HSS Webinar: Throwing Athletes and Shoulder Injuries

In the latest installment of HSS’s series of “Thirty Minute Thursday” sports webinars for student athletes, three HSS Stamford doctors and a physical therapist from HSS Westchester teamed up to discuss the topic of “Throwing Athletes: Avoiding Shoulder Injury” on June 4th.

The webinar participants included:

• Karen M. Sutton, MD, a sports medicine surgeon at HSS, the session moderator;
• Theodore A. Blaine, MD, a sports medicine surgeon at HSS specializing in shoulder and elbow injuries;
• Samuel A. Taylor, MD, a sports medicine surgeon at HSS specializing in shoulder and knee injuries;
• Debi Jones, PT, OCS, SCS, a physical therapist at HSS Westchester

Six Phases of Throwing

Dr. Blaine began by discussing the six phases of throwing motions and the various forces and stresses with these movements. He spelled out the components involved in throwing, which include shoulder rotation, core strength, and scapulothoracic stability. He also reviewed the anatomy of the shoulder, citing tendonitis, rotator cuff, long head bicep tears and labral tears as common shoulder injuries.

Throwing Injuries: Women vs. Men

In comparing shoulder injuries for women athletes versus men, the HSS participants agreed that the underhand motion for women softball pitchers puts more stress on the shoulder. Other common throwing sports among women athletes are water polo and javelin. Dr. Sutton said female athletes have a predisposition to shoulder instability, which can lead to shoulder injuries.

Dr. Taylor noted that football quarterbacks experience far fewer shoulder injuries than pitchers, as a quarterback’s throwing motion leads more with the elbow. Baseball players are more prone to shoulder and elbow injuries, due to the overhand motion. He mentioned that while rotator cuff tears are rare for young athletes, they can suffer rotator cuff internal impingements when shoulder muscles go out of whack due to a deconditioning event following an injury. He recommends rest, physical activities outside their specific sport, and developing muscles around the shoulder blade to treat impingement injuries.

Dr. Blaine says he often sees patient athletes with loose shoulders, which helps generate the necessary force to perform well. But he calls this condition a “thrower’s paradox”, as this same looseness may indicate instability which can cause shoulder injuries.

On the subject of pitch counts, Dr. Blaine follows the rule of 8s: limiting pitchers to eight months of pitching per year, followed by four months of rest; a maximum pitch count of 80 pitches per game; and exercising caution when throwing more than 85 miles per hour. He added that the latest research shows that throwing curveballs may not create added stress to a young pitcher’s arm or elbow.

Important to Build Power

Debi emphasized the importance for athletes to pursue an overall strengthening program, focused on the entire kinetic chain, not just a specific injury area. More than injury prevention, the program’s aim is to increase power. Areas to focus on are trunk stabilization, hips and glutes, balance, and overall aerobic fitness. She notes that the longer an athlete tries to push through pain, the more difficult it is to pull out of an injury pattern. Debi adds that the pandemic’s impact in limiting training and activity means athletes should take it slow in getting back to playing shape.

Other HSS “Thirty Minute Thursday” webinars for student athletes are available at: https://www.youtube.com/playlist?list=PLDps2oOp60a6qPiqVzz5MEGZAk7wKCihU

For more information on HSS (www.hss.edu) patient education programs, please visit:

https://www.hss.edu/public-patient-education.asp.