Shoulder injuries to young athletes have become very common, especially among the young throwing and racquet sport players and swimmers. A primary cause is overuse. Overloading tissue with insufficient rest, playing multiple positions, especially catching in addition to pitching, or just too much activity will lead to pain, tissue damage and altered mechanics when performing the activity.
Overhead motions in throwing and racquet sports actually involve the entire body. Weakness in the lower extremities and trunk can impair a player’s ability to decelerate and control their shoulder mechanics. The end result is pain in the shoulder. Many diagnoses are given for these shoulder conditions including: impingement, rotator cuff tendonitis and scapular dyskinesis to name a few.
Underhand throwing does not result in the same forces and mechanics as the overhead technique. However, softball players also can develop throwing injuries unique to their sport and our therapists are well aware of these issues as well.
Swimming presents a unique set of challenges. Swimming is performed horizontally without the feet on the ground and the arms are pulling you through the water. There is no decelerating in swimming! A few injury similarities exist with throwing but the causes are different.
Impingement syndromes and altered scapular mechanics are often the result of insufficient body roll or incorrect rotational positioning of the shoulder. Muscle imbalances may occur due to the extremely repetitive nature of swimming which need to be corrected through dry land training. Being competitive is a delicate balance of proper training and avoiding over-training. One should apply the most current information for proper mechanics and not outdated, but still quite popular, training techniques. And, supplementing your swim training with specific strength training to avoid the creation of muscle imbalances and poor shoulder control.
Weight lifting shoulder injuries are usually due to poor technique and overloading the tissue. Our muscle gain strength by overloading and allowing for adequate recovery. Often, we are good about the overloading but not about allowing the proper recovery, which leads to tissue breakdown. Also, the shoulder is sensitive to the demand of high forces at the extremes of the range of motion. For example when performing bench presses with dumbbells and allowing the weights to come deep into the position and then generating great force to lift the weights. This places great stress on the front of the shoulder including the long head of the bicep tendon and the supraspinatus with the result being pain in the front of our shoulder, tendonitis, labrum, muscle or tendon injuries.
Creating awareness of potentially damaging positions and movements is a goal of our program. If this information is not included and one continues to perform these adverse movements, it is not a matter of if you will injure your shoulder but when the injury will occur.
Golfis not often thought to create or contribute to shoulder pain. However, there are great demands on the shoulder for sufficient range of motion and force generation from the shoulders. The lead shoulder must be able to reach across the body and the back shoulder must have sufficient external rotation for a normal back swing, which also requires good strength of the shoulder muscles to avoid impingement. The forward swing requires shoulder force generation to pull through the stroke. Of course, the rotation coming from the lower extremities and trunk contribute greatly to the stroke. Unfortunately, few of us have great range of motion and strength, which often leads to injuries when we place demands on our body which exceed the current capacity to control them.
Our specialists have expertise in specific analysis of your unique shoulder motions and will be able to determine your range of motion, strength, coordination and deficiencies. We are not coaches but we will work closely with your coaches to ensure that they are aware of your condition and will offer guidance in practice regarding your performance during your recovery and future competitions. We will prescribe specific exercises to resolve all of the contributing issues and progress you through a complete program which will allow you to return to competing. You will receive an independent program, which will include first aid, exercises, proper rest and safety measures.
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