Shoulder Injuries in Professional Athletes

The shoulder trades stability for mobility. A shallow socket, a labral rim, a capsule and the rotator cuff hold the joint together through an enormous range of motion.

Common conditions include labral tears (including SLAP tears), dislocation and instability, impingement, AC joint separation and arthritis and biceps tendon problems.

Damage in one structure typically changes the mechanics of the others, which is why shoulder problems tend to compound over a career.

• Throwing places the shoulder at the extreme of external rotation at very high angular velocity.
• Blocking and tackling apply direct force to the joint with the arm extended, a common dislocation mechanism.
• Landing on an outstretched arm or on the point of the shoulder is routine in both sports.

Repetitive overhead activity is a well-recognized mechanism for cumulative shoulder injury.

A career of throwing or blocking can be described as continuous trauma to the joint even where individual events were never reported.

More on how repetitive-exposure claims work: Cumulative trauma explained.

• Pain reaching overhead, behind the back or across the body
• Night pain when lying on the affected side
• Weakness lifting or carrying
• Clicking, catching or a sense the shoulder may slip
• Loss of range of motion over time

• Examination with impingement, instability and labral provocative tests
• MRI, often with contrast (arthrogram) for labral evaluation
• X-ray for arthritis, AC joint changes and bone spurs
• Strength testing comparing sides

• Documentation of dislocations, separations and any shoulder surgeries
• Throwing-program and rehabilitation records for pitchers
• Team injury reports, athletic training room logs and daily treatment notes
• Team physician and consulting specialist records, including imaging reports
• Surgical operative reports and post-operative rehabilitation notes
• Contracts, transaction history and roster or practice-squad records showing dates of employment
• Post-career medical records from primary care doctors, orthopedists and other specialists

Shoulder conditions are often claimed together with the neck and elbow because the mechanisms and symptoms overlap.

Prior surgery during the career is generally strong documentation of an industrial origin.

Both specific-injury and cumulative theories are frequently used depending on the history.

Rules differ by state and by sport. Eligibility factors and types of compensation cover the general framework.

• Physical therapy focused on scapular mechanics and cuff strength
• Injections for impingement or AC joint pain
• Arthroscopic labral repair, decompression or stabilization
• Joint replacement in advanced arthritis

• Range-of-motion loss and strength deficits are the usual basis for impairment rating.
• Loss of overhead work capacity can be significant for post-career occupations.
• Bilateral involvement, common in former athletes, generally increases overall impairment.