Rehabilitation of the painful shoulder

Managing the painful shoulder in overhead athletes can be difficult due to a lack of time loss injuries in overhead sports and focusing primarily on either pathoanatomical causes or movement impairments. Although managing the painful shoulder can be challenging, the combination of identifying pathoanatomical causes with movement impairments can provide a more focused rehabilitation approach directed at the causes of shoulder pain. Understanding the potential influence of scapular positioning as well as mobility and/or strength impairments on shoulder pain, can help clinicians develop more directed rehabilitation programs. Furthermore, sports-specific methods such as long toss or using weighted balls for achieiving physiological or performance-based gains have limited empirical evidence regarding their clinical and performance-based benefits which may impede the rehabilitation process. Employing a comprehensive evaluation approach prior to and throughout the treatment process can assist clinicians with selecting the most appropriate treatment based on patient need. Reconsidering traditional treatments based on existing evidence may help refine the treatment process for overhead athletes with shoulder pain.