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The Thrower's Shoulder.

Giovanna Medina1, Arthur R Bartolozzi1, Jacob A Spencer2

  • 1Jefferson Health 3B Orthopaedics, Philadelphia, Pennsylvania.

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|March 18, 2022

View abstract on PubMed

Summary
This summary is machine-generated.

Understanding the throwing shoulder

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Biomechanics

Background:

  • The throwing shoulder is a complex condition resulting from repetitive tensile forces.
  • Key features include posteroinferior capsular contracture and glenohumeral internal rotation deficit (GIRD).
  • Adaptations occur to enhance throwing mechanics, but can lead to injury.

Purpose of the Study:

  • To review the anatomy, pathophysiology, and clinical presentation of the throwing shoulder.
  • To provide a historical perspective on treatment methodologies.
  • To elucidate the pathologic cascade leading to shoulder dysfunction in athletes.

Main Methods:

  • Literature review of relevant anatomy, pathophysiology, and biomechanics.
  • Summary of clinical signs, symptoms, and imaging findings.
  • Historical analysis of treatment strategies for throwing shoulder injuries.

    • Main Results:

    • The "essential lesion" involves capsular contracture and GIRD, potentially with a Bennett lesion.
    • Throwing shoulder complexity arises from interacting factors like capsular changes, pectoralis minor tightness, and scapular dyskinesis.
    • Consequences include rotator cuff impingement/tears, labral injuries, and scapular dyskinesis.

    Conclusions:

    • A comprehensive understanding of the throwing shoulder's pathologic cascade is crucial for effective treatment.
    • Successful treatment requires identifying the specific disturbed point in the cascade.
    • Treatment should address biomechanics, incorporating stretching, stabilization, strengthening, and kinetic chain correction; surgery is tailored to individual pathology.