Shoulder Pain After Exercise — Overhead Sports Injuries

Overhead sports and shoulder injuries

In sports such as swimming, badminton, tennis, volleyball, and baseball, in which the arm is repeatedly raised overhead, considerable load concentrates on the shoulder. In particular, the internal rotators contract explosively during the acceleration phase, and the external rotators (infraspinatus and teres minor) decelerate the arm with eccentric contraction during the deceleration phase, causing repetitive microtrauma. Korean medicine views this as a state in which strain (勞傷) damages the muscles and tendons (筋脈) and qi-blood is in disharmony (不和).

Overuse injuries vs. acute injuries

• Overuse: Includes gradually progressing tendinitis, bursitis, and labral wear. The cause is a sudden increase in training volume or insufficient recovery time. Pain is often mild and easy to ignore, but if left untreated it can progress to tearing.
• Acute injury: Occurs from falling onto an outstretched arm or from sudden external force during a movement. Includes acute rotator cuff tears, SLAP lesions (superior labral tears), and dislocation.
• SLAP lesion: The superior labrum tears at the attachment of the long head of the biceps tendon, causing a "click" or sense of giving way during throwing motions.

Korean medicine treatment and recovery

• Acupuncture and electroacupuncture: Needling points such as Jianyu (肩髃), Jianliao (肩髎), and Naohui (臑會) promotes blood flow around the shoulder and relieves muscle tension. The 2/100 Hz mixed wave of electroacupuncture maximizes endogenous analgesic substance release.
• Pharmacopuncture: Jaha-geo (紫河車) pharmacopuncture is administered at the musculotendinous junction to supply growth factors and promote tissue regeneration.
• Herbal medicine: A bone-knitting prescription combining Sokdan (續斷), Golswebo (骨碎補), and Jayeondong (自然銅) is used to strengthen muscles and bones.
• Ligament-strengthening therapy: Moxibustion is combined with acupuncture to enhance the elasticity and strength of periarticular ligaments, and prolotherapy pharmacopuncture (proliferative pharmacopuncture) is sometimes applied.

Management before and after exercise

• Warm-up: Perform internal/external rotation exercises with a resistance band and scapular activation exercises for at least 10 minutes.
• Cool-down: After exercise, perform thorough shoulder stretches (cross-body stretch, sleeper stretch).
• Training-load management: Not increasing weekly training volume by more than 10% over the previous week is the key principle for preventing overuse injuries.