Every baseball season, orthopedic experts, fantasy baseball players and sports fans prepare for the inevitable “Breaking News Alert” about a shoulder injury suffered by a key pitcher or position player.

But shoulder injuries can happen to anyone who throws overhand, from the major leagues to the little leagues. And these injuries—if left untreated or improperly cared for—can be career-ending.

Let’s take a look at throwing shoulder injuries, specifically injuries to the labrum—and how we diagnose and successfully treat these issues.

Chances are, you’ve never really thought about how the shoulder works unless it’s caused you trouble. For stability, it relies on the labrum, a thick, dense tissue that surrounds the shoulder’s socket and helps keep the ball of the joint in place. Unfortunately, the labrum is vulnerable to injury from the repetitive throwing motion used by ballplayers.

A common shoulder injury involving the labrum is a superior labrum anterior and posterior (SLAP) tear. It occurs at the top of the labrum where the biceps tendon is attached, and it extends from the front to the back of the attachment point.

There are three main ways a SLAP tear can occur. One is through direct trauma, which can occur while bracing with the arm during a fall or from a shoulder dislocation.

A second cause is wear and tear. This is more common among people over the age of 40 who have experienced the “stretching out” of the labrum over a matter of years.

But when it comes to overhead throwing athletes—who make the same shoulder motion repeatedly, and with significant force—the most common cause of a SLAP tear is overuse.

Unlike many other injuries, a torn labrum may not hurt at rest, but it will when the shoulder is used to perform a task, especially one that requires overhead motion—such as throwing. The sensation can be one of catching, clicking and sharp pain as well as feelings of instability. Furthermore, it can lead to a reduced range of motion and loss of strength in the shoulder. A SLAP tear in a baseball player can lead to decreased throwing velocity, diminished accuracy or an inability to throw.

Read: How To Avoid Injuries in Youth Baseball

Older shoulder questionnaires often failed to pick up on the subtleties of athletes’ injuries because many of the symptoms of labral and rotator cuff injuries occur only when the athlete is throwing. For this reason, in 2010, my colleagues developed a new questionnaire that could assess, among other things, the ability to throw a baseball or a football and the likely outcomes from treatment.

The initial treatment for most labral injuries among throwing athletes is rest (no throwing) and physical therapy. When nonoperative treatment doesn’t succeed, surgery is available.

Preventive strategies also have been created to avoid injury in the first place. For example, exercises have been developed for throwing athletes to strengthen and stretch the muscles critical to throwing. When prevention and conservative measures are not enough, orthopedic surgeons at Cedars-Sinai Orthopaedics use the same cutting-edge techniques we rely on for the professional athletes we take care of to help all overhead athletes successfully return to the game they love.