Throwing related Shoulder pain in Sports men

After the just concluded cricket Test series between India and England one saw the shoulder injury of Sachin Tendulkar surface. He has rushed off to England and has undergone arthroscopic shoulder surgery. He will be out of the game for eight weeks and only return for the West Indies tour later this summer. One can also remember that Anil Kumble, Rahul Dravid, & Srinath have suffered shoulder injuries in the past and returned to the game after successful treatment. Shoulder injuries can plague the career of cricketers and if not treated can cut short their lucrative careers. Cricketers are at risk as Cricket is a throwing game where one chucks the ball either as a bowler or a fielder. In this article, I will throw some light on throwing injuries.

Two problems can affect the shoulder in sportsmen who perform repeated acts of raising the arm overhead and swinging it in the course of a throw. These are called impingement and instability.

The shoulder joint is formed by the union of the round upper end of the humerus at the socket part by the scapula. It is a very mobile joint as the socket is shallow. Connective tissue restraints chiefly in the front confer additional stability. When the capsule or its attachments are injured instability results. In instability when the soft tissue restraints are loose the ball of the humerus can slide to the front, down wards or to the back in an abnormal fashion.

Impingement results from the abnormal upward gliding movement of the humerus and rubbing on the undersurface of the Acromion. This initiates or aggravates the damage to the rotator cuff. The rotator cuff is a group of tendons which act to actively stabilize the shoulder when the arm is lifted up.

Both conditions can cause pain and result in confusion to the patient and his doctor.

Slow motion analysis of the throw- Each sport has its own basic pattern, different sports have much in common. The performance of overhead sporting activities begins with a preparatory phase to position the arm. Subsequently the arm is cocked to provide a tense, highly forceful unit ready for an accelerated release. The arm accelerates through the throw and after release of the ball, muscles act to decelerate the limb, to reduce the residual force and to avoid injury. The throw in a typical baseball pitch is divided into five stages.

1) Stage 1- Wind up or preparation phase, which ends when the ball leaves the gloved hand. In cricket the equivalent is the transfer of the ball from the non dominant to the throwing arm.
2) Stage 2 or early cocking- when the shoulder is lifted sideways (abducted) and rotated outwards and ends with the forward foot contacting the ground.
3) Stage 3, late cocking phase