All Health Topics

Common shoulder and elbow throwing injuries

Published July 2, 2016
• Reviewed by Brian Wolf, MD, MS
on July 1, 2018

What are common throwing injuries?

Two common shoulder problems are injury to the rotator cuff and injury causing shoulder instability. A little biology helps tell the story. The rotator cuff is composed of four large muscles that extend from the scapula (shoulder blade) to cover the shoulder joint. These muscles are extremely important for shoulder strength and for holding the shoulder joint in the correct position. Frequent throwing can irritate the rotator cuff or its bursa. A pinching of the bursa and rotator cuff can occur during throwing, especially if the cuff muscles are weak or tired, or if the shoulder has instability.

Treating shoulder irritation

Treatment for shoulder irritation most often includes rehabilitation exercises designed specifically for throwers, a reduction in throwing, and an analysis of throwing mechanics. On occasion, if all other treatments fail, surgery can remove inflamed bursa and create more room for the rotator cuff tendons.

Injuring the labrum

Another common shoulder ailment that can lead to surgery involves the labrum of the shoulder. The labrum is the rubbery cartilage "bumper" of the shoulder socket. The force needed to throw hard and repetitively stresses the shoulder. This can damage the labrum if it tears away from the socket. These tears cause popping, clicking, pain, and the feeling of looseness in the shoulder. Rehabilitation may improve symptoms, but surgery is often needed to repair the tears. A minimally invasive procedure repairs the labrum through small incisions around the shoulder.

What causes throwing injuries?

The most common elbow problems are usually caused by improper throwing mechanics. Throwers often develop muscle and tendon swelling and irritation on the inside of the elbow. This generally responds to rest, icing, and improved throwing mechanics. Occasionally, throwers tear this ligament, also known as the "Tommy John ligament," which often requires reconstructive surgery using a tendon from the forearm or knee.

Preventing throwing injuries

The goal is to return athletes to their desired levels of activity. However, the significant damage that means surgery also means significant recovery time—several months to a year—before the athlete can return to the sport. Prevention is best and can be fostered by using proper mechanics, strengthening exercises, and closely monitoring pitch counts and how much throwing the athlete is doing.