Epidemiology of Shoulder Injuries in Overhead Athletes

Abstract

Injuries and pathology to the dominant shoulder of an overhead athlete are multifactorial and complex. The stresses placed on the glenohumeral and scapulothoracic joints during a throw are immense. Overlapping signs and symptoms exist, making accurate diagnosis difficult for someone who is not fully aware of the complexity of the throwing mechanism. An understanding of the basic forces at work during each phase of the throwing cycle will result in an improved understanding of the possible profiles of injury. Shoulder problems can be secondary to abnormal mechanics, fatigue and imbalance of the shoulder musculature, scapular dyskinesis, capsular laxity or contracture, and repetitive microtrauma. Early discovery of symptoms and diagnosis, followed by rehabilitation with special attention to mechanics, will optimize the results of most dominant shoulder pathologies. If nonoperative management fails, arthroscopic techniques can be implemented to address many intra-articular abnormalities. A coordinated approach among athletic trainers, therapists, and physicians aids in the overall recovery of the overhead athlete.