Shoulder & Elbow Throwing Injuries
Throwing injuries in the shoulder and elbow are common among athletes, particularly those who participate in sports requiring repetitive overhead movements, such as baseball pitchers, javelin throwers, tennis and volleyball players, and swimmers. These overuse injuries result from the high stresses placed on the shoulder and elbow joints during the throwing motion.
- Rotator Cuff and Biceps Tendinitis: Inflammation of the rotator cuff tendons and the biceps tendon can occur due to overuse and result in pain during throwing, overhead movement, and lifting. In severe cases, pain at rest, night pain, and loss of strength can occur.
- Internal Impingement: During the cocking phase of throwing, the underside of the rotator cuff tendons is pinched between the humeral head (ball of the shoulder) and the glenoid (shoulder socket). This can result in injury to the rotator cuff tendon and shoulder labrum and cause limited shoulder internal rotation and pain.
- Shoulder Instability: Years of repetitive throwing may cause instability as the supporting ligaments become stretched, allowing the humeral head to subluxate (partially dislocate) from the glenoid. Symptoms include pain and loss of throwing velocity that can feel as though the arm “goes dead.”
- SLAP (Superior Labrum Anterior to Posterior) Tears: A tear of the top portion of the labrum that surrounds the shoulder socket, often affecting the attachment of the biceps tendon. Symptoms include a catching sensation, pain with overhead movement and throwing, and deep pain in certain arm positions.
- Pain during or after throwing.
- Decreased throwing velocity or accuracy.
- A sensation of the shoulder “popping” or “clicking.”
- Decreased shoulder range of motion.
- Overuse and repetitive stress from throwing motions.
- Poor throwing mechanics.
- A sudden increase in throwing intensity or frequency.
- Insufficient rest.
- Medial Epicondylitis (Golfer’s Elbow): Inflammation of the forearm flexor tendons that attach to the inner (medial) elbow. This can occur with sports that involve gripping and repetitive wrist flexion.
- Ulnar Collateral Ligament (UCL) Injury: The UCL is crucial for stabilizing the elbow during the throwing motion. The UCL is the most commonly injured ligament in throwers. Injuries can range from inflammation to partial tears to complete tears.
- Olecranon Stress Fractures: Stress fractures result when an excessive load occurs through the bone. Repetitive throwing motions cause a stress fracture in the olecranon, the bone at the back of the elbow.
- Valgus Extension Overload: This injury occurs when repetitive stress is applied to the posteromedial (inner back) aspect of the elbow. Extending the elbow causes more pain.
- Ulnar Neuritis: Ulnar neuritis occurs when the ulnar nerve, which runs on the inside of the elbow, gets irritated and inflamed. This nerve goes through a tight spot at the elbow called the cubital tunnel, and when it gets compressed, it can cause pain over the inside of the elbow and numbness and tingling into the ring and pinky fingers.
- Pain on the inside of the elbow during and after throwing.
- Decreased throwing velocity and accuracy.
- Swelling and tenderness around the elbow.
- Difficulty in performing throwing or gripping tasks.
Diagnosis involves a comprehensive approach, including medical history, physical examination, and imaging studies.
Your UCSF Women’s Sports Medicine physician will ask you to describe your symptoms, location and intensity, and activities that aggravate or alleviate them. They will inquire about your sport, position, and throwing mechanics and discuss previous injuries and treatments to the shoulder and elbow. A physical examination follows, where they check for swelling, range of motion, and muscle strength and may perform specific tests to pinpoint the injury.
Imaging studies like X-rays and MRIs offer a closer look at bones and soft tissues, revealing fractures, tears, or inflammation. At the UCSF Women’s Sports Medical Center, we have sports medicine specialists who can provide advanced diagnosis and treatment options, including nonsurgical and surgical options. This comprehensive approach ensures an accurate diagnosis, guiding effective treatment planning.
Prompt recognition and treatment of symptoms can help prevent the progression of injuries and minimize time away from sports. Collaboration with our sports medicine professionals is essential for an effective recovery and return to sport.
At UCSF Women’s Sports Medicine Center, in addition to orthopedic surgeons and sports medicine experts, we offer sports nutrition, sports psychology, athletic training, physical therapy, and a sports performance center to help you play at your best and recover from your injuries. Individualized training to prevent future injuries is available to help you return to the life you love and the sports that make your life meaningful. Contact us to schedule a consultation today.
References
- https://orthoinfo.aaos.org/en/diseases–conditions/elbow-injuries-in-the-throwing-athlete/
- https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-injuries-in-the-throwing-athlete/
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