Pain after throwing a football is a common experience, but it is not a normal part of the game. This discomfort signals that the mechanical stresses of the high-velocity overhead motion are exceeding the capacity of your muscles, tendons, or ligaments. Throwing demands a precise, violent transfer of energy from the legs and core up to the hand. When this kinetic chain breaks down or is repeated too often, the resulting pain points to an underlying injury or chronic stress in the complex structures of the shoulder and elbow.
The Biomechanics of Throwing and Stress Points
The act of throwing is a rapid sequence of events designed to maximize velocity, typically broken into five phases: wind-up, cocking, acceleration, deceleration, and follow-through. Although the motion takes only about two seconds, the forces generated are immense, particularly in the later stages. The cocking phase, especially the late cocking sub-phase, involves maximum external rotation, placing significant torque on the joint. This extreme rotation loads the anterior structures of the shoulder and the medial side of the elbow, preparing the arm for release.
The moment of trauma often occurs during the acceleration phase and the following deceleration phase, which is the most harmful part of the throw. During acceleration, the arm whips forward, generating peak speeds and placing extreme valgus force—a sideways stress—on the elbow. After ball release, the muscles contract eccentrically to abruptly slow the arm down, creating the highest overall torque experienced in the motion. This massive braking force places maximum stress on the posterior shoulder structures and the flexor muscles of the forearm.
Common Causes of Shoulder Pain
Shoulder pain is a frequent complaint because the glenohumeral joint is the most mobile joint in the body, making it inherently less stable. A common issue is Rotator Cuff Tendinopathy, which is the irritation or inflammation of the tendons that stabilize the shoulder. This overuse condition is often felt as a deep ache, particularly during the late cocking and acceleration phases when the cuff stabilizes the head of the humerus.
Another source of pain is Glenohumeral Internal Rotation Deficit (GIRD), a condition where the range of motion for internal rotation is reduced. Repetitive throwing trauma can cause the posterior capsule of the shoulder to thicken and tighten, shifting the humeral head slightly forward during the motion. This tightness can contribute to Impingement Syndrome, where the rotator cuff tendons become compressed between the head of the humerus and the acromion bone.
A more severe structural injury is a Superior Labrum Anterior-to-Posterior (SLAP) tear, involving the ring of cartilage surrounding the shoulder socket. These tears often occur due to the “peel-back” mechanism during the late cocking phase, where the biceps tendon pulls on the superior labrum with significant force. A SLAP tear presents as a deep, sharp pain, sometimes accompanied by a catching or clicking sensation within the joint. Distinguishing between these chronic overuse conditions from acute structural damage requires medical evaluation.
Elbow and Forearm Injuries
While the shoulder manages rotational forces, the elbow must withstand extreme valgus stress, the force that tries to bend the joint sideways. The Ulnar Collateral Ligament (UCL), a band of tissue on the inner side of the elbow, is the primary structure resisting this force during the acceleration phase. Repeated high-velocity throws can stretch or tear the UCL, resulting in instability and pain on the inside of the elbow, often called a “Tommy John injury.”
The powerful muscles on the front of the forearm, known as the flexor-pronator mass, become strained from the repetitive demands of stabilizing the elbow and controlling the wrist. Overuse can lead to Flexor/Pronator Tendinosis, felt as tenderness and pain on the inner bump of the elbow, similar to Golfer’s elbow symptoms. This pain is often exacerbated by gripping or wrist movements.
The ulnar nerve, often called the “funny bone,” travels through a groove on the inside of the elbow and can become irritated or compressed by the throwing motion. This condition, known as Ulnar Neuritis or cubital tunnel syndrome, causes symptoms that radiate down the forearm and into the hand, resulting in numbness or tingling in the ring and little fingers. Any persistent nerve symptom warrants prompt attention, as it indicates a mechanical issue.
Immediate Steps and When to Seek Professional Help
If you experience pain after throwing, the immediate response should follow the R.I.C.E. principles: Rest, Ice, Compression, and Elevation. Discontinue throwing immediately, and apply ice to the painful area for 15 to 20 minutes several times a day to reduce inflammation. Avoid attempting to “throw through” the pain, as this can transform a minor irritation into a more serious chronic injury.
Seek professional medical evaluation if the pain is severe, persists for more than a few days despite rest, or if you notice specific red flags. Consult a physician immediately if the pain was accompanied by a sudden “pop” or tearing sensation, suggesting an acute ligament or tendon rupture. Other concerning signs include visible deformity of the joint, an inability to fully move the shoulder or elbow, or persistent numbness and weakness in the hand or fingers.