- Physician Teams
As the weather warm up, youth athletes are focusing their attention on spring sports. Most spring sports involve some sort of throwing motion, which places the shoulder at particular risk. Any youth athletes who frequently play baseball, tennis, lacrosse, softball, and volleyball face the potential for a shoulder injury.
Over 500,000 Americans seek treatment from a doctor’s office or emergency room annually from baseball injuries alone, and most of these patients are under the age of 18. Youth players, between the ages of 10 to 18, are particularly susceptible due to open growth plates, rapid growth periods, and muscle imbalances as the body struggles to keep up with the growth of the bones. Having some knowledge about the shoulder can help young athletes, and their parents and coaches, prepare for the season ahead and potentially prevent shoulder injuries.
The shoulder is a ball and socket joint, but the socket is very shallow. Because it is so shallow, the shoulder relies heavily on stabilizers to keep it located during extremes of motion. Its shape is also why we can move the arm in so many different planes and positions. The stabilizers include both static ones (the ligaments and capsule) and dynamic ones (the rotator cuff and scapula muscles).
Because the shoulder can move in so many different directions, its stability is highly dependent on strong, balanced muscle groups. Repetitive use and overuse places a lot of stress and strain on these structures, which can lead to dysfunction, pain, and subsequent injury. There is also a structure called the labrum, which lines the socket to help deepen it and gives a little extra seal for the ball. The labrum is also prone to overuse and tearing.
Common shoulder injuries include rotator issues, from minor inflammation to full tears, labral tears, from partial to complete, and impingement, which is pinching of tissue due to imbalance. Young athletes may complain of pain during or after activity, trouble sleeping due to pain, a feeling of dead arm, in which the velocity of the throw is decreased, or a click and catch with certain movements.
It is important to let young athletes know to tell an adult if they are experiencing pain and to seek the advice of a specialist. Ignoring the symptoms and just trying to continue to play through the pain can lead to further damage, which may lead to more aggressive treatment.
Athletes under 18 can also have damage to growth plates. Most issues can be managed with simple measures, which may include rest, activity modification, anti-inflammatory medicine, cortisone shots and physical therapy. For more severe damage, surgery may be required.
Preventing shoulder problems is possible and achievable with a well-designed program of strengthening and stretching the muscles and ligaments around the shoulder. Most people spend very little time actually working on their rotator cuff or don’t know how to isolate it. The core muscles are critical for pitchers, hitters, volleyball spikers, and tennis. The concept of sports performance trainers, who are skilled at designing a program for each person’s needs, is a rapidly growing field with lots of promise. Physical therapists and doctors with sports training can also help design a program for specific sports situations.
It is also important to realize that rest for the shoulder; particularly the growing shoulder is a must. Today’s emphasis is on playing year round, isolating young athletes interest to just one sport, playing in numerous college showcases, and it is easy to get caught up in a cycle of constant throwing. The shoulder needs a period of rest of at least two months in any given year. During that time, athletes should be performing rotator cuff exercises with lots of core work. Numerous studies have shown that excessive playing and throwing leads to overuse injury, some of which can be career ending. For pitchers in particular, it is recommended that young athletes limit the number of pitches per game, the total number per week and give adequate rest in between outings.
Understanding some of the complexities of the shoulder, spending adequate time working on the muscles around the shoulder, and giving your shoulder sufficient rest can lead to a much more productive, healthy and injury free experience.