Training

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Training

• Running Footwear,
• Sprints, jogging warm up preparation
• Weight training
• Free weights/equipment Seasonal, onset
• Plyometrics Supervision
• Core stability Group sessions
• Stretching
• Range of motion Technique
• Throwing technique Coach

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Throwing - Assessment

• Which throw, coach, standard
• Check spine and core stability
• Stable platform for throwing arm
• Know what to check for!
• Number of throws per session/year
• Flexibility
• Strength

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Phases of Throwing

• Wind up
• Stride in baseball - run in javelin
• Cocking of arm
• early
• late
• Acceleration
• Deceleration, eccentric cuff contraction
• Follow through

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Shoulder Anatomy

• Static stabilisers
• Glenoid labrum
• Glenohumeral ligaments
• Negative intra-articular pressure -31 mmHg
• Dynamic stabilisers
• Rotator cuff
• Long head of biceps

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History

• Where is the pain,
• Relationship of pain to throwing
• Mechanism of injury
• Instability symptoms
• Dead Arm syndrome
• Previous treatment

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Examination

• Posture, laxity
• Rhythm and range of movement
• ER, scapula, GIRD, posterior stiffness
• Impingement
• Stress tests, sulcus sign, A-P glide
• Apprehension
• Jobes relocation test
• Slide and glide (posterior laxity)

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Anterior and posterior glide/draw signs
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Beighton score Thumb to forearm Little
finger Recurve of knee and elbow Hand to floor
with legs straight
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Throwing problems

• Excess ABd/ER stretches anterior band of IGHL
• Increased dependence on dynamic stabilisers
• Fatigue of rotator cuff leads to overuse, loss of
  control and increased GH translation
• Wear of glenoid labrum
• Posterior stiffness
• Subluxation and instability
• Primary instability
• Secondary impingement pain

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Instability and Impingement

• Throwing athletes, but also in normal, active
  population
• Impingement caused by primary instability
• Internal Impingement (Gilles Walch and Chris
  Jobe)
• SLAP lesion, labral tear

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