Shoulder pain and upper extremity swelling in a throwing athlete are all too common problems that can involve damage to the glenohumeral joint, acromioclavicular joint or muscles of the rotator cuff. The course of treatment is to diagnose the problem properly, provide immediate relief for the problem and then design a strengthening program that addresses the issues that lead to the injury.
Anatomy
The shoulder joint is composed of three bones -- the clavicle or collar bone, the scapula and the humerus or upper arm bone. All the bone endings are covered by articular cartilage to help them glide smoothly against each other. The end of the humerus bone meets the scapula to for the glenohumeral joint. Under the acromial arch that is formed by the meeting of the clavicle and acroniom bones is the bursa or cushioning sac. Four short muscles start at the scapula and pass around the shoulder and are fused together at their ends, forming the rotator cuff.
Types and Causes
Your shoulder pain and upper extremity swelling may be the result of shoulder impingement. This condition is caused by the acromion rubbing on the rotator cuff as the arm is lifted over the head during a throw. The pain you are feeling may be due to bursitis or an inflammation of the bursa as it is pinched between acromion and rotator cuff. Rotator cuff tendinitis is another type of shoulder injury experienced by throwers. As the rotator cuff is overworked during a throwing workout it may become worn, frayed or torn leading to an inflammation of the rotator cuff tissues.
Treatment
Following an initial incidence of shoulder pain and upper extremity swelling following a throwing workout, you should use an NSAID or nonsteroidal anti-inflammatory drug to combat swelling. Apply ice to the shoulder for the first 24 to 48 hours after becoming injured following a schedule of 20 minutes with ice on the shoulder with a 20-minute break before icing the shoulder again. Do not return to regular activity until a majority of the swelling decreases and pain lessens.
Strengthening Exercises
If your injury does not require surgical intervention you can use special shoulder exercises to help strengthen the tendons, ligaments and muscles of the shoulder joint. You can begin with basic exercises that do not require hand weights, such as shoulder blade squeezes or shoulder shrugs. As you begin to build up strength and your pain level decreases, you may begin intermediate exercises such as internal and external rotations versus a resistance band. Advanced strengthening exercises include pushups, lat pulldown and shoulder press.
