Why Does it Hurt When I Throw a Football?

To my child, the joys of fall are upon us, the leaves are starting to change here in the north, and college football is in the air, and on Friday nights the high school band can be heard from blocks away at half-time of the local football game.  A frequent patient complaint at this time is shoulder pain.  Many times it’s a forty-something year old man who is throwing the football a little too hard and subsequently has been experiencing pain with various movements.  Typical for a rotator cuff tendonitis.  These have been reviewed before, but frequently involve reaching above and grabbing something, any type of extension of the arm away from the body, reaching behind the back, all of these are fairly typical rotator cuff pain.  So why does one of the joys of life that of throwing a roped spiral to your son cause so much pain in the shoulder? 

Well,  the major problem is the superspinatus gets maximally stressed during the throwing motion.  That is the tendon that can get pinched between two hard surfaces in the shoulder.  It is interesting that the rotator cuff is made up of four muscles.  The supraspinatus, the sub-scapularis, the infraspinatus, and the teres minor.  The problems with rotator cuff almost always start at the superspinatus and yet we have to rely on the other three components of the rotator cuff to rescue the supersinatus. 

One common mistake people make is in their attempt to rehabilitate.  They will go back to the exercises of youth to include bench pressing and over head pressing and the thing to understand is that these are really small muscles and they essentially need small exercises, if you will, low weights or no weights are usually a good place to start with advanting of the weight.  The shoulder is a complex joint with over $270 degree range of motion and it is difficult to do the exercises correctly.  That is why your doctor will frequently recommend physical therapy for very specific rehabilitation of your shoulder.  So, good luck with it and we hope to get you back throwing tight 30 yard spiral to your child.