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Shoulder Pain in the Overhead Athlete
By: Mark Duggan, Registered Physiotherapist
Shoulder pain is very common in individuals who play 'overhead' sports such as
baseball, tennis and volleyball. In this group of athletes injury may be the result of an isolated traumatic event
such as a fall or through repeated sporting-use causing micro-trauma to the shoulder region.
The shallow anatomical design of the shoulder joint surface is what makes it
inherently unstable and prone to these types of injuries. This lack of bony support increases the dependency on the
muscles and other soft tissues for stability. Any alterations in how these tissues function will raise the risk of
shoulder injuries.
Two common structural injuries in this group of athletes are the rotator cuff and the labrum.
The rotator cuff is a group of muscles which extend from the shoulder blade to the arm. It insures dynamic
shoulder stability by maintaining the proper relationship between the arm and the shoulder blade.
The shoulder joint is comprised of a ball and socket. The labrum is a fibrous tissue at the edge of the
shoulder blade which extends to cover the ball at the top of the arm bone. It functions to increase the shoulder's
stability by deepening the socket
Typically, you are more prone to injure the labrum at a younger age. This tearing injury is called a SLAP
lesion which is an acronym, (Superior Labrum extending Anterior to Posterior), referring to the location of the injury.
It is a fairly common diagnosis for overhead athletes complaining of shoulder pain. Some studies have found it to be
present in 83% to 91% of these athletes who require shoulder surgery.
Injuries to the rotator cuff are more likely to happen as we get older. Repetitive micro-trauma to these tissues
results in inflamed tendons (tendonitis) and tears.
Tightness in the tissues at the back of the shoulder and weakness in the shoulder
blade muscles are factors that are known to increase your risk for these injuries. An assessment by a physiotherapist
can be beneficial in determining which of these factors are present and designing a program to correct these imbalances
before you have pain.
If you have discomfort and pain every time you cock your arm to throw or serve, or
have experienced the sudden onset of sharp pain or a loss of strength and power, you may already have an injury.
Ignoring these warning signs and continuing to play through the pain can cause damage. If you are experiencing symptoms
a physiotherapist can determine whether a program of stretches for the back of the shoulder and exercises to strengthen
your shoulder blade muscles will allow you to return to your sport with more power to serve or throw, lowering your
chance of re-injury. The earlier you seek therapy the better will be the result.
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