Late spring into early summer is one of the most common times we see shoulder and elbow injuries. A lot of parents often ask me what “warning signs” they should be looking for with their son or daughter’s arm pain. Most importantly they want to know if the pain is serious or not.
To a certain extent, we come from a place where we believe the motto “no pain, no gain”, and in some cases, I fully agree with that mindset. But at other times, this mindset can be very detrimental. How do you determine which pain is okay to play through and which pain is not? Here are four common arm pain areas to evaluate and guidelines to help you decide if your athlete should get the area checked out.
Pain Area #1:
Front or the back of the shoulder
Back of Shoulder Pain
Pain and soreness in the shoulder are not uncommon with athletes, but the key is where the pain is located. Pain and soreness in the back of the shoulder usually occur when athletes use their arm to throw or serve. The muscles in the back of the shoulder often get strained. They are small muscles and take on a lot of force when the arm is stopping after a throw or a swing. Typically, this soreness gets better by the next day and eventually the muscles get stronger so the pain does not return.
Front of Shoulder Pain
Front shoulder pain is a whole different issue. We consider this pain to be concerning, and it should be closely monitored. Structures like the front ligaments of the shoulder, the labrum (cartilage in the shoulder), and parts of the rotator cuff are all stressed during overhead movements. If your athletes are complaining of pain here, this is NOT the pain they should try to play through. The pain can go away on its own; however, if the pain persists for more than three days or if it occurs every time they try to play their sport, go have it furthered examined by a physical therapist or a licensed health care professional.
Pain Area #2:
Outside of the upper arm
Pain and soreness aren’t commonly experienced on the outside of the upper arm as the deltiod muscle is just about the only muscle in that area. Pain here, especially in adolescent athletes, is usually a sign of an injury to the growth plate of the upper arm. Have you ever heard the term “little leaguer’s shoulder”?
Little leaguer’s shoulder can have delayed healing and significant downtime if left unaddressed. Again, like in the shoulder, this pain can go away fairly quickly. However, if it becomes persistent or happens every time the athlete tries to use their arm for activity, it is time to have it checked out.
Pain Area #3:
Inner or outer elbow
Inner elbow pain
Pain and soreness in the elbow are not as common as the shoulder and tends not to be bothersome – unless the athlete is throwing or serving. This infrequency is why I think people don’t have this area looked at as much or soon enough. The inner elbow is home to some key structures that are stressed during overhead movements. The ulnar collateral ligament (Tommy John ligament) and the inner elbow growth plate (little leaguer’s elbow) are the most significant. Once these areas start developing pain, they are usually past the mild stage and are typically in the damage stage.
Outer elbow pain
The outer elbow rarely develops pain and usually does not develop pain without previously having inner elbow pain. Pain in the outer elbow can be significant such as a cartilage lesion on one of the forearm bones. This damage happens from over-compression in the joint, commonly due to a loose ulnar collateral ligament. Like the inner elbow, by the time this area becomes painful, the damage has already set in.
Pain localized to the inner or outer elbow should not be dismissed as the consequences can be detrimental to the longer term health of the elbow.
Pain Area #4:
Biceps or triceps muscles
Pain and soreness in muscle tissue is rarely a “red flag” for us. Injuries to muscles can definitely be painful but more times than not, they will resolve on their own in a reasonable amount of time. The biceps and triceps are the muscles most susceptible to getting strained in sports like baseball, softball, and tennis.
A lot of the time the pain is located in the middle of the muscle or, for tricep pain, down by the elbow joint. Again, these pains usually go away quickly and usually respond well to light to medium massage. If for some reason, the pain is not fully gone in a couple weeks, then I would recommend getting it checked out.
As your athlete participates in the common summer sports, pain and soreness can and will happen. The key as parents is to continuously monitor the symptoms and use the guidelines above to help determine severity. If the pain falls into one of the key areas, don’t be that parent that finally takes their kid in only to find out they fractured their growth plate. On the flip side, if the pain isn’t too bad, “go rub some dirt on it” is sound advice!
When in doubt give us a call 402.932.7111 if you have any questions about your athletes’ arm pain. We’d be happy to answer any questions you may have!
Written By: Travis Manners, PT, SCS, CSCS