Assessment of Motion Loss in the Thrower's Shoulder

The overhead throwing motion is a complex movement which requires soft tissue flexibility and neuromuscular control to generate force from the legs and trunk and propel the ball forward. Repetitive motions and high levels of torque on the shoulder can compromise soft tissue balance and contribute to the high rate of shoulder injuries commonly seen in throwers. A thorough physical examination including inspection of the entire kinetic chain and total arc of shoulder motion is important in making an accurate diagnosis. Nonoperative treatment with a formal progressive rehabilitation program is typically effective in treating the thrower's shoulder. Occasionally, patients may require operative intervention for posterior inferior capsular release for refractory capsular contracture, and selective treatment of superior labrum tears or rotator cuff tears when nonoperative management has been exhausted. A decrease in a thrower's total arc of motion may be more detrimental than a loss of relative internal rotation.