An Overview of Injuries in Overhead Athletes

Sports that involve overhead motions, such as tennis and baseball, place significant stress on the shoulder joint. When injuries do occur, they usually do so in specific patterns that are not common with other shoulder injuries. Recognition of these specific injuries and appropriate, timely treatment is essential so the athlete can return to sports. Common injuries seen by Dr. Peter Millett are rotator cuff injuries, labral and SLAP tears and glenohumeral internal rotation deficit.

Throwing injuries in the overhead athlete are commonly found in baseball pitchers, but injuries can also affect players involved in other sports such as volleyball and tennis. These shoulder injuries are caused by significant stress being placed on the structures within the joint that keep the humeral head centered in the glenoid socket.

In order to fully understand shoulder injuries in overhead athletes, it is necessary to understand the pitching/throwing motion. There are five stages to the motion – wind-up, early cocking, late cocking, acceleration and follow-through. The late cocking and follow-through phases place the most amount of stress on the shoulder joint. When one structure within the joint becomes weakened from overuse and stress, other structures must handle the overload, often leading to joint pain, stiffness and weakness.

Symptoms of Shoulder Throwing Injuries

Throwing injuries in overhead athletes range a great deal in symptoms depending on the shoulder injury that is present. The most common symptoms are shoulder pain, weakness, stiffness, instability and decreased range of motion.

Have you sustained an overhead throwing injury?

There are two ways to initiate a consultation with Dr. Millett:

You can provide current X-rays and/or MRIs for a clinical case review ($250).

You can schedule an office consultation with Dr. Millett.

Diagnosis of Shoulder Throwing Injuries

A diagnosis of throwing injuries in the overhead athlete is reached by Dr. Millett performing a physical examination and diagnostic tests, as well as discussing the patient’s medical history, symptoms and athletic involvement. During the physical examination, he will look at range of motion, stability and strength of the affected shoulder. Diagnostic tests, such as X-rays, an MRI scan and a CT scan, may also be performed to identify associated injuries and to confirm the injury diagnosis.

Treatment of Shoulder Throwing Injuries


The majority of patients will begin treatment with a non-surgical approach, including rest, ice, activity modifications, anti-inflammatory medications and cortisone injections, as well as a physical therapy program aimed at strengthening the joint and improving range of motion.


If shoulder pain and other symptoms are not alleviated with conservative measures, Dr. Millett may recommend a surgical procedure. The type of surgery performed will depend on several factors, such as patient’s age, injury type and severity of injury. Many throwing injuries requiring surgery can be treated with an arthroscopic approach.

For additional resources on shoulder injuries of overhead athletes, please contact the orthopedic office of Dr. Peter Millett.