Football, tennis, basketball, cricket, baseball and so many more. These are sports or activities that have some component of an overhead movement and they are sports that many people play in their adolescent years without having any issues. However, as we age, we start to notice how stiff our shoulders have become even while playing a light game of “catch”.
Commonly, people will attribute this stiffness/discomfort to “wear and tear” or to throwing too much in their younger years, and they will now opt to sit on the sideline rather than be active and get back in the game because they don’t want to cause further damage or pain. As a former quarterback who has thrown hundreds of thousands of projectiles, I am here to dispel that thinking!
The wear and tear that is often alluded to can more specifically be labeled as glenohumeral arthritis (thinning of the cartilage in the joint) or tears of the rotator cuff muscle or tendons. Although it is common belief that these injuries occur to anyone who does a lot of throwing or overhead movements, it is not always the case. In fact, the reverse is true in that using our shoulders appropriately and efficiently leads to prolonging functional use of the shoulder. When we don’t move efficiently, we start to experience discomfort through the shoulder region which leads to avoidance of certain movements, which leads to weakness, which leads to discomfort, which leads to avoidance of movements… you get the point. It is a vicious cycle that we want to avoid. As I finished my football career, I was fortunate enough to escape without any major injuries and a healthy, strong shoulder despite using my shoulder a lot.
There are a number of reasons why this was the case:
It started with consistency and a slow build-up of tolerance. I had been throwing a football weekly for almost 15 years, therefore my body, and more specifically, my rotator cuff was able to acclimatize to the workload and stresses I was putting on it and therefore tolerate playing through a full fall season of daily practices consisting of hundreds of throws.
Secondly, a gradual warm up, not only of the shoulder musculature, but the entire body. This would consist of performing a few exercises and stretches to prepare the tissues and muscles for the movement you will be performing. These could include simple movements such as arm circles, lunges with a trunk twist or some banded shoulder external rotation as an example. The warm-up is essential to help mitigate the risks of injury, as it is more likely to be injured by doing too much, too soon.
Commonly, people will attribute this stiffness/discomfort to “wear and tear” or to throwing too much in their younger years, and they will now opt to sit on the sideline rather than be active and get back in the game because they don’t want to cause further damage or pain. As a former quarterback who has thrown hundreds of thousands of projectiles, I am here to dispel that thinking!
The wear and tear that is often alluded to can more specifically be labeled as glenohumeral arthritis (thinning of the cartilage in the joint) or tears of the rotator cuff muscle or tendons. Although it is common belief that these injuries occur to anyone who does a lot of throwing or overhead movements, it is not always the case. In fact, the reverse is true in that using our shoulders appropriately and efficiently leads to prolonging functional use of the shoulder. When we don’t move efficiently, we start to experience discomfort through the shoulder region which leads to avoidance of certain movements, which leads to weakness, which leads to discomfort, which leads to avoidance of movements… you get the point. It is a vicious cycle that we want to avoid. As I finished my football career, I was fortunate enough to escape without any major injuries and a healthy, strong shoulder despite using my shoulder a lot.
There are a number of reasons why this was the case:
It started with consistency and a slow build-up of tolerance. I had been throwing a football weekly for almost 15 years, therefore my body, and more specifically, my rotator cuff was able to acclimatize to the workload and stresses I was putting on it and therefore tolerate playing through a full fall season of daily practices consisting of hundreds of throws.
Secondly, a gradual warm up, not only of the shoulder musculature, but the entire body. This would consist of performing a few exercises and stretches to prepare the tissues and muscles for the movement you will be performing. These could include simple movements such as arm circles, lunges with a trunk twist or some banded shoulder external rotation as an example. The warm-up is essential to help mitigate the risks of injury, as it is more likely to be injured by doing too much, too soon.
Finally, utilizing proper throwing mechanics is essential in not only optimizing our throwing capabilities, but it is one of the most important aspects in being able to prevent injuries. Throwing mechanics will vary from individual to individual and there is no one-size-fits-all approach to throwing things. However, there are some key components to the movement that are essential throughout all sports and overhead movements. These components include activation and coordination of lower legs, hips and trunk. The ability to rotate through the trunk and thoracic spine provides the driving force in our throwing motion which decreases the stresses put on the rotator cuff, allowing it to simply stabilize the arm and shoulder throughout the movement. When we lose the ability to rotate, whether it be through the shoulder blade, spine or hips, it forces us to try and generate that extra force through the shoulder and that is when overuse injuries occur.
To summarize, shoulder injuries typically occur because of trying to do something too soon or by doing too much. By developing tolerance through slowly increasing repetitions, performing a proper warm up and focusing on proper mechanics, we can significantly decrease the chances of injury.
When in doubt, it is always a good idea to get some guidance from a physio who will help you on your journey to being able to participate in sports and activities overhead, thereby allowing you to get off the sideline and back into the game!
To summarize, shoulder injuries typically occur because of trying to do something too soon or by doing too much. By developing tolerance through slowly increasing repetitions, performing a proper warm up and focusing on proper mechanics, we can significantly decrease the chances of injury.
When in doubt, it is always a good idea to get some guidance from a physio who will help you on your journey to being able to participate in sports and activities overhead, thereby allowing you to get off the sideline and back into the game!
~ Kyle Siemens, Physiotherapist
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