Protecting Your Shoulder During Summer Sports.

Summer brings a lot of outdoor sports and activity, but the shoulder takes a lot of the load. Any “overhand” or “overhead” sport that involves arm rotation, like swimming, tennis, volleyball, and baseball, especially pitching, uses different muscle mechanics, but all of them can lead to shoulder instability over time. Repetitive rotating motion can gradually loosen the shoulder ligaments, and in some cases even lead to dislocation. Our physical therapists recommend paying close attention to how your shoulder feels during your sport. A quick pain when raising your arm overhead, or a sensation of something slipping or pinching in the joint, can be a sign of shoulder subluxation, which is worth having a physical therapist evaluate.

Common Shoulder Injuries From Overuse

Frequent, repetitive use of the shoulder can cause problems in the rotator cuff, the group of four muscles and tendons that surround the shoulder and connect to the scapula, collarbone, and upper arm. Swimmers, tennis players, and even golfers are prone to shoulder impingement, which happens when frequent rotation causes the bursa, a small fluid-filled cushion that reduces friction in the joint, to swell. As it swells, pain and discomfort increase, sometimes enough to interrupt sleep, especially when rolling onto the affected side.

Tennis players in particular can also develop tendonitis of the rotator cuff, where the tendons connecting the muscles to the surrounding bones begin to degenerate. It shows up as shoulder pain, but left untreated it can progress to an actual tear. Rotator cuff tears themselves happen when those tendons are partially or fully torn, often from overuse in sports that involve a lot of force during rotation, like tennis or baseball. A partial tear may still allow a fairly normal range of motion, but in general, the larger the tear, the more weakness and lost motion it causes.

Extra Risks for Baseball Players

Baseball players, especially pitchers, face a couple of additional risks. The labrum is a layer of tissue that cushions the shoulder socket where it meets the upper arm bone. Repeated wear from throwing can thin it out over time, leading to a labral tear, which can also result from a dislocation or a hard fall. The main symptom is a sharp pop or catching sensation during certain shoulder movements, sometimes followed by a dull ache for several hours. Even without pain, a labral tear can leave the joint feeling loose or like it slips during certain motions.

Quadrilateral space syndrome is a related but different problem, caused by overuse compressing the axillary nerve, which runs from the armpit and wraps around the upper arm. It’s often caused by extra bands of muscle fiber pressing on the nerve, or by a dislocated shoulder. It shows up as vague shoulder pain, numbness or tingling down the arm, tenderness over the area, a dull ache that worsens with repeated overhead movement, or general weakness and instability in the joint.

When to See a Physical Therapist

Many of these problems can improve without surgery through physical therapy and rehabilitation, especially when treatment starts as soon as the pain begins. Since overuse is behind most of these injuries, the more intense your sport, the more rest you need between games or events. If shoulder pain continues after a day or two of rest, it’s worth having a physical therapist or doctor take a look before you get back onto the field.