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Shoulder pain in the overhead throwing athlete.

Seroyer ST, Nho SJ, Bach BR, Bush-Joseph CA, Nicholson GP, Romeo AA - Sports Health (2009)

Bottom Line: Pain and dysfunction in the throwing shoulder may be attributed to numerous etiologies, including scapular dysfunction, intrinsic glenohumeral pathology (capsulolabral structures), extrinsic musculature (rotator cuff), or neurovascular structures.Early discovery of symptoms, followed by conservative management with rest and rehabilitation with special attention to retraining mechanics may mitigate the need for surgical intervention.An anatomic approach is used in this report, focusing on common etiologies of pain in the overhead thrower and emphasizing the clinical presentation and treatment.

View Article: PubMed Central - PubMed

Affiliation: Rush University Medical Center, Chicago, Illinois.

ABSTRACT
Treatment of the overhead throwing athlete is among the more challenging aspects of orthopaedic sports medicine. Awareness and understanding of the throwing motion and the supraphysiologic forces to which the structures of the shoulder are subjected are essential to diagnosis and treatment. Pain and dysfunction in the throwing shoulder may be attributed to numerous etiologies, including scapular dysfunction, intrinsic glenohumeral pathology (capsulolabral structures), extrinsic musculature (rotator cuff), or neurovascular structures. Attention to throwing mechanics and appropriate stretching, strength, and conditioning programs may reduce the risk of injury in this highly demanding activity. Early discovery of symptoms, followed by conservative management with rest and rehabilitation with special attention to retraining mechanics may mitigate the need for surgical intervention. Prevention of injury is always more beneficial to the long-term health of the thrower than is surgical repair. An anatomic approach is used in this report, focusing on common etiologies of pain in the overhead thrower and emphasizing the clinical presentation and treatment.

No MeSH data available.


Related in: MedlinePlus

Anterior anatomy view of the shoulder.
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fig9-1941738108331199: Anterior anatomy view of the shoulder.

Mentions: In the quadrilateral space syndrome, the thrower often complains of intermittent, poorly localized anterior shoulder pain with distally radiating paresthesias, aggravated by forward flexion, abduction, and external rotation. On examination, discrete point tenderness over the quadrilateral space will be present.12 The quadrilateral space is bounded by the teres minor superiorly, long head of triceps medially, teres major inferiorly, and the surgical neck of the humerus laterally (Figures 8 and 9). Initial treatment includes internal rotation stretching with posterior rotator cuff and periscapular muscle strengthening and stretching. Thirty percent of throwers will not respond to conservative measures and will require surgical intervention.12 During surgical exploration, obliquely oriented fibrous bands have been identified tethering the neurovascular bundle in the quadrilateral space.32,51


Shoulder pain in the overhead throwing athlete.

Seroyer ST, Nho SJ, Bach BR, Bush-Joseph CA, Nicholson GP, Romeo AA - Sports Health (2009)

Anterior anatomy view of the shoulder.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3445067&req=5

fig9-1941738108331199: Anterior anatomy view of the shoulder.
Mentions: In the quadrilateral space syndrome, the thrower often complains of intermittent, poorly localized anterior shoulder pain with distally radiating paresthesias, aggravated by forward flexion, abduction, and external rotation. On examination, discrete point tenderness over the quadrilateral space will be present.12 The quadrilateral space is bounded by the teres minor superiorly, long head of triceps medially, teres major inferiorly, and the surgical neck of the humerus laterally (Figures 8 and 9). Initial treatment includes internal rotation stretching with posterior rotator cuff and periscapular muscle strengthening and stretching. Thirty percent of throwers will not respond to conservative measures and will require surgical intervention.12 During surgical exploration, obliquely oriented fibrous bands have been identified tethering the neurovascular bundle in the quadrilateral space.32,51

Bottom Line: Pain and dysfunction in the throwing shoulder may be attributed to numerous etiologies, including scapular dysfunction, intrinsic glenohumeral pathology (capsulolabral structures), extrinsic musculature (rotator cuff), or neurovascular structures.Early discovery of symptoms, followed by conservative management with rest and rehabilitation with special attention to retraining mechanics may mitigate the need for surgical intervention.An anatomic approach is used in this report, focusing on common etiologies of pain in the overhead thrower and emphasizing the clinical presentation and treatment.

View Article: PubMed Central - PubMed

Affiliation: Rush University Medical Center, Chicago, Illinois.

ABSTRACT
Treatment of the overhead throwing athlete is among the more challenging aspects of orthopaedic sports medicine. Awareness and understanding of the throwing motion and the supraphysiologic forces to which the structures of the shoulder are subjected are essential to diagnosis and treatment. Pain and dysfunction in the throwing shoulder may be attributed to numerous etiologies, including scapular dysfunction, intrinsic glenohumeral pathology (capsulolabral structures), extrinsic musculature (rotator cuff), or neurovascular structures. Attention to throwing mechanics and appropriate stretching, strength, and conditioning programs may reduce the risk of injury in this highly demanding activity. Early discovery of symptoms, followed by conservative management with rest and rehabilitation with special attention to retraining mechanics may mitigate the need for surgical intervention. Prevention of injury is always more beneficial to the long-term health of the thrower than is surgical repair. An anatomic approach is used in this report, focusing on common etiologies of pain in the overhead thrower and emphasizing the clinical presentation and treatment.

No MeSH data available.


Related in: MedlinePlus