SPORTS MEDICINE
With the snow finally melting and the days growing longer, baseball season in New England is fast approaching. However, nothing can ruin a baseball season faster for a pitcher than elbow or shoulder pain. Unfortunately, elbow and shoulder injuries have become increasingly frequent among little league, middle school, and high school players. However, the risk of these injuries can be drastically reduced by following a few basic guidelines.
1.) A pitcher should be warmed up before he “warms up.”
Elevated body tissue temperature increases the flexibility/pliability of muscles, which in turn decreases the risk of an injury. Before a pitcher even picks up a ball, he should go through an active warm up. The warm up can include running/jogging, static/active stretching, and exercises using resistive bands to increase muscle activation. By getting these muscles to “wake up,” they will be more likely to be able perform correctly.
2.) Exercise off of the diamond.
Repeatedly throwing a baseball at a high velocity can be very stressful on both the elbow and shoulder joints. To minimize the wear and tear on the passive stabilizers, such as the labrum of the shoulder and ulnar collateral ligament (UCL) of the elbow, an athlete can work to strengthen their active stabilizers. This is especially important for pitchers as they hit puberty and begin throwing at higher speeds, which results in more torque on the arm. Strengthening of the rotator cuff and scapular stabilizers will allow the pitcher to transfer power from their lower body to the pitch, and will minimize undue pressure placed on the joints. A light to moderate strengthening program using resistive bands and light weights with a focus on the muscles of the shoulder girdle can minimize injury risk.
3.) Respect pitch limits
Pitch limits are put in place for a reason. Research has found that shoulder and elbow injuries of adolescent teens are directly correlated to the number of pitches thrown in an average week during the season. This is especially important to take into consideration with the expansion of AAU and American Legion seasons that overlap with little league/middle school/high school teams. Pitchers should not throw through their designated pitch count in one league and then continue to pitch in another league. While this may seem like common sense, it is a mistake that is made too often. Another hazard that must be navigated for young pitchers is the increase in pitching showcases, which are used as opportunities for athletes to be scouted for college/professional opportunities. Studies have shown an increase in injuries with pitchers that perform in showcases, which may be due to a combination of pitchers "overthrowing" and using excessive effort to throw hrad, which may compromise their mechanics, as well as pitches that are throwing past their pitch count limits. Additionally, pitchers of larger height and weight are also at a higher risk. This fact runs counter to the belief that larger teenagers will be able to handle a greater workload due to their size.
4.) Listen to your body
Youth pitchers should never be pitching through pain. While Curt Schilling may have pushed through a painful and bleeding ankle, it is important to remember that youth pitchers are not professionals and their game is not of quite the same importance as an MLB playoff game. Youth pitchers should not be utilizing NSAIDs to dull pain so that they are able to pitch. Whether or not the pitcher has a possible college/professional baseball future, their next game is not as important as preserving long term shoulder/elbow health.
Olsen SJ, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk Factors for Shoulder and Elbow Injuries in Adolescent Baseball Pitchers. American Journal of Sports Medicine. 2006;34(6):905-912.
