Overuse Shoulder Injuries

Shoulder Injuries
NASPE/NCAT Sport Injury Resource

Shoulder Impingement:
There are various structures within the shoulder joint complex that may become impinged or “pinched” due to repetitive movements using poor technique, when there is an imbalance of strength in the shoulder region, doing too much too soon or just doing too much at one time. Overuse injuries usually occur over time. If tendons become inflamed due to impingement factors, tendonitis (inflammation of the tendon) occurs. Sometimes tendons of the rotator cuff muscles of the shoulder can become impinged; other times one of the tendons of the biceps brachii (prominent muscle in the upper arm) can become irritated. If a bursa (fluid-filled sac which protects bone and tendon) becomes inflamed due to impingement, the overuse injury is termed bursitis (inflammation of the bursa).

Since overuse injuries occur over time, severity of signs and symptoms develop in a progressive nature.
- Initial symptoms of overuse shoulder injuries may include shoulder soreness when getting out of bed in the morning, or prior to practice. Usually once the shoulder is warmed up during practice, the pain goes away and performance is not affected.
- As the injury progresses, the athlete will notice pain before, during, and sometimes after practice. Although the athlete may be able to practice/play, the performance may be affected due to pain.
- Eventually, if left untreated, the athlete may not be able to move the arm during the day without pain and soreness.

It is important to make sure athletes inform coaches and athletic trainers when the shoulder becomes sore, even if the soreness is minimal. It is IMPORTANT to take care of this injury early. Once tendonitis or bursitis becomes established, it is very difficult to heal the injured area and rest is generally the main prescription.

Prevention is Key in overuse injuries.
· Apply an ice pack to the shoulder after practice, even if the shoulder is not sore.
· During initial weeks of practice, start slow and allow the shoulder to become accustomed to the demands of the activity.
· Include adequate warm up before intensity is increased.
· Be firm on proper/correct technique.
· Include shoulder strengthening exercises, especially for the rotator cuff muscles. Include shoulder strengthening exercises during the off-season as well.
· If the athlete complains of soreness in the shoulder, do not ignore the complaint. Send the athlete to a Certified Athletic Trainer or other qualified person for proper care.

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