by Edward Lockwood, DPT
Overhead athletes of all levels are at an increased risk for shoulder injuries. The shoulder complex consists of 4 important joints, but the most important for an overhead athlete are the glenohumeral joint and scapulothoracic joint. The glenohumeral joint is a ball and socket joint, which is widely accepted as one of the most unstable joints of the body due to the shallowness of the socket. With the instability of the glenohumeral joint, rotator cuff strength is very important for shoulder stability, but correct movement and strength of the scapulothoracic joint is required for adequate stability of the shoulder when it is in the overhead position. As the arm is brought into the overhead position, the function of the scapula is to rotate and remain compressed against the rib cage/thorax. Weakness of the surrounding scapular muscles is what allows for the scapula to either not rotate correctly or inappropriately lift off the rib cage/thorax. This in turn demands more of the glenohumeral joint and all of the structures that provide its stability.
Physical therapy can be very affective for overhead athletes who have had shoulder injuries and for the prevention of shoulder injuries. Assessing the strength of specific scapular and rotator cuff muscles, followed by targeted strengthening the weak muscles can be critical for overhead athletes. Without strong periscapular and rotator cuff muscles, you are essentially trying to fire a canon out of a canoe.
Dr. Lockwood is a Physical Therapist at Boston Sports Medicine