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PM R. 2016 Mar;8(3 Suppl):S78-90. doi: 10.1016/j.pmrj.2015.12.005.

Rehabilitation of the Overhead Throwing Athlete: There Is More to It Than Just External Rotation/Internal Rotation Strengthening.

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Champion Sports Medicine, 805 St Vincent's Dr, Suite G100, Birmingham, AL 35205(∗); Tampa Bay Rays Baseball Team, Tampa Bay, FL; American Sports Medicine Institute, Birmingham, AL. Electronic address:
Advanced Rehabilitation, Tampa, FL(†).
Champion Sports Medicine, Birmingham, AL(‡).
American Sports Medicine Institute, Birmingham, AL; Andrews Research and Education Foundation, Gulf Breeze, FL(¶); The Andrews Institute, Gulf Breeze, FL.


The repetitive nature of throwing manifests characteristic adaptive changes to the shoulder, scapulothoracic, and hip/pelvis complexes that result in a set of unique physical traits in the overhead throwing athlete. An effective rehabilitation program is dependent upon an accurate evaluation and differential diagnosis to determine the causative factors for the athlete's pathologic features. The treatment program should be individualized with specific strengthening and flexibility exercises to achieve the dynamic stability that is required for overhead function. In this article we describe the characteristics of the throwing shoulder, along with a multiphased rehabilitation program that allows for the restoration of strength, mobility, endurance, and power and is aimed toward a return to unrestricted sporting activity. We also describe exercises that link the upper and lower extremities because of the importance of core control and leg strength in the development of power during the act of throwing. Additionally, proper throwing mechanics, utilization of pitch counts, appropriate rest, and proper off-season conditioning will help decrease overall injury risk in the overhead throwing athlete.

[Indexed for MEDLINE]

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