A 2009 JBJS current concepts review by Braun, Kokmeyer, and Millett examining the biomechanics of the throwing motion and how it produces predictable shoulder injury patterns in overhead athletes. The paper covers kinematics, anatomical adaptations, common pathologies (SLAP lesions, rotator cuff tears, impingement variants, GIRD, scapular dyskinesia), and a phased nonoperative treatment framework.
When evaluating a throwing athlete with posterior shoulder pain and velocity loss, quantify GIRD against the contralateral side: a deficit ≥25° signals clinically meaningful posteroinferior capsular tightness that should drive a structured stretching program before any operative workup.
Exhaust all four phases of the rehabilitation protocol before considering surgery — subacromial decompression alone rarely returns throwers to their prior level, and even rotator cuff repair succeeds in only about half of cases.
A 2009 JBJS current concepts review by Braun, Kokmeyer, and Millett examining the biomechanics of the throwing motion and how it produces predictable shoulder injury patterns in overhead athletes. The paper covers kinematics, anatomical adaptations, common pathologies (SLAP lesions, rotator cuff tears, impingement variants, GIRD, scapular dyskinesia), and a phased nonoperative treatment framework.
When evaluating a throwing athlete with posterior shoulder pain and velocity loss, quantify GIRD against the contralateral side: a deficit ≥25° signals clinically meaningful posteroinferior capsular tightness that should drive a structured stretching program before any operative workup.
Exhaust all four phases of the rehabilitation protocol before considering surgery — subacromial decompression alone rarely returns throwers to their prior level, and even rotator cuff repair succeeds in only about half of cases.