Shoulder pain while pitching

[Cornbread]

Update: We did get in to ortho 3 weeks ago. She was diagnosed with deltoid tendonitis. We were given daily exercises to do and were told we could continue softball activity as long as the pain does not exceed a 3 on the scale. As of Monday, we can get 5 full speed pitches in (after stretching and warmup of course) before the pain reaches level 3. Batting also produces pain exceeding a 3 after 15 swings. We are approaching 2 months of rest and rehab and I do not feel that we are making any progress. Since the initial 3 weeks of rest, it has hurt more than it did before rest. We have a follow up appointment coming up on Monday.

Did they MRI? What is her pain on range of motion?

 

[Ken Krause]

One thing I notice that could be a contributing factor is that it appears she tightens up her shoulder when she gets to release. If you look in the video her shoulder kind of hunches up. That can create stress and tension which can lead to pain and injury.

See if you can get it to relax. That might help.

 

[gator5]

Update: We did get in to ortho 3 weeks ago. She was diagnosed with deltoid tendonitis. We were given daily exercises to do and were told we could continue softball activity as long as the pain does not exceed a 3 on the scale. As of Monday, we can get 5 full speed pitches in (after stretching and warmup of course) before the pain reaches level 3. Batting also produces pain exceeding a 3 after 15 swings. We are approaching 2 months of rest and rehab and I do not feel that we are making any progress. Since the initial 3 weeks of rest, it has hurt more than it did before rest. We have a follow up appointment coming up on Monday.

So sorry to hear that. Get a second opinion with the doctor. If you have seen one PT person, go see another.

I was surprised to hear you were encouraged to pitch while having any pain at all.

 

[Seedogg]

Did they MRI? What is her pain on range of motion?

They did not do any imaging. The only movements in her ROM that produce pain are when she has her arm straight out in front horizontal and raises to vertical with resistance and also with arm horizontal to the side, elbow bent at 90° and horizontal as well, then rotating forearm from horizontal to vertical with resistance while upper arm stays horizontal. Similar to the stop signal. All other movements are pain free with and without resistance.

 

[Cornbread]

They did not do any imaging. The only movements in her ROM that produce pain are when she has her arm straight out in front horizontal and raises to vertical with resistance and also with arm horizontal to the side, elbow bent at 90° and horizontal as well, then rotating forearm from horizontal to vertical with resistance while upper arm stays horizontal. Similar to the stop signal. All other movements are pain free with and without resistance.

If it were my DD I would request and MRI. You and your DD need peace of mind. It could just be some loose cartilage that needs to be cleaned up. Her being able to throw a few pitches before pain gets worse I think is a good sign. These things start out small but eventually it get too painful to do normal everyday stuff. Does she have pain brushing her hair?

 

[Seedogg]

If it were my DD I would request and MRI. You and your DD need peace of mind. It could just be some loose cartilage that needs to be cleaned up. Her being able to throw a few pitches before pain gets worse I think is a good sign. These things start out small but eventually it get too painful to do normal everyday stuff. Does she have pain brushing her hair?

She does not have pain while brushing her hair. I will definitely request an MRI. I would expect them to order one anyway since there has been no improvement.

 

[Acschiropractic1]

Update: We did get in to ortho 3 weeks ago. She was diagnosed with deltoid tendonitis. We were given daily exercises to do and were told we could continue softball activity as long as the pain does not exceed a 3 on the scale. As of Monday, we can get 5 full speed pitches in (after stretching and warmup of course) before the pain reaches level 3. Batting also produces pain exceeding a 3 after 15 swings. We are approaching 2 months of rest and rehab and I do not feel that we are making any progress. Since the initial 3 weeks of rest, it has hurt more than it did before rest. We have a follow up appointment coming up on Monday.

Based on where your thumb is in the picture that is the insertion point of the deltoid muscle. I’d be concerned with the labrum or instability of the shoulder if it is not showing improvement. The deltoid can spasm to try and stabilize the humeral head into the socket.

 

[slowcelica]

We are approaching 2 months of rest and rehab and I do not feel that we are making any progress. Since the initial 3 weeks of rest, it has hurt more than it did before rest. We have a follow up appointment coming up on Monday.

Same thing happened with my DD, they did x-rays and diagnosed it as tendonitis at first, went back after a month and they sent her for an MRI because of no improvement. They didnt find anything but diagnosed her with LL shoulder which is a growth plate injury. Because of that she's been resting it for 3 months, and it still bothers her some when just throwing overhand. I'm not letting her try pitching until she is a 100% now.

 

[DrRiello]

Update: We did get in to ortho 3 weeks ago. She was diagnosed with deltoid tendonitis. We were given daily exercises to do and were told we could continue softball activity as long as the pain does not exceed a 3 on the scale. As of Monday, we can get 5 full speed pitches in (after stretching and warmup of course) before the pain reaches level 3. Batting also produces pain exceeding a 3 after 15 swings. We are approaching 2 months of rest and rehab and I do not feel that we are making any progress. Since the initial 3 weeks of rest, it has hurt more than it did before rest. We have a follow up appointment coming up on Monday.

That there is lateral deltoid. They got it correct. I do t see anything in her motion other than the little shoulder up thing she does at the end.
When the arm gets to 3 palm down puts stress on that muscle. She is not exactly palm down as she rotated the the hand in a little at three.
This very well may not be tendinitis but more a small tendon tear. Which will take longer to heal. But it should.
You really have to use your ice, heat and rest appropriately with action. Pitching.
Pitch easy try to stay away from areas that recreate pain. So 12, 9 positions should be pretty painless. Go from 3 back slowly a little each workout to influence the muscle. But if you go too hard you re-tear. Slow steady consistent with small increases in volume and intensity.
Hope this helps.


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[Seedogg]

Based on where your thumb is in the picture that is the insertion point of the deltoid muscle. I’d be concerned with the labrum or instability of the shoulder if it is not showing improvement. The deltoid can spasm to try and stabilize the humeral head into the socket.

Thank you for your opinion. Would an MRI show a labrum tear?