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Preventing Injury for Pitchers
Shannon Becker on Injury Prevention
Cat Osterman on Dealing with an Injury
The shoulder is one of the most overused joints in sports. Tremendous stress is placed on it, which can cause damage and instability. In particular, labrum tears are a common issue for athletes who are involved in baseball, golf and gymnastics. For any athlete who is experiencing shoulder pain, it's likely that you might have to rehab your joint. Note: always consult with your physician before starting a rehab program. (Prevent shoulder injuries with these exercises.)
The labrum is a connective tissue structure with a 360-degree surface area that keeps the head of the humerus in the shoulder socket. Common causes of a labral tear include dislocation from contact and overuse.
Some of the cardinal symptoms of a labral tear include a deep ache in the joint, a popping sound when moving the arm, locking in certain positions and loss of range of motion. Significant signs that a pitcher has a labral tear include a pop in the shoulder accompanied by a loss of velocity.
Interestingly, there is evidence that this injury is quite common, even in "healthy" or asymptomatic athletes (meaning the athlete does not report any problems). A study by Miniaci et al.(1) noted that most professional baseball pitchers had abnormal changes in the labrum without any pain. Connor et al.(2) reached a similar conclusion about the rotator cuff in athletes. The same can be found in the general population.
Left unchecked, the injury can cause chronic degenerative changes and a subsequent replacement of the shoulder. However, long-term effects are beyond the scope of this article. We are exclusively looking at athletes who play with torn labrums.
A great example is Drew Brees. During his 2006 season, he suffered a full 360-degree labral tear with a small rotator cuff tear. After extensive surgery and months of grueling rehab, he was able to return to elite status—albeit with a reduced contract our of fear that he would not perform as he was capable. Fortunately for Brees, things turned out well for him. (Watch how Brees build his shoulder strength.)
Ed Reed played through a labral tear and didn't even reveal which shoulder was affected. He remains one of the most feared safeties in the NFL, showing that athletes can adapt and continue to play at a high level. Unfortunately, he is at risk for further injury in the future and this approach is not recommended by any medical professional or STACK.
In order to prevent damage to your labrum, it's of the utmost importance to adjust your routine to account for the instability. A critical step to preventing further injury is to warm up your shoulders properly.
The muscles that surround the shoulder, including the four rotator cuff muscles, support the joint. It is critical to warm up these muscles before activity to ensure they are active and prepared to withstand the forces of competition.
Mobility is not of primary concern, but it should be monitored and addressed during the warm-up. Perform exercises that do not cause any pain or popping sensation. Also, continue to develop mobility in your neck and upper back.
The final piece of your warm-up should be self-myofascial release exercises with foam rollers or a tennis pall. Focus on the delts, upper chest, biceps and upper back.
If you believe you have a labral injury, see your orthopaedic surgeon for further analysis. Yes, you can play with a minor injury, but a significant tear must be addressed or you may cause further damage to your shoulder.
(1) Miniaci, et al., "Magnetic resonance imaging of the shoulder in asymptomatic professional baseball pitchers." American Journal of Sports Medicine. 2001 Jan-Feb; 30(1):66-73
(2) Connor, PM, et al., "Magentic resonance imaging of the asymptomatic shoulder of overhead athletes: a 5-year follow-up study." American Journal of Sports Medicine. 2003 Sep-Oct; 31(5):724-7