a rotator cuff problem if you have pain or stiffness in your shoulder when you lift your arm above your head to brush your hair or when you reach behind your back. “You won’t be able to do a lot of things you want to do, such as put dishes in an upper cabinet, play tennis, or do garden pruning,” says Dr. Ramappa.
Rotator cuff impingement. A rotator cuff impingement happens when there is irritation, inflammation, or compression of the tendons or bursa in the shoulder. An impingement can be caused by an injury, but it can also just result from general wear and tear from daily life.
Rotator cuff tears. A tear in the rotator cuff will produce pain that is similar to an impingement but has one additional differentiating feature. “If the pain is associated with weakness, it is likely caused by a tear, and if you just have pain, it may only be a rotator cuff impingement,” says Dr. Ramappa.
Performing simple stretches two to three days a week can help keep your muscles flexible and reduce pain, provided your doctor approves.
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