Overhead activities such as throwing a baseball, is one of the most strenuous motions you can perform at your shoulder and elbow. No other exercise or activity can quite reproduce the stress on the joint and ligaments quite like throwing a ball. Baseball players are at risk for several injuries due to the high repetitions of throws they have to perform in games and practices. One typical injury we see is having pain in the anterior or front portion of the shoulder while throwing. This is called anterior instability and can be tested by performing an apprehension test which Dr. Chuck Bachi describes in this video. By placing the arm in the cocked position it causes the head of the humerus bone to slide forward and stress the front of the shoulder. When he pushes down on the head of the humerus to “ relocate” it, the pain is gone. This is a positive test for anterior Instability. So how do we treat it?
Stretching to the back of the shoulder or posterior capsule of the shoulder is important. When the capsule and muscles in the back of the shoulder are tight, they may contribute to pushing the head of the humerus bone forward. This is called secondary impingement and can end up creating issues with your rotator cuff tendons. In the video above, Dr. Chuck demonstrates joint mobilizations performed by a Physical Therapist to improve elasticity in posterior capsule. He also performs manual stretching and Instrument Assisted Soft Tissue Mobilization to improve the flexibility and motion at the back of the shoulder. At the end of the video, John demonstrates a stretch that he can perform on his own to maintain the motion he has gained.
After you have improved your motion through stretching you want to prevent this from reoccurring. Key areas to strengthen are your scapular muscles and your posterior rotator cuff muscles. Your scapula provides the stable base for your shoulder to move. Check out these videos on Y’s and T’s to help stabilize your scapula. The other important area to strengthen is your posterior rotator cuff muscles. These muscles help you to decelerate the ball when you throw. They need to be extra strong to prevent your posterior capsule from tightening up and to handle the high demands repetitive throwing results in. Check out this video of John performing a posterior cuff strengthening exercise.
Not all pain in the front of the shoulder is from instability. If you are having shoulder pain of any kind, you want to be evaluated by your Physical Therapist to personalize your exercise and treatment program.