Overhead athletes are the individuals those involved in playing racquet sports such as squash, racquetball, and badminton, and sports that involve throwing action such as baseball and cricket. Overuse of shoulder joint and extreme range of motion required for these sports increase the risk of shoulder injuries. Overuse injuries of the shoulder is one of the common problems most of the overhead athlete suffer from. The injuries may restrict the movement of shoulder joint and may affect their performance.
The factors that cause overuse injuries may be extrinsic or intrinsic. Some of the extrinsic factors include errors in training, poor nutrition, uncomfortable environmental conditions such as terrain and use of inappropriate sports gears. Intrinsic factors responsible for overuse injuries are muscle weakness or imbalances, malalignment, and psychological factors.
Different types of shoulder injuries the overhead athletes may suffer from include rotator cuff tendonitis, rotator cuff tears, internal impingement, SLAP lesions and posterior glenoid exostosis (Bennett’s lesion).
Rotator cuff tendonitis
It is the inflammation of the bursa and also the inflammation of rotator cuff muscles (four muscles involved in movement and stabilization of the shoulder joint). Athletes with rotator cuff tendonitis often complain of pain during overhead activity and muscle weakness. Tendonitis in an overhead athlete usually occurs at the beginning of the season because of inadequate conditioning but may also occur at the end of the season.
Rotator cuff tears
Rotator cuff muscles are highly involved in throwing action. The different phases of throwing action may bring the rotator cuff muscles in to a position of impingement and the tensile loads on the muscles during the action may further increase the chances of tear of undersurface of the rotator cuff. Rotator cuff tear may be of partial or full thickness and results in shoulder pain during throwing action.
In overhead athletes, the extreme extension and external rotation of the shoulder joint may cause the pinching of the bulged part of arm bone against the lining of the shoulder joint cavity. This is called as internal impingement. Repeated internal impingement may lead to rotator cuff and posterior labral tears. Athletes with internal impingement suffer dull, aching pain at the backside of the shoulder.
A superior labral anterior-posterior (SLAP) lesions is the injury to the labrum of the shoulder joint. SLAP lesions can be of four types, type I to type IV. Patients with SLAP lesions may experience pain in front of the shoulder, a catching sensation and clicking in the shoulder, limited range of motion, and increase in pain with movement.
Bennett’s lesion or posterior glenoid exostosis also called thrower’s exostosis is the formation of bony spur on the glenoid (socket joint of the shoulder). This happens because of repetitive trauma. Athletes with this problem experience a pinching sensation during throwing movement and often pain is felt in the back side of the shoulder.