Special considerations in the athletic throwing shoulder

Overhead athletes are susceptible to a number of shoulder problems due to the repetitive nature and force needed to perform at a competitive level. Frequently, the rotator cuff becomes injured due to primary or secondary impingement. In young athletes, subtle instability is often the cause of rotator cuff tendinitis, but will frequently respond to a coordinated rehabilitation program. Older athletes are more likely to have rotator cuff injuries due to anatomic changes in the coracoacromial arch. This article outlines the mechanism of injury to the rotator cuff and our approach in dealing with shoulder problems in the overhead athlete.