“The shoulder is our most flexible joint in the entire body giving us a great range of motion but also making it vulnerable to injury; especially for the throwing athlete,” says Doctor Alexander Miscannon of TORQ Physical Therapy in Riverton, NJ.
ANATOMY:
The shoulder is formed by the union of three bones – the humerus, the scapula (known as the shoulder blade), and the clavicle (known as the collarbone). It consists of two joints; The glenohumeral joint and the acromioclavicular joint. For this article, our focus is on the glenohumeral joint.
The glenohumeral joint is a ball and socket joint formed by the articulation of the rounded head of the humerus and the cup-like depression of the scapula known as the fossa. This fossa is shallow and requires the support of muscles, cartilage, and ligaments for reinforcement. Two main contributors to shoulder stability are the rotator cuff and the labrum.
The rotator cuff is composed of four muscles originating on the scapula and inserting on the humerus. Their primary function is the stability of the glenohumeral joint but also elevates and rotates the shoulder.
The labrum is a ring of cartilage surrounding the fossa and extending onto the humerus. It increases stability while allowing flexibility of the joint and is also an attachment site for tendons and ligaments.
Unfortunately, the rotator cuff and labrum are at risk for the throwing or overhead athlete. Injuries to the structures are on the rise at all levels of sport: high school, college, and professional.
Research has shown a limited range of motion into shoulder flexion and external rotation and strength deficits; especially in the rotator cuff, bicep, and lower trapezius muscles can contribute to an athlete’s risk. Physical therapists specialize in evaluating movement dysfunction, diagnosing potential risk factors in athletes, and prescribing appropriate personal training programs to decrease pain and risk for injury.
An evaluation consists of assessing the athlete’s entire body: range of motion, strength/stability, balance, body mechanics, and posture. Therapists will educate an athlete on any potential risk factors and will compose a customized exercise program to decrease risk and enhance performance.
After a proper evaluation, the Physical Therapist will determine the appropriate treatments for the athlete, such as massage, stretching, cupping, and more. In addition to hands-on treatments, the athlete will be assigned a personalized exercise regimen to maintain mobility and strength in their shoulder.
A well-rounded exercise and rehabilitation program for the shoulder incorporates both strength training and stability exercises. This unique combination of exercises will benefit the athlete the most by allowing them to use their newly improved strength in their sports. Because of the demand of the sport of throwing this training is often more intensive and requires multiple training sessions weekly as well as a hands-on approach to minimize the effects of overtraining.
It is important to understand the common symptoms of overtraining which include soreness lasting for more than three days, persistent sharp pain in the front of the shoulder, and reductions in strength or range of motion. Qualified Doctors of Physical Therapy and other sports practitioners are best suited to help minimize overtraining in throwing athletes while providing the most effective training programs possible.
