What is it about sport as a teenager that’s so important to your shoulder management as an adult? - Part One
This blog from our Osteopath, Neil, will be the first in a series of short explorations into what can go into the assessment and management of shoulder complaints, with an emphasis on throwing to give some context. Shoulders can be curious and complex conditions to manage with this first blog discussing your shoulders can be quite different from side to side, especially if you’re someone who did a lot of overhead sport as a kid.
When completing a detailed assessment of the shoulder here at the Injury Rehab Centre, one key detail that cannot be overlooked when we are taking your initial history, is your sporting history, particularly in the teenage years.
What is it about sport as a teenager that’s so important to your shoulder management as an adult?
During the early teenage years, prior to your final growth spurt, there is an area of the humerus (upper arm bone) that remains as cartilage and eventually turns into bone.
With enough stress applied to the shoulder from repeated activity from overhead throwing sports or sports dominant to one hand e.g. cricket, baseball, softball. This area of cartilage adapts and creates an additional twist in the bone prior to fusing.
This can be considered to be a positive adaptation and one mechanism that can be the difference between a powerful and weak throw because of the amount of ‘wind-up’ or ‘lay-back’ that can be generated at the shoulder. If you ever watch a baseball pitcher in slow motion from side on, you’ll see the shoulder rotate so far you’ll wonder why it hasn’t snapped!
Once the bone has fused, this can present with an ongoing asymmetry between the shoulders that won’t change with treatment. If you have this sporting history, even when healthy and pain free, you will have greater available movement into external rotation at the expense of less internal rotation when compared to the other shoulder and that of the ‘textbook normal’ reference ranges.
What we then need to consider is that the combination of both movements remain equal - suggesting the total movement available through rotation in your shoulder is the same, just in a different arc due to the bony change.
What some may consider an asymmetrical problem, and restrictions that may need to be addressed, can turn out to just be your normal and nothing to worry about!
This is just one of the pieces that goes into the puzzle of assessing a shoulder here at The Injury Rehab Centre, as part of our comprehensive testing services.
If rotational mobility is not the problem for your shoulder, what else do we need to consider?
Stay tuned for part 2.
Refs:
Keller, R. A., De Giacomo, A. F., Neumann, J. A., Limpisvasti, O., & Tibone, J. E. (2018). Glenohumeral Internal Rotation Deficit and Risk of Upper Extremity Injury in Overhead Athletes: A Meta-Analysis and Systematic Review. Sports health, 10(2), 125–132. https://doi.org/10.1177/1941738118756577
Nutt, C., Mirkovic, M., Hill, R., Ranson, C., & Cooper, S. M. (2018). REFERENCE VALUES FOR GLENOHUMERAL JOINT ROTATIONAL RANGE OF MOTION IN ELITE TENNIS PLAYERS. International journal of sports physical therapy, 13(3), 501–510.
