Journal Club: A Guide for Overhead Athletes

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In today's installment of journal club, we are going to discuss a topic that I have not mentioned much on the blog but one that is definitely important in the rehab world. And that is helping overhead throwing athletes get better and return to their sport with the help of a throwing program. So many of our athletic patients play sports that require some type of shoulder or throwing movement and there is a high incidence of shoulder and elbow injury across age brackets within these sports.

So, we need to consider a couple of things when thinking about taking care of our overhead athletes when they are injured and the first one is biomechanics.  We need to make sure that we are assessing the posture of the overhead athlete. In fact, this is the first and primary place that I start when I am seeing an overhead athlete in the clinic. Oftentimes fixing the posture improves an athlete's throwing mechanics.  Then, we want to make sure we look at the strength of the different muscle groups in the throwing extremity. We must be thorough here to find any imbalance that could lead to injury. Finally, we need to assess their overhead/pitching mechanics. It can be very useful to use your phone for slow motion capture so you can break down the different phases and assess where joints are in the movement pattern. There are many excellent courses to help you learn about different phases and the mechanics behind them but these are 3 key things to consider from a biomechanical standpoint.

The other consideration is a good throwing program. Once symptoms are under control and mechanics have improved, we need to introduce the actual sport movement patterns in a controlled way. And recently in a course I was taking, a really good throwing program from Kevin Wilk was outlined and I wanted to share it as a resource for your usage in your clinic.

Comprehensive Guide to Return Overhead Athletes to Full Function and Throwing Program

This program outlines a few important exercises but what I found more helpful was the throwing program on page 6-8. Kevin breaks the program up into 3 phases and each phase is appropriately gradual with increasing force and distance. This particular throwing program provides really helpful background information as far as criteria to start the program and if in the program when to progress or regress as well. I especially appreciate the inclusion of just athletic practices like jogging for a warm up. And while this particular program is focused on baseball players, I think there is a lot of crossover for other overhead athletes. You will just need to be creative and tailor it to your patient's sport.

Take some time and look through the program and see if it will be helpful to you. We spend a lot of time rehabbing shoulder and elbow injuries in throwing athletes and weekend warriors so we want to make sure that we are returning them at the appropriate time confident and ready to go!

Jason

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