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Throwing Injury Surgery

at Cedars-Sinai Marina del Rey Hospital

If you regularly play sports that require you to throw, such as baseball, and especially if you play sports for a living, you are at high risk of suffering a throwing injury. Depending on how serious your injury is, you may need surgery to restore the normal function of your arm. The orthopaedic surgeons at Cedars-Sinai Marina del Rey Hospital have the necessary competence and experience to provide you with the treatment you need for your throwing injury in a warm and comfortable environment.

Throwing injury is a term that encompasses injuries that occur when a person repeatedly throws objects such as baseballs while playing sports. The injury may affect the shoulder or the elbow. If the damage is severe, surgery is highly recommended to restore the function of the arm. As the name suggests, throwing athletes are significantly more likely to suffer a throwing injury, as they have to perform this action very often. Throwing injuries in the shoulder usually affect baseball pitchers, but they can actually occur in any athlete who partakes in sports that require frequent overhead motions.

Similarly, if non-invasive treatments fail to work for a throwing injury, the patient will most likely have to undergo surgery. If you play sports, your surgeon, as well as your physical therapist, will give you the advice you need with regard to when you can resume your activity and whether you will have certain restrictions when it comes to physical activity or strenuous effort. Sports such as baseball and softball that require frequent, overhand throwing motions place considerable stress on the shoulder.

This stress can lead to a wide range of injuries that affect the tendons, muscles, and tissues in your shoulder. They include:

  • biceps tendonitis
  • tendon tear
  • rotator cuff tendonitis
  • rotator cuff tears
  • and internal impingement

If non-surgical treatment such as anti-inflammatory medication, ice application, or physical therapy do not provide you with the alleviation you need, it is high time you considered throwing injury surgery.

Naturally, the surgery you will have to undergo for a throwing injury will depend on the area of your arm that is damaged. Some of the most popular, as well as effective, surgical procedures for throwing injuries are the following:

  • biceps tendon rupture surgery: it is performed with the purpose of repairing a tear in the biceps tendon at the shoulder or at the elbow, and it entails the surgeon making a small incision over the upper arm through which the tendon is pulled out and subsequently reattached to the radius bone
  • elbow arthroscopy: the aim of this surgery is to repair problems that occurred in the elbow joint, and during the procedure, the surgeon makes several tiny incisions around the affected region through which they insert the medical instruments to achieve the repair
  • medial ulnar collateral ligament reconstruction: it is also known as Tommy John surgery, and this procedure is performed to repair a torn ulnar collateral ligament, which is the one that holds the upper and the lower arm bones together in the elbow, by using a healthy tendon from elsewhere in the body of the patient
  • shoulder arthroscopy: as a minimally invasive surgery that allows the surgeon to look inside the shoulder so as to see whether there is any kind of damage, shoulder arthroscopy aims at repairing any abnormalities found by the surgeon in the shoulder of the patient
  • superior labrum anterior to posterior lesion tear surgery: this is a surgery that is meant to repair any type of injury to the labrum, which is the cuff of cartilage around the shoulder joint that helps sustain the stability of the shoulder

Certain throwing injury surgeries can be performed by using a minimally invasive technique, while others cannot due to the extensive damage of the arm. As a patient, it is important to keep in mind that only your orthopaedic surgeon can recommend the most suitable and the safest procedure to treat your throwing injury.

The main benefits of throwing injury surgery, regardless of the type, are pain relief and the restoration of the normal function of the part of your arm that was damaged, such as your elbow or your shoulder. However, regaining full strength in your arm could take a while, as most people who undergo throwing injury surgery will also have to do physical therapy and rehabilitation for 6 months to one year after the procedure. Other noteworthy benefits of these surgeries include the following:

  • regaining throwing velocity
  • restoration of motion and strength in your arm
  • experiencing no more pain during and after throwing
  • the disappearance of numbness and tingling in your arm
  • the alleviation of pain on the inside of your elbow


After undergoing throwing injury surgery, you will have to wear a sling for several days to a week in order to protect your arm while the site of the surgery is healing. The sling will prevent your arm from moving, which is essential for recovery during the first week. When you are allowed to take the sling off, you will most likely begin doing physical therapy to ensure you will regain complete range of motion and strength in your arm. One of the aspects physical therapy will focus on in the case of throwing injuries is flexibility, and you will have to do gentle stretches during the program.

Within 4 to 6 weeks after your surgery, your physical therapist will expand the program so as to include more complex and strenuous exercise. These will help strengthen your shoulder muscles and the rotator cuff, which is the group of muscles and tendons that can be found around your shoulder joint. If your ultimate goal is returning to throwing as part of the sport you play, your physical therapist will have you perform a special exercise in this respect. Complete pain relief usually occurs within 2 to 4 months following surgery. Nevertheless, if you play sports, you may have to wait one year before resuming your normal activity.


Although the surgical procedures that are performed to treat a throwing injury are generally safe and not very complex, they still involve risks, just like any other invasive procedure. Some of these risks are the following:

  • numbness or weakness in your arm
  • stretching or rupture of the new tendon
  • temporary or permanent neuropathy
  • the need for another surgery to treat ulnar neuropathy
  • inability to completely extend the elbow
  • infection at the wound site

To prevent the occurrence of these postoperative risks, there will be a medical team supervising you while the surgery is taking place, and you will also benefit from close supervision following the procedure. This will minimize the risk of experiencing serious health complications.


Very few people who undergo throwing injury surgery experience major complications after the procedure, as these surgeries are safe and effective. Nonetheless, as it is the case of any surgery, these procedures may lead to the occurrence of the following complications in rare instances:

  • damage to the nerves or blood vessels
  • stiffness in your shoulder
  • instability in your arm
  • pain in your arm
  • failure to heal
  • deep infection around the surgical site