Common Upper Body Injuries in Athletes
Introduction:
As physiotherapists, we know how much stress athletes place on their upper limbs, whether it's through throwing, tackling, lifting, or bracing during falls. Your upper extremities are vital for performance in countless sports and activities. Injuries to the upper extremities can be just as limiting as those in the lower body.
Whether you're a baseball pitcher, tennis player, pickleball player, CrossFit athlete, golfer, or beach volleyball player, understanding the most common upper extremity injuries can help you stay active, strong, and out of the clinic.
We will be discussing the most common upper extremity injuries in athletes, why they occur, how to recognize them early, and most importantly, how to manage and prevent them.
1. Rotator Cuff Tendinopathy
What it is:
A common overuse injury, rotator cuff tendinopathy affects the group of muscles and tendons stabilizing the shoulder. It often results from repetitive overhead activity or poor shoulder mechanics.
Common in:
Swimming, baseball, tennis, volleyball, CrossFit, weightlifting, golfing, cheerleading, kayaking, canoeing.
Symptoms:
Pain in the front or side of the shoulder, especially with lifting or overhead motion, weakness, and stiffness.
Risk Factors:
Repetitive overhead motion, poor posture, shoulder instability, muscle imbalances, inadequate shoulder warm-up, scapular dyskinesis.
2. Shoulder Instability / Dislocations
What it is:
Occurs when the head of the humerus moves out of the shoulder socket, either partially (subluxation) or fully (dislocation). Often a result of trauma or chronic instability from hypermobility.
Common in:
Contact sports (football, rugby), hockey, basketball, gymnastics, cheerleading.
Symptoms:
Pain, visible deformity, swelling, limited range of motion, a “dead arm” feeling, repeated slipping or popping of the shoulder.
Risk Factors:
Previous dislocation, weak rotator cuff or scapular stabilizers, joint laxity, poor proprioception, high-impact sports.
3. Tennis Elbow (Lateral Epicondylitis)
What it is:
Overuse injury of the forearm extensor tendons, causing pain around the outside of the elbow.
Common in:
Tennis, pickleball, squash, CrossFit, manual laborers, throwing sports, golf, cheerleading, gymnastics.
Symptoms:
Pain or burning on the outer elbow, weakness in grip strength, symptoms worsened with wrist extension or gripping.
Risk Factors:
Repetitive wrist extension and gripping, poor lifting mechanics, improper racquet technique, weak forearm muscles.
4. Golfer’s Elbow (Medial Epicondylitis)
What it is:
Similar to tennis elbow, but affects the tendons on the inside of the elbow. Caused by repetitive wrist flexion or pronation.
Common in:
Golf, baseball (especially pitchers), weightlifting, climbing, pickleball, cheerleading, gymnastics.
Symptoms:
Pain on the inner elbow, reduced grip strength, discomfort with wrist flexion or pronation.
Risk Factors:
Repetitive use of wrist flexors, poor technique, tight forearm muscles, inadequate recovery between training sessions.
5. Shoulder Impingement Syndrome
What it is:
Occurs when the rotator cuff tendons are compressed or irritated in the space beneath the acromion (the bony tip of the shoulder).
Common in:
Swimming, baseball, volleyball, tennis, pickleball, CrossFit, overhead lifting, gymnastics, cheerleading.
Symptoms:
Sharp pain during overhead movement, pain lying on the shoulder, and weakness or loss of range in lifting arms.
Risk Factors:
Poor posture, weak scapular stabilizers, poor thoracic mobility, repetitive overhead activity, structural variations in the acromion.
6. Wrist Sprains and TFCC Injuries
What it is:
Wrist sprains occur when ligaments in the wrist are overstretched or torn. TFCC (Triangular Fibrocartilage Complex) injuries affect the cartilage that stabilizes the wrist, particularly the ulnar side (pinky finger side).
Common in:
Gymnastics, skateboarding, snowboarding, hockey, wrestling, martial arts, golf, pickleball, cheerleading.
Symptoms:
Pain with twisting motions or weight bearing through the wrist, swelling, clicking or instability.
Risk Factors:
Falling on an outstretched hand, repetitive twisting or weight-bearing through the wrist, prior wrist injuries, weak grip and forearm muscles.
Physiotherapist’s Approach to Upper Extremity Injuries
As physiotherapists, our approach to upper limb injuries in athletes emphasizes full functional restoration. Athletes need strong, mobile, and stable shoulders, elbows, and wrists to perform and stay pain-free. Our strategy includes:
1. Comprehensive Assessment
We assess posture, range of motion, shoulder mechanics, scapular function, and functional movements like pressing or throwing. This helps identify the injury and the root cause.
2. Individualized Rehabilitation Plan
Tailored programs based on sport demands, specific deficits, and injury stage. These often include:
Targeted strengthening (especially rotator cuff, scapular, and forearm muscles)
Controlled mobility work
Proprioceptive and neuromuscular retraining
Sport-specific movement drills
3. Load Management & Return-to-Sport
We guide progressive loading, monitor training volumes, and build criteria-based return-to-play protocols.
4. Education & Empowerment
We help athletes understand their injury and how to train smarter. Education includes:
Proper warm-up techniques
Posture and ergonomic awareness
Technique fine tunging to reduce joint stress
Preventive exercises and recovery habits
5. Ongoing Support
We continue supporting athletes even after return-to-play, monitoring for early signs of compensation, and providing tune-ups as needed during intense training or competition.
Top 6 Injury Prevention Tips for Upper Limbs
Strengthen your rotator cuff and scapular stabilizers regularly.
Prioritize good posture and thoracic mobility.
Don’t skip your warm-up—especially for shoulders and elbows.
Focus on technique, not just strength or speed.
Rest and recover adequately between upper body sessions.
Work with a physio to address movement inefficiencies early.
Conclusion:
Upper extremity injuries can impact everything from your throwing speed to your ability to do a simple push-up. The good news? With the right guidance, you can prevent most of these issues or recover stronger than ever if they do occur.
As physiotherapists, our role isn’t just about rehab; it’s about helping athletes move better, play smarter, and train for longevity.
Call to Action:
Are you dealing with shoulder pain, elbow stiffness, or wrist injuries that are limiting your game? Don't wait for it to get worse. Contact Integrative Physiotherapy and Wellness today to book your assessment. Our team is here to help you recover fully and return stronger.
Written By: Stacey Stys, Registered Physiotherapist. MPT BAKin
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