Shoulder
Injury Prevention for the Overhead Throwing Athlete
Part
Two: Normalizing range-of-motion
Rob Woodside MPT, CSCS
Athletes
who throw professionally, or in some cases collegiately will
be familiar with the stretch shown in this article. However,
most athletes have never seen it. It is designed to maintain
flexibility of the shoulder in throwers.
Normally,
the overhead throwing athlete will develop more "external
rotation" of the shoulder (cocking the arm back). This
overall increase is not necessarily a bad thing, so long as
the rotator cuff muscles surrounding the shoulder are strong
and healthy. This added flexibility allows the athlete to wind-up
more in the cocking phase of throwing, therefore adding more
velocity to the throw. Some of this increased mobility is thought
to be due to a retroversion (permanent bony backward twist/shift)
of the head of the humerus during childhood years (5).
The side-effect
of this shift in flexilbility is that the athlete now has less
"INTERNAL rotation" of the shoulder (motion during
the follow-through of throwing). This is caused by tightness
in the posterior rotator cuff muscles and posterior capsule
of the shoulder. These tight structures then force the shoulder
to translate forward during the follow-through phase of throwing,
greatly increasing the stress placed on the anterior shoulder,
rotator cuff, and even the elbow (1-4).
THE STRETCH
1)
Lie in a quarter-turn from your back as shown. Your underside
arm is the shoulder you will be stretching. It should be almost
perpendicular to your torso.
2) Bend
90 degrees at the elbow. Take your other hand and push down
on your wrist/forearm, rotating your shoulder joint internally
(your forearm goes toward the table).
Do this VERY SLOWLY AND GENTLY!
3) Hold
at least 30 seconds. You should feel the stretch in the back
of the shoulder.
The goal
is to isolate and stretch the posterior rotator cuff and posterior
capsule of the shoulder joint. If those structures are tight,
then the shoulder will translate forward and be at more of a
risk for strain or dislocation during throwing activities.(1)
If you feel
a stretch anywhere else besides the back part of the shoulder,
or if you feel pain anywhere, try to re-adjust your body position.
If you continue to feel pain, you should consult your physician
or physical therapist.
This stretch
is best done after a light warm-up, at least 3-5 reps of 30
second holds followed by a sport-specific warm-up before throwing.
References:
1. Harryman
DT, et al: Translation of the humeral head on the glenoid with
passive glenohumeral motion. J Bone Joint Surg 1990 72(9):1334-43.
2. Crockett HC, et al: Osseous adaptation and range of motion
at the glenohumeral joint in professional baseball pitchers. Am
J Sports Med 2002 Jan-Feb;30(1):20-6.
3. Fleisig GS, et al: Biomechanics of overhand throwing with implications
for injuries. Sports Med 1996 Jun;21(6):421-37.
4. Chagneau F, Delamarche P, Levasseur M. Stroboscopic computerized
determination of humeral rotation in overarm throwing. Br J Sports
Med 1992 Mar;26(1):59-62.
5. Reagan KM, et al: Humeral retroversion and its relationship
to glenohumeral rotation in the shoulder of college baseball players.
Am J Sports Med 2002 May-Jun;30(3):354-60.
