Care of the Shoulder
My younger son Matt was about 16-years old when he was diagnosed as having suffered a sub-luxation in his throwing shoulder. The injury was caused when a dive was made back into a first base bag with his throwing arm extended. Later, it was determined that the impact with the bag caused the arm to move excessively in the shoulder joint (not technically a dislocation), damaging a portion of the socket surface and creating a tear in the labrum (the cartilage type material that surrounds the joint).
A long period of time was spent trying to rehab and strengthen the shoulder using free weights and rotator cuff exercises that were prescribed at the time (Jobe’s exercises). When the rotator cuff program was not successful, a more aggressive rehab program was undertaken using a Cybex machine located at UNC Sports Medicine. The Cybex machine added dynamic strengthening exercises to the rehab program and also allowed Matt’s shoulder strength to be measured throughout the exercises. None of these rehab efforts proved totally successful and surgery was finally recommended.
Matt’s major symptom after the injury was that he could throw close to maximum velocity one day but he would then need three days as a recovery period before he could throw hard again. During the days after maximum effort, his shoulder and arm felt “dead.” The UNC doctors explained that excessive movement in the shoulder joint was causing trauma to the muscles and tendons around the joint and the “dead” time was time the shoulder needed to recover from the trauma of throwing. Due to a labrum tear, Matt was never able to develop sufficient shoulder strength to limit the movement within the shoulder joint and ended up having shoulder surgery.
Recently Matt’s son Kaede encountered pain in the upper arm while working through a start up throwing program. Specifically, after about two months of throwing every other day he complained of pain during the cocking phase of throwing. We shut Kaede down immediately and Matt took him to Duke Medical Pediatric Orthopedics where Kaede was diagnosed with a postural issue that was causing GIRD. GIRD is an internal rotation deficit caused by poor positioning of the scapula. He has been in PT for approximately a month and it appears, through a set of daily exercises and attention to his upper body posture, that Kaede has made the necessary corrections to gain normal range of motion in the shoulder.
During this PT work at Duke it has become clear that the older exercises Matt did for the rotator cuff are significantly outdated and some of the exercises are not recommended any more. As a result of talking with the Duke PT guys we’ve decided to remove the older Jobe’s rotator cuff exercises from this web site. Our recommendation to parents and players is to discuss shoulder issues and maintenance with a qualified baseball physical therapist or orthopedist.