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1. Most people around baseball have heard of the Rotator Cuff, but what is it and where is it on the body? - The rotator cuff is a group of 4 muscles that connect the shoulder blade to the upper arm bone. These muscles are responsible for keeping the arm stable against the shoulder blade, helping to raise the arm above head and "rotating" the arm in and out. All 3 of these functions are very important for proper throwing mechanics.
2. What are some common injuries that can occur to the Rotator Cuff? - One of the most common injuries is Rotator Cuff Tendonitis, which is often referred to as a RTC strain. This happens when the RTC becomes inflamed, swollen, and painful. Tendonitis could be caused by many reasons, but is most likely from overuse, improper warm-up, poor flexibility or poor strength.
3. Why are Rotator Cuff injuries common in pitchers?
- Pitchers, especially high school age and younger, often are not prepared properly at the beginning of baseball season. Some players are coming right off another sports season and their bodies can be run down. These players then come into baseball season without proper RTC strength and flexibility. Some pitchers go out and try to throw as hard as they can or try to throw too many breaking balls early in the season and end up irritating their shoulder. Research has shown that high pitch count and throwing breaking balls are two of the biggest factors relating to shoulder pain in youth baseball. Another problem could be bad throwing mechanics. Pitchers who throw side-arm at all, put increased strain on the structures in the shoulder and elbow and are more prone to this injury as well as many others.
4. What are some signs of Rotator Cuff injury and what can be done initially to treat the shoulder?
- Some signs of RTC injury include: Pain in the front, side or back of the shoulder, difficulty raising your arm over your head and weakness in the shoulder (especially rotating motions).
- Initial treatment would include resting for 24-48 hours and putting ice on your shoulder for 15 minutes ( you may have noticed in post-game interviews that most professional pitchers will ice their shoulder down after eery game to made sure that inflammation does not occur and to relieve any pain they may have). This would be followed by a stretching and strengthening program and eventually a slow return throwing activities. If your symptoms reoccur or last longer than a couple of days, I would recommend seeing an orthopedic doctor for further evaluations.
5. What can happen if Rotator Cuff Tendonitis is left untreated and a pitcher tries to play through the pain?
- If left untreated, minor RTC injuries can lead to impingement syndrome, where the tendon along with other structures in the shoulder get pinches with any overhead activity. This chronic condition will leave you more susceptible to RTC tears. Another problem that we see when pitchers play through the pain is a change in mechanics, which can lead to abnormal stress on the elbow, back, abdominals and legs, and could lead to problems at these joints.
6. What types of things could be done to help prevent Rotator Cuff injuries?
- Using proper pitching mechanics, giving yourself enough rest time in between starts, keeping good strength and flexibility in your shoulder, legs and trunk muscles and icing your shoulder after you pitch.
7. Why do I need to do extra stretching and strengthening exercises?
- A strong, flexible muscle is more resistant to injury.
- A lot of the exercises that I see athletes do for the RTC is either done incorrectly, or is not actually focusing on the Rotator Cuff.
8. Can you show us some exercises to help with our Rotator Cuff strength and flexibility?
- Sleeper stretch.
- Empty can, sidelying LR, prone LR, T-band LR, MR, Reverse T, seated push-up, PNF throwing diagonal.
9. Are baseball players the only people that normally get Rotator Cuff injuries?
- No. Because of the nature of the shoulder anatomy, anyone who spends a lot of time with their hands overhead, are prone to getting RTC injuries. This includes swimmers, volleyball players, football quarterbacks, and even non-athletes such as painters, carpenters and electricians.
Download an exercise sheet for the Rotator Cuff
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