My name is Gigi M. Knudtson, and for over a decade I’ve worked with athletes whose sports demand powerful, repeated rotation. In my experience, injuries in these athletes are rarely caused by one weak muscle. They usually come from a breakdown in how the whole body transfers force from the ground, through the trunk, and into the arms or club. This article explains how physical therapy addresses those demands in a practical, evidence-based way.
Rotational athletes generate and absorb force through twisting motions. This group includes baseball and softball players, golfers, tennis players, hockey players, lacrosse players, quarterbacks, and throwers.
A single swing or pitch can place:
A critical lesson I’ve learned is that symptoms often appear far from the true cause. Shoulder pain may start with limited hip rotation. Elbow pain may originate from poor trunk control.
Limited rotation in the hips or thoracic spine forces the shoulder and elbow to compensate. Therapy often starts with manual techniques and controlled mobility drills to normalize motion.
Strength must develop from the ground up: feet → hips → core → shoulder → arm. Skipping this order increases reinjury risk.
Many athletes can generate force but cannot slow it safely. Eccentric training for the posterior shoulder, trunk, and hips is essential.
Rotational speed depends on precise sequencing. Physical therapy integrates medicine ball work, cable rotations, and sport-specific drills to retrain this timing.
Focus: inflammation reduction, gentle range of motion, and maintaining fitness without stressing injured tissue.
Focus: restoring hip and thoracic rotation, scapular control, and core endurance.
Focus: resisted trunk rotation, single-leg stability, and shoulder endurance.
Focus: progressive throwing, swinging, or shooting programs with volume and intensity carefully controlled.
In my experience, rushing back to competition is the single biggest predictor of reinjury in rotational athletes. The tissue may feel better long before the movement system is ready to tolerate full speed rotation.By Gigi M. Knudtson, Founder
Timelines vary by injury severity:
These are averages. Individual biomechanics, age, and training history all influence recovery.
Even uninjured athletes often gain:
Yes. Mild pain often signals early overload. Addressing mechanics early can prevent structural injury.
Usually yes, but volume and intensity must be modified to avoid stressing healing tissues.
They benefit most from anti-rotation and controlled rotation exercises rather than traditional sit-ups alone.
No. Many soft-tissue and overuse injuries are diagnosed clinically and respond well to conservative treatment.
Baseball pitching and professional golf produce some of the highest rotational joint stresses, but injury risk depends more on volume and mechanics than sport alone.