The "overhead athlete" is a term we hear often, especially in baseball. However, to define what an overhead athlete truly is, you have to look at and analyze the sport. Volleyball, Water Polo, Baseball, Swimming, and Football are all examples of sports that involve overhead movement of the shoulder, elbow, and hand. This population of athletes is usually younger and, in most cases, still in their development... unless you are Tom Brady. This means that as our youth athletes grow, they can start to present with a variety of common shoulder injuries. The one that we are focusing on in this blog is rotator cuff tendinitis.
Rotator cuff tendinitis is a term used to describe the irritation of one or more of the four rotator cuff muscles and their attached tendons. The most common in this youth population is the supraspinatus, followed by the infraspinatus. This irritation can last for up to three months and could lead to long-term dysfunction if not treated correctly. The athlete will report pain along the back or side of the affected shoulder and will most likely experience that pain with overhead reaching and resisted movements.
Rotator cuff tendinitis develops due to a variety of reasons. These reasons include excessive stress on the tendon, increased workload over a short time frame, and scapular dyskinesis. One or more of the listed factors can begin the process of breaking down the tissue, leading to small micro-tears which cause inflammation and pain. This verbiage DOES NOT mean that the rotator cuff has torn and needs surgical repair. It means that the tendon has "broken down" and did not have enough time to recover before the next activity of stress was placed upon it.
Treatment for rotator cuff tendinitis can be difficult at first if the athlete's shoulder is “hot” (meaning irritated at a high level). The recovery process may start slow with the physical therapist providing pain mitigation techniques. A steroid injection could be provided by an orthopedic doctor to decrease pain levels more quickly. This could lead to a more successful rehabilitation early in the athlete's recovery. Targeted rehabilitation exercises and manual techniques improve on any deficits noted and help the athlete return to their normal level of function and progress back to their sport. Once a physical therapy course of care has been completed, long-term success for that athlete will consist of continued exercise. Utilizing a performance coach can make our athletes more resilient, decreasing the likelihood of re-injury.