Monday Medical: The functional shoulder |

Monday Medical: The functional shoulder

Susan Cunningham
For Steamboat Pilot & Today

When it comes to overhead sports like baseball and tennis, the shoulder joint plays an important role. Its wide range of motion makes it possible to pitch or serve a ball, but also leaves the joint susceptible to injury.

“Of all our joints, shoulders are the ones with the most range of motion, which means they’re less constrained and rely more on soft tissue and muscle balance for stability,” said Dr. Adam Wilson, an orthopaedic surgeon in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center. “That makes shoulders much more prone to injury.”

Sports-related issues

Overhead sports can be hard on shoulders.

“Pitchers take the shoulder to extremes of motions, creating a strong force as the shoulder externally rotates. That can lead to a loss of internal rotation,” Wilson said. “With tennis, the same thing can happen with serves.”

And then, the arm must quickly decelerate after a pitch is released or the ball is hit.

“A lot of force goes into the shoulder to slow it from maximum speed to resting,” Wilson said. “Irritation, pain and certain injuries can result from the massive force that’s repetitively put through the shoulder.”

Shoulder injuries that are more common with overhead sports include loss of internal rotation, issues with the biceps tendon and labrum and irritation and tears to the rotator cuff.

To avoid injury, be sure to rest appropriately and avoid overuse. That’s especially important for younger players, who are more susceptible to injury.

Prevention Tip No. 1: Strengthen

To maintain a healthy, functional shoulder, you should work those muscles. But a well-rounded strengthening regimen may not be what you’d expect.

“A lot of times when people are working out their shoulders, they focus on the big muscles, like the trapezius and deltoids,” Wilson said. “Really, the small muscles are the most important for maintaining a healthy, mobile shoulder.”

For instance, to strengthen the rotator cuff, which is the group of muscles and tendons surrounding the shoulder joint, Wilson recommends keeping the elbow at the side, then using light resistance while rotating the hand out and in towards the stomach.

Prevention Tip No. 2: Stretch

When thinking of shoulders, the phrase “use it or lose it,” comes to mind.

“If the shoulder isn’t used, it’s prone to getting stiff,” Wilson said. “Even for a minor injury, if the arm is put in a sling or the shoulder isn’t used because of pain, inflammation can cause the joint capsule to constrict and get stiff, which results in more pain, creating a cycle.”

Wilson recommends patients continue to use the shoulder even with a certain amount of pain, unless the injury needs to be immobilized.

“It’s a balance,” Wilson said. “We want to keep it from getting stiff, while allowing it to heal.”

To create mobility, hold onto a broomstick or baseball bat, then use one arm to take the other through a wide range of motions.

And try the sleeper stretch: Lie on your side with your elbow at your side, then let your arm ease down towards the abdomen.

When injury strikes

See a health care professional if you have a specific injury — maybe you hear a pop or feel immediate pain — or if you have chronic pain that doesn’t improve after resting and avoiding irritating activities.

And don’t forget the power of rest.

“The first step is often rest, which is hard for a lot of athletes to do,” Wilson said. “But pushing through the pain can result in worse injuries or a more difficult recovery.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at

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