Physio 101: Recovering from a Throwing Arm Injury
Contrary to popular belief, you should be entirely pain free when throwing. This applies to aggressive pitching as well. Any amount of pain in throwing may indicate an injury.
Your shoulder is a ball-and-socket joint made up of three bones: your humerus, or upper arm bone; your scapula, or shoulder blade; and your clavicle, or collarbone. The head of your upper arm bone fits into a rounded socket in your shoulder blade surrounded by a rim of strong, fibrous tissue called the labrum. Think of it as the suction cup that holds your shoulder joint together.
Your shoulder relies on having strong muscles to keep your shoulder stable. A group included in these muscles is the rotator cuff. You’ve probably heard the rotator cuff referenced in passing by those who have experienced an injury to this region. The rotator cuff is comprised of four muscles that come together, forming a covering (or cuff) of tissue around the head of the humerus.
When athletes throw repeatedly at high speed, significant stress is placed on the shoulder region. Tendonitis, torn tendons, sprains, and strains are common amongst avid pitchers. The rotator cuff is one of the most commonly affected areas.
Throwing is intensely studied by physiotherapists and athletic scientists. As one of the fastest human motions performed, it can be difficult to assess the motion as a whole. To achieve a better understanding, we’ve broken the mechanics of throwing into phases. This makes it possible to understand exactly where injury might occur.
Mechanical Phases of Throwing
The phases of an overhead throw consist of the wind up, stride, cocking, acceleration, deceleration, and follow-through. Each phase activates different muscles and creates varied potential for a repetitive stress injury.
During the winding up phase, there is minimal muscle activity. When performed correctly, this should be a low intensity motion. As the stride leg is flexed, your weight is transferred from the stride leg to the pivot leg and hip abductor region. The pivot leg acts as the weight absorber while the abdominal muscles rotate and stabilize with the upwards rotation of the collarbone.
The cocking of the arm is broken into two parts: early cocking and late cocking. A substantial amount of kinetic energy is transmitted to the shoulder in this phase. About 80 percent of your body weight is transferred upwards from the lower region. The scapula and shoulder muscles are highly activated at this point, promoting and sustaining movements within the shoulder, particularly the external rotation.
Early cocking takes place when the stride leg reaches its maximum height and makes contact with the ground. The hip muscles are activated while the stride leg works against the throwing motion. This controls the lowering centre of gravity within the body. The abdominal muscles are also controlling excess stress on the lumbar to prevent hyperextension.
Late cocking begins from the point the stride leg comes in contact with the ground to when the throwing arm reaches its maximum external rotation. In late cocking, the hip, knee, and calf of the pivot leg transfer the force up the kinetic chain and drive it into the throwing arm.
Acceleration is the most explosive phase of the pitching process. During this phase, it is critical to maintain stability in the scapula due to the abrupt forward acceleration of the arm.
Acceleration is followed by deceleration, which is the most active phase for the muscles of shoulder. This is because the muscles in the shoulder need to move in reverse as they work to decelerate the arm after the ball is out of the hand.
Labral tears commonly occur in both the acceleration and deceleration phases of a throw. Rotator cuff lesions are also a common result of repetitive stress in these phases.
In the follow-through phase, the body continues to move forward until the throwing arm has ceased motion. During this phase, the rest of the body catches up with the arm, bringing the body back into an upright position. Tendon tears are particularly common in the follow-through when the motion is stopped too abruptly, shocking the activated muscles.
Recovering from a Softball Shoulder Injury
Proper stretching and targeted exercise are essential to recovering fully from a softball shoulder injury. Your Capture Therapeutics team will likely first make suggested changes to your daily routine that will help prevent further injury to your shoulder region. We’ll also create a stretching and strengthening regimen for you to follow with us at the office and at home.
With a holistic approach to recovery, we’ll target your core and legs as well as the affected shoulder. Expect to incorporate lunge-type exercises and a few minutes of cardio in addition to your shoulder stretches. Increasing the range of motion in your shoulder and eliminating any discomfort in throwing will be our priority in working with you.
One of our kinesiologists can also show you how to mindfully recreate the mechanical phases of throwing to better understand what your body is communicating to you in each phase. We’ll help translate for you and, where appropriate, make a plan for responding better next time through stretching, posture, and position.
We’re Rooting for You!
Are you experiencing pain when pitching or experiencing other pain in your shoulder? We want to hear from you and answer all of your questions. If you’d like a virtual appointment, go to www.capturerehab.ca and book your appointment with our team. Or you can give us a call at (833) U-R-HEARD, Monday to Friday, or book your appointment with us online here if you’d like to attend in person at one of our locations.
We'’re rooting for you and can'’t wait to become a part of your recovery game!