What does throwing a strike, swimming the butterfly stroke, and serving a tennis ball have in common? They all involve overhead movements that increase the risk of injuring your shoulders.

“One reason young athletes are at risk for shoulder injuries is that they still have open growth plates, which are the areas of growing tissue near the end of long bones,” says Dr. Paul Nitz an orthopedic surgeon specializing in sports medicine.

“Growth plates in the shoulder are a weak spot, and when the tissues get aggravated, they can cause pain and affect the muscles and ligaments around them.”

1. Are your shoulder muscles balanced?

Athletes can do a lot to protect their shoulders from injury. The first step is to make sure the muscles around your shoulders are balanced. Lifting weights can help, but you have to be smart about it.

“Many young athletes tend to focus on the ‘show me’ muscles, like the biceps and pectorals, and neglect the rotator cuff and scapular muscles, which stabilize the shoulder,” says Tyler Steele, an athletic trainer with Kettering Health. “This tends to lead to muscle weakness, which causes poor shoulder alignment and can result in inflammation and impingement in the rotator cuff, and even muscle tears. Athletes need to incorporate a shoulder maintenance program that includes strengthening and stretching two to three days a week.”

2. Are you overusing your shoulder?

The second important step in preventing shoulder injuries is to avoid overuse. This is a big issue for pitchers, especially those who play on multiple teams or work with a coach in the off-season.

In addition to adhering to pitch counts, pitchers—like all other athletes—must rest their shoulders. That means avoiding sports-specific overhead activities for at least two months after the season ends. “I always encourage young athletes to play multiple sports, instead of trying to specialize in one sport,” says Steele, who, as part of his role with Kettering Health, works with players on the Dayton Dragons minor league baseball team. “This can help them stay in good shape year-round but avoid overusing specific muscle groups.”

Dr. Nitz cautions that ignoring these guidelines can cause lifelong problems. “Athletes can develop scarring and tightening at the back of the shoulder. That causes a lot of stress on the shoulder and elbow,” he explains. “They might not notice any problems at first, but eventually, bad habits can catch up.”

3. How good are your mechanics?

The third way to prevent shoulder injuries is to use good mechanics when throwing, swimming, lifting, or playing tennis. Kettering Health uses Dartfish performance analysis software to help identify trends, mistakes, and weaknesses in an athlete’s form.

For pitchers, problems can include late arm action or poor follow-through. Athletic trainers can use the analysis to correct poor mechanics and prescribe treatment to improve performance and shoulder health.

If you experience shoulder pain, try resting your arm for a few days. If your symptoms don’t improve, see a sports medicine specialist for an evaluation. “The good news is that surgery is rarely needed for young athletes experiencing shoulder pain,” Dr. Nitz says.

“If rest doesn’t solve the problem, the doctor may recommend physical therapy or working with an athletic trainer—in most cases, that’s all it takes to get healthy again.”

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Learn more about Dartfish and other sports performance services at Kettering Health.