Throwing Injuries in the Shoulder
you know it places significant stress on the shoulder?
If not properly addressed, they can lead to pain, reduced performance, and interference with even basic everyday activities. For athletes recovering from injury and safely returning to throwing requires a structured approach that prioritizes recovery, strength, and proper biomechanics. Here’s a breakdown of the key components of a successful return-to-throwing program.
Why is the Shoulder Prone to Throwing Injuries?
The shoulder is the most mobile joint in the body, capable of an incredible range of motion.
This mobility, however, comes at the cost of stability, making it vulnerable to
injuries—especially during repetitive or forceful movements like throwing.
Throwing involves a complex sequence of motions:
1. Wind-up
2. Early and late cocking (where the shoulder rotates backward)
3. Acceleration (where force is generated to throw forward)
4. Deceleration and follow-through (where stress on the shoulder peaks as the
arm slows down)
If any part of this sequence is off—due to muscle weakness, poor mechanics, or
overuse—the shoulder tissues (muscles, tendons, and ligaments) can become impaired.
Physiotherapy Assessment and Treatment in the Throwing Athlete
1. Assessment of Range of Motion
An important step in rehabilitation is assessing the range of motion (ROM) of the shoulder.
For throwing athletes, the goal is to maintain a combined internal and external rotation of
around 175 degrees. Limitations in ROM can be caused by conditions like posterior shoulder
instability, which can lead to guarding and difficulty with certain movements. Regular
reassessments during rehab can track progress and ensure that the shoulder is moving
properly as you progress through recovery.
2. Retraining Motor Patterns
A key part of recovery involves retraining the motor patterns that stabilize the shoulder joint.
This helps prevent re-injury and promotes dynamic stability. Rehab exercises start with
improving scapular stability, strengthening the muscles around the shoulder blade, and
working on rotator cuff control. Techniques like posterior sling taping may also be used to
stabilize the shoulder during rehab, allowing for better joint support. As rehab progresses,
more advanced exercises focus on building posterior shoulder strength and challenging the
joint in positions that mimic the movements used in throwing.
3. Building General Strength Rehabilitation for throwing injuries isn’t just about the shoulder—it also involves strengthening the entire kinetic chain, which includes the muscles throughout the core, upper
and lower body.
In the upper body, a progressive strengthening program incorporates both
pushing and pulling movements, with a gradual increase in intensity. As shoulder stability
improves, the program will incorporate overhead movements to ensure the joint can handle
the specific demands of throwing.
4. Tailored Throwing Rehab Exercises, Rehab also focuses on reintroducing the throwing motion itself. A tailored program is designed to gradually return to throwing mechanics and rebuild explosive power. This process involves controlled exercises that simulate throwing motions, for example, weighted
ball plyometric exercises can mimic the action of throwing whilst working on technique and
power.
5. Developing a Throwing Plan
The final stage of rehab is the return to sport. This phase involves a carefully structured
throwing plan that may start with low-intensity drills, such as double underarm throws or
single-arm tosses. Your physiotherapist will gradually increase the volume and velocity of
the throws to match the demands of your sport. Throughout this process, progress is closely
monitored, and regular reassessments of range of motion and isometric muscle strength
help ensure that the shoulder is handling the repetitive motions required for throwing.
Conclusion
Throwing injuries can be a challenge for athletes and active individuals, but they don’t have
to sideline you for long. By focusing on restoring shoulder stability, retraining motor patterns,
and gradually increasing the intensity of throwing motions, you can return to your sport
safely and effectively. Following these steps will help you minimize the risk of re-injury and
get back to doing what you love—throwing with power and precision!
