By Amy McGorry
Quarterbacks are especially susceptible to shoulder injuries. Not only are they prone to being tackled and driven into the ground, but repeatedly throwing a ball can also contribute to tears in the tissue that surround the shoulder joint. Why? During a throw, rotating your arm outward when it's at your side causes your biceps to contract and pull on the labrum, the piece of cartilage that lines your shoulder socket.
Football players aren't the only ones who are vulnerable. Any athlete who throws overhead (such as baseball, tennis and volleyball players) or is at risk of falling on an outstretched arm (such as skiers) can experience this potentially season-ending injury. Even just lifting a heavy object at home can cause a labral tear.
When Shoulders Are A Pain
The shoulder is a ball and socket joint. The "ball" or head of your arm bone sits in a socket (called the glenoid) that only partially covers the ball. The labrum lines the rim of the socket, which allows the ball to sit better. Tendons and ligaments surrounding the ball attach to the labrum, providing further stability in an unstable scenario.
Rotator cuff muscles help the labrum stabilize the joint, but weakness can allow the ball to move around excessively. This leads to wear and tear of the labrum. Labral tears can lead to further shoulder instability and possible dislocation. Remember Mel Gibson’s character in Lethal Weaponwho popped his shoulder out of the socket? Imagine what his labrum looks like!
A "SLAP" lesion (Superior Lesion Anterior to Posterior) is a labral tear located in the top portion along the front to back of the rim. It usually involves the biceps tendon. Another type, a Bankart lesion, involves the glenohumeral ligament and occurs in the lower portion of the rim. While some tears can heal on their own, surgery is often required to repair the damaged tissue and address instability when conservative treatment doesn't work.
Why You're Sidelined
A labral tear can form a flap of tissue that gets pinched in the shoulder joint during certain movements. Athletes complain of a “catching” sensation and general ache inside the joint. Some feel the shoulder “pops out” of the socket.
A hit or fall can jam the humeral head into the rim, displacing it out of the socket and causing a shear of the labrum. This can lead to shoulder instability, resulting in loss of power during a throw. Pain can occur in the arm as the humeral head rubs along the damaged tissue during the throwing motion.
Lack of a good blood supply in parts of the labrum makes healing difficult. Surgery is then required. Surgeries involving just the removal of damaged tissue are associated with shorter recovery times than surgeries addressing the tear, instability of the joint, and tendon and ligament involvement. A quarterback facing a SLAP lesion repair may take up to six months to return to his full throwing capacity.
How To Stay In The Game
Shoulder instability is a problem with labral tears. Strengthening the muscles around the shoulder blades and the rotator cuff is one way to support the labrum.
External Rotation Sidelying
- Lie on your side
- Bend your elbow at 90 degrees on your waist
- Turn your arm up to the ceiling, keeping elbow on body
- Do 3 sets of 10 reps with a light weight
- On stability ball, hold weights with your elbows bent
- Squeeze shoulder blades
- Row elbows up 3 sets of 10 reps
Physioball Walk Outs
- Lie on ball and slowly walk yourself out and back
- Do 10 reps
Always check with a physician prior to any exercise routine. And remember: You may be sidelined... but not for long!