Shoulder injuries in athletes who partake in overhead and throwing activities


Sports such as tennis, squash, swimming, cricket and volleyball all require the athlete to be able to perform overhead arm movements, but unfortunately structures in the shoulder complex can become injured as a result of repetitive strain. Shoulder injuries are on the rise, and account for 30% of all injuries.


Biomechanically, it has been observed that individuals who partake in activities that require repetitive overhead movements have altered mobility patterns when compared to the non-dominant shoulder. This usually presents as excessive external rotation (putting your hand behind your head), and reduced internal rotation (putting your hand behind your back). This change in function then stresses and can damage the cartilage, rotator cuff muscles and tendons, and joint capsule.


Stretching is a useful tool in helping to restore shoulder range of movement, and reducing the incidence of shoulder injury and soreness. The Sleeper Stretch was developed specifically to improve Gleno-humeral joint internal rotation whilst stabilising the scapula. The stretch involves the patient lying on their side with their lowermost arm at 90 degrees to the body, and elbow bent at 90 degrees. The patient then uses their uppermost hand to gently press down on the back of the hand to passively mobilise the shoulder into internal rotation. Performing 3 sets of 30 second stretches is thought to be appropriate for patients who have reduced internal rotation due to overhead or throwing activities. Strength and conditioning should be an important component to rehabilitation to reduce the chances of re-injury occurring.