Shoulder Pain in Overhead Athletes

When discussing the overhead athlete, the shoulder is always in conversation. Whether swinging, hitting, shooting, lifting, or something else, the shoulder is in use. The repetitive and chronic nature of it’s use is what brings us to our topic today. Let’s break down shoulder pain in the overhead athlete!

I work with many tennis players, volleyball players, and CrossFit athletes. All three of these sports require the arm to be overhead repetitively. The most common issue that arises is the aspect of overuse or chronic workload put into the system. Now there are plenty of people who use their arms all the time and have no issues, so it’s not a guarantee that chronic overuse causes injuries, but there are factors that lead to them. We will break those down below.

Overhead shoulder mobility is often blamed on the shoulder itself, but the shoulder isn’t always the problem area! The shoulder is quite a complex region of the body, consisting of the collarbone, scapula, humerus (arm bone) from a bony structure standpoint, but then all of the overlying muscle and connective tissue as well. We have nerve contribution from the neck which can play a role on shoulder function, and so can the thoracic spine (or mid back). The thoracic spine is where I have my athletes focus their mobility work when the shoulder itself is moving well. If the thoracic spine isn’t moving optimally, that will change how the shoulder moves!

Now let’s say mobility looks great through the whole chain. If there remains ‘mobility’ deficits but evaluation shows good overall passive mobility, than this is an ‘active’ problem. An active problem would mean that there is not an optimal amount of strength through the system to move you through movement proficiently. This could cause mal-movement mechanics through your low back/neck/elbow or somewhere else to allow you to be ‘successful’ in movement but really it’s a learned compensation pattern. The focus would then have to turn to building adequate strength through the system! See how this can be tricky? That’s where a trusted physical therapist comes in!

When I work with my tennis players, volleyball players, and CrossFit athletes on overhead mobility or strength or performance tasks, these are all the beginning areas of where I consider how to optimize movement. If you begin with that information stated above, you will be off to a great start. So in summary, find out the main issue and then attack that. Don’t shoot blindly as what you are guessing the issue is, get to the root cause!

Need assistance in solving your tennis injury or volleyball injury? Let’s chat! I would be happy to discuss further how Loon State Physical Therapy can be a teammate in getting you back to moving and feeling your best! Call us at (612) 405-8503 or book with us online at www.loonstatephysicaltherapy.com for an in-person or virtual appointment.

Until next time!

Andrew Eccles

Owner and Physical Therapist at Loon State Physical Therapy