WebBall.com - Rotator Cuff Injuries

First Aid Questions & Answers

A special feature by permission of Primal Pictures

Q Everyone seems to have their own stories about rotator cuff injuries. Why is this an area with so many problems?

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The first fact every ballplayer and coach must accept is that 'rotator cuff' is a convenient short-hand for both the joint between the upper arm bones and shoulder and all of the connecting tissue (muscles, tendons, etc.). The shoulder area is under extreme stress when it rotates, stretches back and pulls forward in all the ways required of pitching (and hitting, and fielding). So rotator cuff injuries are not one problem with a single solution for all.

What can go wrong? Anything and everything and it is often difficult for anyone but a trained sports medicine specialist to really diagnosis both the nature and severity of the problem. It could be a simple muscle ache or a more severe tear, an inflammed bursa, a ruptured tendon, or a combination of factors. It could be caused by a sudden severe overload, or long-term overuse. It could be because some of the musculature is not strong enough, or the body isn't mature enough, or the pitching mechanics are poor. It could also be brought on by a pain or injury elsewhere - for instance a sore elbow, or painful back muscle - causing you to adjust your throwing motion away from what is best and safest.

Fixing the problem (once you know what it is) can be a matter of some simple Jobe Exercises (also see notes in pop-up windows), or an adjustment in throwing mechanics, or something more drastic - like arthroscopic or even more invasive surgery and a long rehab afterwards. It all depends on what you've got and why it happened.

This page shows 3 different common problems visually (and in animation), and the technical notes in pop-ups explain a few of the issues involved. Our best advice: if you experience soreness while throwing you might have some form of tendonitis or normal strain, but if the pain is still there when, for instance, you are lying down resting - you may have bigger problems. In EVERY case, go see a specialist.

By the way, some athletes will never have a problem, other ballplayers may face recurring or different problems - not everyone's bones and connective tissue are shaped or work the same way - some people just aren't good throwers.