With baseball season underway, there is no doubt that we will likely see more shoulder injuries than any other sport. Throwing athletes, like baseball pitchers, play extremely high stresses on the shoulder, which can commonly lead to overuse type of injuries.


Phases of throwing

There are several shoulder injuries that some of your favorite baseball players have, or may, experience throughout their career.

Glenohumeral Internal Rotation Deficit (GIRD)

Extreme external rotation is required to throw at high speeds. This typically causes the ligaments at the front of the shoulder to stretch and loosen. A natural and common result is that the soft tissues in the back of the shoulder tighten, leading to loss of internal rotation.

This loss of internal rotation puts throwers at greater risk for labral and rotator cuff tears.


SLAP Tears (Superior Labrum Anterior to Posterior)Untitled1

In a SLAP injury, the top part of the labrum is injured, the long head of the biceps tendon also attaches here. A SLAP tear occurs both in front (anterior) and in back (posterior) of this attachment point.

Typical symptoms are a catching or locking sensation, and pain deep within the shoulder.


Biceps TendinitisUntitled2

Repetitive throwing can inflame and irritate the long head of the biceps tendon, called biceps tendinitis. Pain in the front of the shoulder and weakness are common symptoms of biceps tendinitis.


Rotator Cuff Tendinitis and Tears


The rotator cuff is made up of four muscles that come together as tendons to form a covering around the head of the humerus. The rotator cuff is frequently irritated in throwers, resulting in tendinitis.

Early symptoms include pain that radiates from the front of the shoulder to the side of the arm.

As the damage worsens, the tendon can tear. When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. Most tears in throwing athletes occur in the supraspinatus tendon.


Although these injuries are common in baseball, especially baseball pitchers, they can be seen in many other athletes who participates in sports that require repetitive overhand motions, such as volleyball, tennis, and some track and field events (e.g. javelin throwers). All of these injuries should be evaluated and treated by a physician. In most extreme cases, injuries such as SLAP and rotator cuff tears require surgery to fix. More conservative measures can be take with biceps tendonitis and GIRD.


Provided by Primus Sports Medicine Staff