Throwing athletes use their shoulders aggressively and are at increased risk of rotator cuff damage.

Contributor: Elizabeth G. Matzkin, MD, is Surgical Director of the Women’s Sports Medicine Program at Brigham and Women’s Hospital (BWH) and Team Physician for Stonehill College Athletics.

The rotator cuff is composed of four muscles surrounding the shoulder joint. They act like cables on a suspension bridge to coordinate movement of the shoulder in space and to enhance the stability of the shoulder joint. Injury to this important group of muscles can cause pain and limit shoulder function. Non-sports activities can cause such injuries, but throwing athletes use their shoulders aggressively and are at increased risk of rotator cuff damage.

Simple everyday measures, however, can significantly improve the health of the rotator cuff and prevent future injuries. Dr. Elizabeth G. Matzkin, Surgical Director of the Women’s Sports Medicine Program at BWH and Team Physician for Stonehill College Athletics, offers patients the following five simple tips for maintaining a healthy rotator cuff.

 1. Stretch before exercise

Stretching the shoulder prior to activity is paramount in throwing athletes. It reduces muscle tension across the shoulder joint, improves flexibility, and helps prevent acute tears of the rotator cuff during aggressive exercise. Stretching has even been shown to improve blood circulation to the muscle. Something as simple as stretching before exercise goes a long way.

 2. Strengthen the rotator cuff

The rotator cuff, like any other muscle group in the body, can be strengthened with focused exercises. It isn’t necessary or ideal to use heavy weights when strengthening the rotator cuff, as heavy weights will recruit bigger muscle groups. It is preferable to perform specific motions with light resistance to isolate the rotator cuff and other muscles that support the shoulder. The American Academy of Orthopaedic Surgeons recommends a variety of exercises to help keep the shoulder joint stable in its rotator cuff and shoulder strengthening program.

 3. Strengthen the core and lower extremities

Much of the power behind the throwing motion comes from the core and lower extremity (leg and gluteal) musculature. By strengthening these muscle groups, throwing athletes can develop better-coordinated throwing mechanics and prevent overuse or improper use of the rotator cuff.

4. Re-establish proper throwing mechanics

After any shoulder injury, it is a good idea for the throwing athlete to enlist in a graduated throwing program to retrain and redevelop proper throwing mechanics. This will lessen the risk of reinjury.

 5. Use ice and anti-inflammatories as needed

It is common for throwing athletes to experience inflammation in the dominant (throwing) shoulder after aggressive exercise. Ice and over-the-counter anti-inflammatories are often effective for easing inflammation in these situations, but athletes should consult their physician if symptoms persist.

Dr. Matzkin offers diagnosis and treatment services for rotator cuff injuries and other shoulder conditions at the Brigham and Women’s Ambulatory Care Center in Chestnut Hill, Brigham and Women’s/ Mass General Health Care Center in Foxborough, and Brigham and Women’s Hospital in Boston.

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