Thrower's Arm

QUESTION: I have pain in my arm after throwing a baseball. It seems to hurt worse as the season has progressed. I notice it hurting when I start to throw, then it gets a little bit better; but, then after practice or a game, it hurts again. Have I torn a muscle?

ANSWER: Most episodes of pain in a thrower’s arm are related to overuse and irritation of the rotator cuff muscles. Similar situations occur in tennis and swimming. Rotator cuff is made up of four separate muscles that function together to help create a stable shoulder joint. Usually, they are irritated from the overuse activity. With this, the muscles get weaker and the pain increases.

Pain is most often noted when the arm is raised overhead or to the side. Many people find it difficult to sleep on the involved shoulder due to pain. The pain is usually noted to be in the outer aspect of the shoulder and arm with occasional radiation to the elbow.

Initially, it is recommended that you stop the activity that causes the pain but to continue to remain active in other aspects of your particular sport and/or other exercise activity to maintain your fitness. Regardless of the activity during this time of rest, icing the shoulder for 10 to 15 minutes after the activity will help decrease any irritation of the shoulder that may occur. Even with running, this shoulder is moved and can become irritated. If after a two- to three-week period, this shoulder is not improved, then evaluation by your physician is advised.

Generally, routine history and a physical alone will provide the proper diagnosis. X-rays, though, are often required to evaluate your shoulder fully. Treatment of rotator cuff irritation consists of active rest, restoration of flexibility and strength, and evaluation of the mechanics of the inciting activity. Often a change in the throwing position, the serve, or the swim stroke will eliminate much of the irritation. Most individuals are able to return to their sport at their pre-injury level within four to ten weeks. Occasionally, surgery is needed and, although recovery is longer, most individuals return to the level of participation they desire.

WRITTEN BY: Brent M. Johnson, M. D.