Monday, April 16, 2012

Baseball Season: Protect your Shoulder

Spring is in the air!  It is baseball season; time to get out and enjoy this classic American sport.  Many kids and adults play the game and probably give little thought to the impact playing can have on the shoulder.  It is important to be aware of the potential injuries that can occur so that a small strain does not evolve into a serious problem. 

Bursitis, rotator cuff weakness and rotator cuff tears are all possible complications from the constant throwing, batting and diving that are involved in the wonderful sport of baseball.   What are injuries should you be aware of and how are they caused? 
Rotator Cuff Weakness:  Rotator cuff weakness can be caused by a constant throwing motion.  Weakness occurs when the rotator cuff tendons become inflamed and may get pinched under the shoulder blade. 

Tendonitis/Bursitis:  Tendonitis occurs when the rotator cuff tendons and/or the bursa become irritated and inflamed.  Symptoms include extreme pain or weakness, especially when the shoulder is in motion.   These conditions often occur in conjunction with each other, but pain associated with Bursitis tends to be located just under the joint capsule. 
Rotator Cuff Tear:  Here we have the ‘worst case scenario’.   Rotator cuff tears occur when the tendon is ripped off the bone.  Symptoms include:  limited motion, decreased shoulder strength and aching and weakness when you lift your arm above your head.  Surgery is often required to fix a rotator cuff tear. 
The big question is:  how do you avoid these injuries and stay in the game? 
One great way to prevent injuries of the shoulder is Strength Training.  Around the shoulder blade (also called the scapula) are a series of muscles that together with the rotator cuff, allow a dynamic, fluid motion seen with throwing. Many athletes perform exercises that strengthen the large muscles of the shoulder, such as the pectoralis major and deltoid muscle, but ignore the rotator cuff and smaller muscles surrounding the shoulder blade.  Failure to strengthen these smaller muscles, called the parascapular muscles and rotator cuff muscles, can result in pain while throwing, and issues with shoulder function.   
Examples of rotator cuff exercises are resisted external and internal rotation exercises of the shoulder, reverse flies and seated rows (look for future posts for more details on these exercises).  All of these exercises should be performed with an emphasis on squeezing your shoulder blades together while doing each repetition.  These muscles are small in relation to other muscles in the body and do not require a significant amount of resistance.  A few pounds of weight or a light resistance band is usually adequate for strengthening. 

As a reminder, prior to performing any of these exercises it is important to see your orthopedic surgeon if you are unable to lift your arm, or if you are unable to perform these exercises due to pain or discomfort.

Prevention of these injuries is often possible.  In addition to the strength training mentioned above, here are some additional tips from STOP Sports Injuries (
  • Warm up & stretch -  it is important to  stretch out  the shoulder and start with a few “softer” throws.
  • Play various positions - this is especially important for the younger athletes.  Switching positions and using different body parts/muscles is an important component to preventing injury.  
  •  DON’T play through the pain!  If pain persists, see a doctor. 
  • Take time to rest.  If you are a pitcher, try to take a day or two off between games. 
  • Concentrate on control, form and accuracy when throwing or pitching

If you suspect you or your child has a shoulder injury, we are here to help.  Skyview Orthopedic Associates is an excellent resource.  Our staff is focused on individualized, state of the art patient care and is led by John Vitolo, MD.  Dr. Vitolo specializes in injuries and disorders on the shoulder and knee.  He is board certified in orthopedic surgery and sports medicine.  Dr. Vitolo was also recently named to the NJ Top Doc list.   For additional information, visit or call 973-300-1553.