Throwing biomechanics and common throwing injuries

Summer is nearly here and that means Northern Beaches cricketers will be dusting off the whites and getting ready for a spit free Summer of cricket. It also means your local Dee Why physio is getting prepared for the annual increase in throwing injuries and other shoulder, elbow and wrist injuries.

While throwing injuries usually occur in throwing sports such as cricket, softball, javelin and water polo, they can also pop up in sports that simply use a lot of overhead rotation and movement like serving in volleyball and tennis.

The biomechanics of throwing

Throwing is the co-ordinated effort of a number of muscle groups and is one of the fastest actions human beings can perform. Major league pitchers’ maximum humeral internal rotation velocity has been measured at over 7500°/second.[1]

An overhead throw has 6 phases:

  • wind up,
  • stride,
  • cocking,
  • acceleration,
  • deceleration and
  • follow through


Escamilla RF, Andrews JR. Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports[2]

Throwing injuries tend to occur due to overuse, poor throwing technique and can come on gradually, sneaking up on you before you realise you’ve done yourself a painful injury.

Throwing injuries most commonly occur in the shoulder of the throwing arm, but can also appear as elbow and wrist complaints too.

Shoulder injuries

The shoulder is the most common location for injuries from throwing and overhead movements and different phases of throwing gives us the possibility of all kinds of different injuries.[3]

  • Windup – No injuries are common
  • Cocking – Anterior subluxation, internal impingement, glenoid labrum lesions, subacromial impingement.
  • Acceleration – Shoulder instability, labral tears, overuse tendinitis, tendon ruptures.
  • Deceleration – Labral tears at the attachment of long head of biceps, subluxation of long head of biceps by tearing of transverse ligament, lesions of rotator cuff
  • Follow Through – Tear of superior aspect of glenoid labrum at the origin of biceps tendon, subacromial impingement.

Elbow injuries

During the throwing motion, your arm is acting like a whip just before it cracks. This leaves your elbow under a lot of stress and at risk of injury as well.

That repetitive sideways force to the elbow combined with a poor throwing technique is the recipe for a Medial Collateral Ligament Sprain and swelling and pain.

How do physiotherapists treat throwing injuries?

A number of factors contribute to the development of throwing injuries and your physio will do an in-depth biomechanical and injury assessment before getting stuck into your new program.

A bespoke program designed by a musculoskeletal physio will aim to:

  • Improve shoulder flexion, abduction, external and internal rotation
  • Utilise manual and massage therapy techniques on muscle tightness in your latissimus dorsi, pectorals, rotator cuff, abdominals & hip flexors
  • Improve thoracic spine flexibility when performing extension and rotation of throwing

Help prevent throwing injuries with help from your physio

Whether you’re a weekend warrior or an elite athlete, a musculoskeletal physio is a goldmine for injury prevention techniques to ensure you can maintain optimal performance while taking care of your body.

A visit to a physio can help decrease your chances of injury in the future.

  • Help to correct your throwing technique

Ensure your throwing technique is safe and efficient, minimising the risk of injury to the shoulder and elbow. Make sure you use the whole body, including the legs and hips rather than confining the throwing motion to the upper body.

  • Improving flexibility

Upper back flexibility is extremely important for athletes that throw or use overhead motions regularly. Not only does upper back flexibility help with injury prevention to the shoulder, but it also acts as a performance enhancer. Having adequate flexibility in your upper and lower body is important to improving your throwing technique, reducing the risk of injury and performing to your full potential Key joints which require adequate range of motion for throwing include:

  • Shoulder
  • Elbow
  • Upper Back
  • Lower Back
  • Hips
  • Core

For more information on throwing injuries, injury prevention techniques and managing sports injuries, give us a call on (02) 8964 4086 and send an email to info@fixio.com.au.

[1] Seroyer ST, Nho SJ, Bach BR, Bush-Joseph CA, Nicholson GP, Romeo AA. The kinetic chain in overhand pitching: its potential role for performance enhancement and injury prevention. Sports Health. 2010 Mar;2(2):135-46. doi: 10.1177/1941738110362656. PMID: 23015931; PMCID: PMC3445080.

[2] Escamilla RF, Andrews JR. Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports. Sports Med. 2009;39(7):569-90. doi: 10.2165/00007256-200939070-00004. PMID: 19530752.

[3] Houglum PA, Bertoti DB. Brunnstrom’s clinical kinesiology. FA Davis; 2012

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