Evaluation and management of shoulder instability in the elite overhead thrower (Reprinted from Operative Techniques in Sports Medicine, July, 2000)

The elite throwing athlete places significant forces on the soft-tissue sta bilizers of the shoulder with every pitch. Anterior translation forces can be as high as 40% of body weight and distraction forces as high as 80% body weight during the act of throwing. Injury to the static and dynamic stabil izers can lead to significant pain and loss of function in these athletes. To successfully treat the injured thrower, it is important to accurately di agnose the pathologic process. This article reviews the biomechanics of thr owing and pathologic processes seen in the elite thrower. We cover the esse ntials of the history and physical in this population and conclude with a d iscussion of the various treatment regimens.