You’ve just had a big game, and you feel a sharp pain in your shoulder. Or, maybe you’ve been dealing with this pain throughout the season, and you’re not sure what’s causing it. Throwing is a common activity in many sports. It’s something that most athletes do without giving it much thought, but it can also cause shoulder pain and injuries if not done correctly. Shoulder pain when throwing is one of the more common problems for athletes and can lead to issues like bicep tendonitis or a rotator cuff injury.

Shoulder injuries from throwing most often result from overuse. Throwing motions that place your arm behind or above your body can cause pain and inflammation in the shoulder joint. The good news is there are exercises you can do to avoid these injuries so you can still perform your best while limiting any future damage.

Possible Throwing Injuries

Athletes, especially those participating in baseball, cricket, or Olympic field events, are susceptible to rotator cuff injuries. Other common injuries among throwing athletes include bicep tendonitis, SLAP tears, and shoulder impingement syndrome.

Rotator Cuff Injuries

A rotator cuff is a group of shoulder muscles and tendons that attach your upper arm bone to your shoulder blade. These muscles and tendons help lift your arm and rotate it inward and outward.

Rotator cuff injuries occur when this group of muscles and tendons are overused or injured, usually from repetitive overhead movements. For example, activities such as repeatedly throwing a ball can cause a tear in the rotator cuff muscles or tendons.

Symptoms of a Rotator Cuff Injury

When suffering from a rotator cuff injury from throwing, you may experience pain at the tip of your shoulder and upper arm. Other symptoms of a rotator cuff injury may include:

• Pain that increases when you reach behind your back
• Discomfort when rotating your arm outward and up
• Pain when lifting the arm, especially overhead
• Swelling and stiffness in the shoulder joint
• Weakness in the arm

Treatments for Rotator Cuff Injuries

A rotator cuff injury will often heal by resting the shoulder and doing exercises to stretch and strengthen the muscles. Other treatment options include:

• Physical therapy
• Anti-inflammatory drugs (NSAIDs)
• Ice

More severe injuries such as a rotator cuff tear, particularly due to a single injury, may require surgery to repair the torn tendon. Surgery is usually successful in relieving pain, although there is a risk of re-injury or further injury post-surgery.

Bicep Tendonitis

The bicep muscle is located in your upper arm and has two tendons that attach it to your shoulder bone. When you move your arm, the bicep pulls on these tendons. As a result, repetitive throwing motions can cause the upper bicep tendons to become inflamed and irritated. This is known as bicep tendonitis.

Symptoms of Bicep Tendonitis

The symptoms of bicep tendonitis are very similar to those of a rotator cuff injury. You may experience pain and discomfort at the top of your shoulder and upper arm. Other symptoms of bicep tendonitis may include:

• Pain in the front of the shoulder
• Pain or aches that radiate down the upper arm bone
• A snapping sound or sensation in the shoulder

Treatment for Bicep Tendonitis

While bicep tendonitis may be uncomfortable and painful, it can typically be treated without surgery. Treatments for bicep tendonitis include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Cold packs to reduce swelling
• Corticosteroid injections
• Rest

In extreme cases, surgery to repair the damaged tendon may be required.

SLAP Tears

SLAP stands for Shoulder Labrum Anterior-Posterior (referring to the position of the bony rim around your shoulder joint). SLAP tears are an injury to the labrum, a ring of cartilage that helps hold your shoulder joint together.

Symptoms of a SLAP Tear

SLAP tears are caused by stresses on the shoulder joint greater than what the labrum can withstand. This can happen when throwing a ball or making other overhead motions with your arms. Symptoms of a SLAP tear include:

• Pain when lifting objects
• Decreased range of motion
• Popping, locking, or catching sensations
• The feeling that your shoulder may pop out of the joint.

Athletes such as baseball pitchers may notice a decrease in throw velocity or the sensation of having a limp/”dead arm” after throwing.

Treatment for SLAP Tears

If your SLAP tear is minor and diagnosed early, nonsurgical treatments may suffice.

These treatments may include:

• Rest
• Ice
• Physical therapy
• NSAIDs

SLAP Surgery

If the tear is severe or nonsurgical treatment options aren’t effective, surgery may be required. One common surgical method is arthroscopic SLAP repair. During arthroscopic surgery, the surgeon will make tiny incisions in your arm or shoulder to expose the damage to your labrum. Using a small camera and surgical instruments, the surgeon may repair your labrum by either:

• Trimming the tear
• Removing the damaged tissue
• Stitching the labrum back together

Another surgical option for a SLAP tear is to cut out the upper bicep tendon. This procedure is usually done if you have a SLAP tear in combination with bicep tendonitis.

Shoulder Impingement Syndrome

Shoulder impingement syndrome is a condition that occurs when the bony tip of the outer shoulder blade edge rubs or pinches the rotator cuff tendons that lie beneath it.

Symptoms of Shoulder Impingement Syndrome

Shoulder impingement syndrome from throwing is often caused by the overuse of the rotator cuff muscles and tendons. Symptoms typically take weeks or even months to develop and may include:

• Shoulder weakness
• Arm stiffness
• Pain when lifting objects
• Discomfort when lying on your side
• Pain when reaching behind the back

Treatments for Shoulder Impingement Syndrome

nonsurgical treatment options for shoulder impingement syndrome may include:

• Rest
• Ice
• NSAIDs
• Steroid injections
• Physical therapy

If more conservative treatments fail to reduce pain, surgery may be required.

Ways to Prevent Shoulder Pain When Throwing

If shoulder pain when throwing is a common problem for you, consider these tips to help prevent or reduce it:

Build Your Strength

Work on strengthening the muscles in your upper back and shoulders to help support your arm. You can do this by incorporating exercises such as push-ups, pull-ups, and upright rows into your workout routine.

Improve your Range of Motion

Doing bicep stretches and shoulder exercises may help to improve your range of motion. Increasing your range of motion will help your shoulder function more efficiently, reducing the risk of discomfort when throwing.

Focus on Throwing Technique

Proper throwing technique is key to preventing shoulder pain. Make sure you’re in a comfortable starting position and use your entire body when throwing. Avoid overloading your arm and know when to take a break.

When trying to avoid a pitching injury, make sure to keep your elbow and arm high and follow through with the ball after throwing it. Remember, the late-cocking and follow-through phases of your pitch cause the most significant stresses on your shoulder.

Contact Comprehensive Medical Care

Comprehensive Medical Care is dedicated to providing elite sports medicine and performance training of the highest quality. Our FASSST sports medicine division offers the most up-to-date orthopedic services to help athletes of all levels get back on the field and stay there.

If you are experiencing shoulder pain when throwing or are looking for ways to prevent it, our team can help. Contact us by calling (732) 532-3507 or click here to request a consultation today.