Throwing Shoulder
Shoulder injuries are very common in the throwing athlete. The use of high-speed video technology has shown that pitching a baseball requires the arm to accelerate at a speed of 7,000 degrees per second. Larger muscles surrounding the shoulder are most active during the acceleration of the throw, whereas the smaller, more delicate rotator cuff muscles are most active during the deceleration phase.
Our specialists will evaluate the throwing athlete by obtaining a thorough history and physical exam. A series of tests will be performed on both shoulders to compare range of motion, strength and evaluate maneuvers that elicit pain. Radiographic imaging and MRIs will be obtained when necessary for diagnosing the problem. Microtrauma injuries to the rotator cuff muscles are common and can cause pain while throwing, whereas more significant tears may cause profuse night pain. Instability may cause pain or give the sensation of subluxation especially during the follow through phase of throwing. Athletes that are experiencing decreased range of motion, particularly internal rotation, may have contracture of the posterior capsule.
Treatment for shoulder injuries in the throwing athlete will be focused on the patient’s specific issue. There are many different possible pathologies in the shoulder that can cause pain and dysfunction. Our shoulder specialists focus on conservative management initially which usually requires physical therapy directed toward strengthening the shoulder girdle, stretching and decreasing pain. If there are no improvements seen over a three to six month time period, surgical treatment may be considered.
Frequently Asked Questions
Most shoulder pain can be treated with rest, anti-inflammatories and physical therapy. Any primary doctor or general orthopedist can prescribe these simple solutions, but a trained shoulder specialist won’t just treat your pain — they will diagnose and treat your specific problem.
At Modern Orthopaedics, our trained shoulder specialists will ask the right questions, perform specific examinations and order imaging when appropriate. They will be able to diagnose your problem and treat you whether your problem is simple or complex. Although you may not feel like your shoulder issue is “bad enough” to see a specialist, it is advantageous to have the opinion of an expert in the field when it comes to your health.
Before deciding on the treatment for your shoulder pain, our doctors will first diagnose your problem. Depending on the type and severity of your problem, the treatment options will vary.
Generally, physical therapy will be involved in the first step of treatment. You will work closely with a therapist two to three times a week to develop a routine that is tailored to your diagnosis and needs. Therapy may take some time to help, which is why a six-week trial is generally recommended before proceeding with other treatment options.
Cortisone injections are often used in orthopedics. Our doctors are conservative when it comes to using cortisone injections and reserve them for specific situations. They are most commonly used for patients who may have a stiff or frozen shoulder or shoulder arthritis. They use them less commonly for rotator cuff issues, but there are exceptions. Each patient’s situation is unique, and our doctors will work with you to ensure the highest level of care.
Surgical intervention is reserved for shoulder issues that do not respond to more conservative measures or acute injuries that need to be addressed right away. The most common shoulder surgeries performed by our doctors are done arthroscopically. This allows for smaller incisions and a quicker recovery for our patients. The length of recovery, immobilization period and rehabilitation protocol differ depending on the surgery.
Personalized care
As our patient, you will have an in-depth consultation with one of our doctors. We will create an individualized treatment plan together, tailored to your problem and lifestyle. Our doctors prefer non-invasive treatments whenever possible, including physical therapy and/or injections. If your problem ultimately does require surgery, our doctors prefer the least invasive surgical techniques possible. Our goals are the same as yours: to get you back to living your best life, pain free.
