SHOULDER INJURY PREVENTION FOR THE OVERHEAD THROWING
ATHLETE
Part Two: Normalizing
range-of-motion
Steve Daisey MPT, CSCS
Athletes
who throw professionally, or in some cases collegiately will be
familiar with the stretch shown in this article. However, most athletes
have never seen it. It is designed to maintain flexibility of the
shoulder in throwers.
Normally, the
overhead throwing athlete will develop more "external rotation"
of the shoulder (cocking the arm back). This overall increase is
not necessarily a bad thing, so long as the rotator cuff muscles
surrounding the shoulder are strong and healthy. This added flexibility
allows the athlete to wind-up more in the cocking phase of throwing,
therefore adding more velocity to the throw. Some of this increased
mobility is thought to be due to a retroversion (permanent bony
backward twist/shift) of the head of the humerus during childhood
years (5).
The side-effect
of this shift in flexilbility is that the athlete now has less "INTERNAL
rotation" of the shoulder (motion during the follow-through of throwing).
This is caused by tightness in the posterior rotator cuff muscles
and posterior capsule of the shoulder. These tight structures then
force the shoulder to translate forward during the follow-through
phase of throwing, greatly increasing the stress placed on the anterior
shoulder, rotator cuff, and even the elbow (1-4).
THE STRETCH
1) Lie in a quarter-turn
from your back as shown. Your underside arm is the shoulder
you will be stretching. It should be almost perpendicular
to your torso.
2) Bend
90 degrees at the elbow. Take your other hand and push down
on your wrist/forearm, rotating your shoulder joint internally
(your forearm goes toward the table).
Do this VERY SLOWLY AND GENTLY!
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3) Hold
at least 30 seconds. You should feel the stretch in the back
of the shoulder.
The goal is to isolate and stretch the posterior rotator cuff
and posterior capsule of the shoulder joint. If those structures
are tight, then the shoulder will translate forward and be at
more of a risk for strain or dislocation during throwing activities.(1)
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If you feel
a stretch anywhere else besides the back part of the shoulder, or
if you feel pain anywhere, try to re-adjust your body position.
If you continue to feel pain, you should consult your physician
or physical therapist.
This stretch
is best done after a light warm-up, at least 3-5 reps of 30 second
holds followed by a sport-specific warm-up before throwing.
REFERENCES
1. Harryman
DT, et al: Translation of the humeral head on the glenoid with passive
glenohumeral motion. J Bone Joint Surg 1990 72(9):1334-43.
2. Crockett HC, et al: Osseous adaptation and range of motion at the
glenohumeral joint in professional baseball pitchers. Am J Sports
Med 2002 Jan-Feb;30(1):20-6.
3. Fleisig GS, et al: Biomechanics of overhand throwing with implications
for injuries. Sports Med 1996 Jun;21(6):421-37.
4. Chagneau F, Delamarche P, Levasseur M. Stroboscopic computerized
determination of humeral rotation in overarm throwing. Br J Sports
Med 1992 Mar;26(1):59-62.
5. Reagan KM, et al: Humeral retroversion and its relationship to
glenohumeral rotation in the shoulder of college baseball players.
Am J Sports Med 2002 May-Jun;30(3):354-60.
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