Shoulder Pain and Friction in Baseball Pitchers

Sports Injuries (Shoulder)

I experience a sensation of bone friction in the internal area of my right shoulder (where the arm connects to the shoulder) when throwing a baseball.
There is pain when I exert force to throw the ball.
After warming up my shoulder, the friction sensation diminishes, but after throwing just a few pitches, my shoulder becomes fatigued.
Previously, I did not warm up properly, and my throwing technique was not correct, leading to excessive reliance on the strength of my shoulder, which may have caused some injury.
Additionally, I injured myself while playing badminton; when I quickly pulled my arm back to hit a deep shot, I felt a sudden pain (I even heard a sound coming from inside my arm).
My entire arm and shoulder experienced immediate pain, making it difficult to exert force, although I could still move it.
However, I couldn't lift it much, and raising it caused pain.
I have undergone treatment with traditional Chinese medicine, and currently, I can lift my arm and move it normally, but the sensation of bone friction has not improved.
When I perform chest expansion exercises with both arms, I experience the same sensation (only in my right arm, not in my left).
I visited an orthopedic clinic, and after an X-ray, the doctor said that the bones appeared to be fine.
After examining my shoulder and asking about the pain points, the doctor suggested that there might be some inflammation in the shoulder, prescribed anti-inflammatory medication, and advised me to apply heat.
After finishing a week of medication, I still feel the same, with no significant improvement.
Therefore, I would like to ask for your opinion before deciding whether to pursue further examination.

syu, 10~19 year old female. Ask Date: 2011/07/25

Dr. Hong Ximing reply Orthopedics

Your shoulder joint injury is likely confirmed.
X-rays may not necessarily reveal any abnormalities.
It is recommended to allow the injured area to rest completely for four weeks before starting rehabilitation.
If there is persistent pain and limited range of motion, an MRI or direct arthroscopy should be used for diagnosis.
Wishing you a speedy recovery!

Reply Date: 2011/07/25

More Info

Shoulder pain and friction in baseball pitchers is a common issue that can arise from various factors, including improper warm-up routines, incorrect pitching mechanics, and overuse injuries. The symptoms you describe, such as a sensation of friction in the shoulder joint during throwing, pain when lifting the arm, and a feeling of weakness, suggest that there may be underlying issues that need to be addressed.

One of the most common causes of shoulder pain in pitchers is rotator cuff injuries, particularly involving the supraspinatus muscle. This muscle is crucial for shoulder stability and movement, and inflammation or tears can lead to pain and a sensation of friction during arm movements. The fact that you experience reduced pain after warming up indicates that your shoulder may benefit from a more structured warm-up routine that focuses on increasing blood flow and flexibility in the shoulder joint.

Another potential issue could be shoulder impingement syndrome, where the tendons of the rotator cuff become irritated and inflamed as they pass through the shoulder joint. This can occur due to repetitive overhead motions, such as those involved in pitching. The pain you feel when throwing could be a result of the tendons being pinched between the bones of the shoulder, leading to inflammation and discomfort.

Given your history of not warming up properly and using excessive shoulder strength to throw, it is essential to focus on both strengthening and flexibility exercises for the shoulder. Strengthening the rotator cuff muscles can help stabilize the shoulder joint and prevent further injury. Exercises such as external rotations, internal rotations, and scapular stabilization exercises can be beneficial. Additionally, incorporating stretching routines for the shoulder and chest muscles can improve flexibility and reduce the risk of impingement.

If you have already consulted with a physician and received anti-inflammatory medication without significant improvement, it may be time to consider further diagnostic imaging, such as an MRI, to assess the soft tissues around the shoulder. An MRI can provide a clearer picture of any potential tears in the rotator cuff or other soft tissue injuries that may not be visible on X-rays.

In the meantime, it is crucial to allow your shoulder adequate rest and avoid activities that exacerbate the pain. Ice therapy can help reduce inflammation, and alternating between ice and heat may provide relief. Physical therapy is also highly recommended, as a trained therapist can guide you through a tailored rehabilitation program that addresses your specific needs and helps restore strength and function to your shoulder.

In summary, shoulder pain and friction in baseball pitchers can stem from various causes, including rotator cuff injuries and shoulder impingement. A comprehensive approach that includes proper warm-up routines, targeted strengthening and flexibility exercises, and possibly further imaging studies will be essential in diagnosing and treating your shoulder issues effectively. Always consult with a healthcare professional before starting any new exercise regimen or treatment plan to ensure it is appropriate for your specific condition.

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