Shoulder pain is one of the most frequent complaints that we treat in our overhead and throwing athletes. One of the primary associations with the development of shoulder pain is an increase in throwing volume, speed and or effort in excess of the athletes’ capacity. As Physiotherapists we have a role in not only treating the injury, but also preventing recurrence and improving performance. In the throwing athlete it has been well established that deficits in glenohumeral and scapulothoracic motion contribute to the development of shoulder pain. The role of the remainder of the kinetic chain is less clear.
Sauers et al (2013) found no relationship between hip rotation range and shoulder range in healthy professional baseball players. Robb et al (2010) found some relationship between non-dominant hip ROM and lower limb throwing biomechanics, but neither author investigated lower limb strength.
Saeterbakken et al (2011) investigated the effect of unstable core stability training on throwing velocity in adolescent handball athletes. Over the course of six weeks the exercise group performed 12 x 75 minute core stability and lower limb training session in addition to the regular training in the control group. Whereas the control group showed no change, the core-training group showed a significant (4.9%) increase in throwing velocity. The authors hypothesized that this could be due to an improved ability to use the trunk to generate power and transfer energy to the ball. The mechanisms discussed included improved proximal segment force production, improved segmental decelerative capacity and improve trunk stability during throwing.
Regardless of the exact mechanism the paper demonstrates that core stability training is a powerful tool and arguably an essential part of rehabilitation in the athletes shoulder, improving their performance and reducing their re-injury risk.
Robb et al (2013) Passive ranges of motion in the hips and their relationship with pitching biomechanics and ball velocity in professional baseball pitchers. American Journal of Sports Medicine 38: 2487-2493
Saeterbakken et al (2011) Effect of Core stability training on throwing velocity in female handball players. Journal of strength and conditioning research. 25 (3) 712-718.
Sauers et al (2013) Hip and Glenohumeral rotation range of motion in healthy professional baseball pitchers and position players. American Journal of Sports Medicine Preview Nov 8, 2013.