Injury Patterns and Biomechanics of the Athlete's Shoulder

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Although shoulder injury patterns vary by sport and position, overhead sports, such as baseball, swimming, tennis, and volleyball, share a common dependence on the integrity of the kinetic chain. Disruption of this critical mechanism predisposes to injury and deserves attention as the most important of the biomechanical principles required to help evaluate and manage problems of the athlete's shoulder.

Section snippets

The practical biomechanics of throwing

Repetitive throwing of a baseball at high velocity places tremendous stresses on the upper extremity. Given the popularity of youth baseball, the advent of year-round play, and the seeming increase in elbow and shoulder injuries in throwers of all ages, it is incumbent on the sports medicine physician to understand the basic mechanics of the overhand throwing motion to help diagnose and treat these injuries. In addition, an understanding of these mechanics is helpful when educating parents and

The biomechanics of batting

Despite an interest in hitting dating back to the beginning of baseball, there has been little scientific research on this topic. This is especially true in contrast to pitching and is probably due to the preponderance of upper extremity injuries from pitching. Nonetheless, hitting is clearly important from a performance standpoint, and is still a source of injury. Injuries emanating from batting more often involve the trunk—the thoracolumbar spine and supporting musculature. The lower

Observation of Stroke Mechanics

Review of the athlete's stroke mechanics by video or direct observation is very helpful to check on poor techniques. The “nodes” model gives a framework for the evaluation. Observation of multiple repetitions of the motion and focusing on 1 node per serve repetition can demonstrate if any of the nodes are not being used. The most commonly deficient nodes are lack of knee flexion and hip counter-rotation, which results in the pull-through service motion, and lack of cocking, which results in GH

Summary

Many of the injury patterns and biomechanical motions in tennis are the same as those in baseball. However, tennis-specific kinetic chains are required for optimal force production and minimal joint loads. As in baseball, the shoulder joint in tennis faces repetitive high loads and is a common site of injury. Efficient kinetic chain activation sequences such as push-through and traditional serve motions minimize loads and maximize ball velocity. Visual observation of progression through the

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