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Careful throwing prevents shoulder injuries by djh75337

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									                                           Orthopaedics          &   Sports      Medicine                                                                                                             O r t h o p a e d i c s   &   S p o r t s   M e d i c i n e



    Careful throwing prevents shoulder injuries

    It has 108 stitches of bright red wax cotton                                                                                                                                                                                                          Prevent throwing injuries
    thread on pure white leather. Measuring 9
                                                                                                                                                                                                                                                          Warm-up before throwing by:
    inches around and weighing five ounces, it is
                                                                                                                                                                                                                                                          • Stretching
    rubber and cork at the core with layers of twine.
                                                                                                                                                                                                                                                          • Running
    If thrown hard enough, it can travel in excess of
                                                                                                                                                                                                                                                          • Easy, gradual throwing
    90 miles an hour.
                                                                                                                                                                                                                                                          • Avoiding overusing the arm
    It’s hard to imagine that throwing something                                                                                                                                                                                                          • Limiting the number of pitches and games.
    that small can cause damage. But if a baseball
                                                                                                                                                                                                                                                          Watch for throwing injuries
    is thrown hard enough – and often enough – the
    movement can damage a rotator cuff or tear the                                                                                                                                                                                                        Listen for:
    cartilage in the thrower’s shoulder.                                                                                                                                                                                                                  • Complaints of pain in the overused area.
                                                                                                                                                                                                                                                          The player may first note this pain when
    “Throwing a ball is a biomechanically difficult
                                                                                                                                                                                                                                                          the affected area is used and again later
    task. The amount of force and speed of rotation
                                                                                                                                                                                                                                                          when it is at rest.
    is impressive,” said Dr. John R. Green III,
    Husky team physician and UW associate                                                                                                                                                                                                                 Look for:
    professor of orthopaedics and sports medicine.                                                                                                                                                                                                        • Change in throwing form
    “It’s amazing that a body is capable of throwing                                                                                                                                                                                                      • Other outward signs that the player
    at such speeds.”                                                                                                                                                                                                                                      has pain, such as continually rubbing a
                                                                                                                                                                                                                                                          sore area.
    Anyone who is an overhead athlete – tennis
    players, volleyball players or throwers – is at                                                                                                                                                                                                       Feel for:
    risk of injuring his or her shoulders, Green said.                                                                                                                                                                                                    • Tenderness to pressure over the injured
    Injuries can include:                                                                                                                                                                                                                                 area (mild, moderate, severe)
                                                                                                                                                                                                                                                          • Swelling (usually not present).
    • Tears in the shoulder’s labrum, the cartilage
    rim around the socket                                                                                                                                                                                                                                 Move:
                                                                                                                                                                                                                                                          • See if the player can move the joint fully
    • Damage to the rotator cuff, which is made up
                                                                                                                                                                                                                                                          (compare to other side). This is especially
    of the four muscles around the ball and socket
                                                                                                                                                                                                                                                          important in the elbow, where the ability
    joint in the shoulder
                                                                                                                                                                                                                                                          to straighten all the way is easily lost.
    • Bone spurs or ligament tears in the elbow.                                                                                                                                                                                                          • See if muscle strength is equal to that
                                                                                                                                                                                                                                                          on the other side. Have player tighten the
    “For problems that develop slowly, most people
                                                                                                                                                                                                                                                          muscle against your resistance. Note pain
    get better with rehab,” Green said. But for those
                                                                                                                                                                                                                                                          and/or weakness.
    who don’t improve or have a sudden injury, sur-
    gery may be the best way to return function.                                                                                                                                                                                                          Treatment:
                                                                                                                                                                                                                                                          • Rest, especially from the activity that
    The UW Medicine Sports Medicine Clinic sees
                                                                                                                                                                                                                                                          created the injury in the first place
    all kinds of athletes from the “recreational
                                                                                                                                                                                                                                                          • Use ice to reduce soreness and
    athlete who is just trying to stay healthy to
                                                                                                                                                                                                                                                          inflammation
    Husky collegiate athletes and select professional
                                                                                                                                                                                                                                                          • See a physician, especially if symptoms
    athletes,” he said. “Injuries at the beginning of    “If they don’t get better with selected exercises,                                                      short periods during a year, with long rests in      Rico Le May is pitching for
                                                                                                                                                                                                                                                          persist or if there is a lack of full range
    the season are frequently related to inadequate      often we do an MRI and see if there’s a mechani-                                                        between, Green said. Limiting the maximum            his school baseball team
                                                                                                                                                                                                                      again this season after             of motion
    preseason preparation. It is often too much too      cal problem impeding rehabilitation,” he said.                                                          number of pitches and the number of games
                                                                                                                                                                                                                      a successful surgery to             • Once pain is gone and full motion is
    soon, when the sun comes out in the spring.”                                                                                                                 helps prevent injuries. But coaches, parents
                                                         If surgery is needed, it’s almost always done                                                                                                                repair his shoulder.                present, a throwing rehabilitation
                                                                                                                                                                 and players don’t always follow the guidelines,
    When an athlete comes in with a sore shoulder,       arthroscopically, meaning the surgeon makes                                                                                                                                                      can start.
                                                                                                                                                                 he said.
    the physicians first take a medical history and       small incisions to repair the shoulder. Those
                                                                                                                                       Photo by Bill Stickney.




                                                                                                                                                                                                                                                          Source: The American Orthopaedic Society
    examine the shoulder. X-rays are obtained to look    surgeries are done on an outpatient basis,                                                              If a thrower’s arm is rehabilitated, Green                                               for Sports Medicine.
    at the bones and assist in making a diagnosis.       followed by several months of rehabilitation.                                                           recommends an interval throwing program to
                                                                                                                                                                 help throwers regain their strength, motion and
    Most of the time, patients improve with appro-       Shoulder problems can occur when an athlete
                                                                                                                                                                 confidence by gradually increasing the number
    priate physical therapy.                             changes from one sport to another without            Dr. John R. Green, III                                                                                                                      For information:
                                                                                                                                                                 of throws and the distances.
                                                         a rest in between. The key is to throw for                                                                                                                                                       www.orthop.washington.edu


8   BREAKTHROUGH SPRING 2007                                                                                                                                                                                                                                              BREAKTHROUGH WINTER 2006       9

								
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