Sports Medicine Treating Arm and Shoulder Injuries in Throwing Athletes By Centers for Rehab Services, April 6, 2016 The spring temperatures are rising which means it’s time to warm up your body in preparation for the baseball and softball seasons. Michael Woodward, PT, DPT, facility director at the UPMC Centers for Rehab Services’ Chicora location, discusses common arm injuries associated with “overhead athletes,” or those who use their shoulder and upper arm to propel objects overhead. He recommends certain warm-up exercises to prevent fatigue and muscle soreness. “As a physical therapist and baseball coach, I have seen a significant number of arm injuries associated with overhead athletes,” Michael says. “These injuries have occurred in everyone from T-ball players to the pros. There may be a large difference in size and velocity [in which players propel the ball) between those players, but the arm injuries stay the same and can be caused by the same weaknesses or deficits.” Baseball and Softball Shoulder Injuries “If you look back to the primary function of both the labrum and rotator cuff, it is to protect and stabilize the shoulder joint,” Michael says. “When you have a labral tear, you often have instability and increased movement of the shoulder within the joint. When a rotator cuff tear is present, there will usually be a muscle imbalance that will cause weakness and abnormal movements.” Labral tears The labrum is a ring of cartilage that provides stability and protection for the shoulder. It also is the attachment point for the long head of the biceps. A tear may be caused by: Overuse Traumatic injury Quick movements The most common in overhead athletes is called a SLAP tear, which stands for “superior labral tear from anterior to posterior.” This also may involve the location where the biceps attach. Rotator cuff tear Another common shoulder injury is a rotator cuff tear. Some think the rotator cuff is a single muscle, but it is made up of four muscles: Infraspinatus Subscapularis Teres minor Supraspinatus (most common to tear) These muscles provide stability to the shoulder and allow the shoulder to rotate. As with the labral tears, the rotator cuff is typically torn because of traumatic incidents or overuse caused by throwing or repetitive overhead activities. Treatment for Shoulder Injuries There are several effective treatment options for labral and rotator cuff tears. Global strengthening program An effective treatment option is to incorporate a global strengthening program, like the “thrower’s ten,” to increase stability of the shoulder and strengthen the remaining muscles to eliminate dysfunctional movements. This same strengthening program can be used to protect athletes and the general population from developing shoulder injuries. By strengthening the rotator cuff and surrounding muscles, it will: Increase stability and strength Eliminate the chances of overuse injuries Thrower’s Ten program An effective program for both pre and post-injury is called the Thrower’s Ten program, which is recommended by many top sports medicine doctors and physical therapists. It is a set of 10 strength training and stretching exercises designed to strengthen and support the body mechanics and physiology of throwing athletes. The exercises combine rotator cuff strengthening and overhead training to mimic a proper throwing pattern. This program is particularly helpful for younger athletes to develop rotator cuff strength at an early age. The program is also helpful for pre-season training, prepping muscles of the shoulder ready for the upcoming season. Shoulder surgery If alternative treatments do not work, labral and rotator cuff tears can be treated with surgery. “For those who play, coach, or have children playing baseball or softball, I strongly encourage you to speak to a physical therapist about a pre-season training program,” Michael recommends. “By learning to do the right exercises, you will not have the fatigue or muscle soreness you may have had before and you’ll also increase your performance velocity.” Learn more about sports rehab at UPMC Centers for Rehab Services, which helps many recreational, amateur, and professional athletes get back to their game.