Baseball is a popular and growing sport in Australia. It not only represents a pathway to Olympic representation or a professional contract but combines a number of skills such as hitting, throwing, sprinting and catching. However, like all sports participants, baseball players have a risk of injury.
The upper limb is by far the most common site of breakdown. One recent study found that nearly two-thirds of baseball injuries were in the shoulder or elbow, due to the extreme speeds of throwing in the sport.
The risk of an elbow or shoulder injury was 2.6 times higher for a pitcher than a position player, confirming that repeatedly throwing a ball is a very challenging task for a shoulder! This high breakdown rate is not surprising when throwing is analysed biomechanically.
One recent study revealed some startling data: the shoulder rotates at approximately 12000 degrees per second during a fast baseball pitch! Furthermore, the speed of the hand was measured at nearly 1000 metres/second!
With such enormous forces, it is easy to see why baseball upper limb injuries are so common.
How do you prevent shoulder throwing injuries?
The secret is to maintain the balance around the joint. What exactly do we mean by ‘joint balance”?
Joint balance has two main components:
- The passive structures. These are the bits that hold your bones together such as ligaments and joint capsule, and
- The active components – the muscles that move the joint.
If the passive structures become either too tight or too lax then your throwing movement will become unbalanced. Your joints will either grind too tightly on internal structures when the throwing action forces it into certain positions or will move around too far during the vital acceleration phase, causing microscopic tears.
In either case, the grinding or tearing slowly accumulate until they become major injuries.
The same type of imbalance can occur with your muscles: if they become weak, they will be unable to stabilise your joint during the massive acceleration involved in throwing a ball. Similarly, if some muscles are overactive, they will pull your joint out of its normal alignment, causing accumulated damage.
How can physio help in treating throwing injuries?
First, we assess the balance of your shoulder, including all the passive structures and active components. We then direct your treatment toward correcting any anomalies. For example, you may have some tightness in your joint capsule that requires mobilisation, massage and stretching to loosen it, and some exercises for your rotator cuff muscles to strengthen them and increase their stability. You may need some throwing practise drills to make sure that you use your new shoulder in the most efficient way.
Throwing a fast baseball is an extreme ‘occupational hazard’ for your shoulder, but with the right biomechanics, you can perform it without undue risk of injury. Who knows, maybe an Olympic Gold Medal or an MLB contract might be yours one day … or maybe not. But in the meantime at least you’ll have a lot of fun.
Baseball Pitcher Guidelines
Elbow and shoulder injuries are common in adolescent baseball pitchers. These injuries are often the result of overuse, poor conditioning or suboptimal pitching technique.
Recommendations to avoid these injuries were outlined by the American Sports Medicine Institute in 2013:
- Monitor levels of fatigue, often associated with deteriorating technique as well as with decreased accuracy or pitching speed. If these signs are beginning to surface, allow a break from pitching/throwing.
- Furthermore, if a child reports pain in the elbow or shoulder, cease throwing activities and seek an expert’s opinion.
- Allow a period of 2-3 months with no competitive overhead throwing per year.
- Prevent pitching duties on multiple teams with seasons that overlap.
- A child should not have both pitching and catching duties. This places too great a load on the upper limb with the throwing requirements.
- Ensure spikes in pitch counts are offset with increased rest in the days following.
- Pitching more than 100 competitive innings in a calendar year is considered an injury risk.
- Emphasise the importance of correct technique prior to a velocity focus.
Leg Pain Causes
Common Youth Leg Injuries
Pelvis & Hip
- Osgood Schlatter's Disease
- Sinding Larsen Johannson Disease
- Patellofemoral Pain Syndrome
- Patella Dislocation
- Meniscus Tear
- Discoid Meniscus
- Juvenile Osteochondritis Dissecans
Heel & Ankle
Arm Pain Causes
Arm pain and injuries are widespread. Arm pain can occur as a result of either sudden, traumatic or repetitive overuse. The causes can be related to sports injuries, work injuries or simply everyday arm use.
Causes of Arm Pain by Region
Causes of Arm Pain by Structure
Neck-Related Arm Pain
Shoulder-Related Arm Pain
- AC Joint Injury
- Biceps Tendinopathy
- Broken Shoulder - Fractured Humerus
- Bursitis Shoulder
- Dislocated Shoulder
- Frozen Shoulder
- Rotator Cuff Calcific Tendinopathy
- Rotator Cuff Syndrome
- Rotator Cuff Tear
- Shoulder Arthritis
- Shoulder Impingement
- Shoulder Tendonitis
- Swimmer's Shoulder
Elbow-Related Arm Pain
Wrist-Related Arm Pain
Hand-Related Arm Pain
Muscle-Related Arm Pain
- DOMS - Delayed Onset Muscle Soreness
- Muscle Strain (Muscle Pain)
- RSI - Repetitive Strain Injury
- Overuse Injuries
Other Sources of Arm Pain
Common Causes of Arm Pain
- Your rotator cuff or frozen shoulder most commonly causes shoulder pain.
- Elbow pain is most commonly caused by tennis elbow or golfers elbow.
- Wrist & hand pain can be related to carpal tunnel, wrist arthritis or even a thumb tendon condition known as de Quervain's tenosynovitis.
Referred Arm Pain
As mentioned earlier, arm pain can be referred to from another source. Cervical radiculopathy is a common source of referred arm pain. Cervical radiculopathy will not respond to treatment where you feel the arm pain. However, it will respond positively to treatment at the source of the injury (e.g. your neck joints).
Professional assessment from a health practitioner skilled in diagnosing both spinal-origin and local-origin (muscle and joint) injuries (e.g. your physiotherapist) is recommended to ensure an accurate diagnosis and prompt treatment directed at the arm pain source.
Arm Pain has Diverse Causes.
The causes of your arm pain can be extensive and varied. Due to this diversity, your arm pain should be assessed by a suitably qualified health practitioner to attain an accurate diagnosis, treatment plan and implementation specific to your arm pain.
What Arm Pain is Associated with a Heart Attack?
Left-arm pain can be an early sign of a life-threatening cardiac issue. Based on this, a professional medical assessment that involves an accurate history, symptom analysis, physical examination and diagnostic tests to exclude a potential heart attack is important to exclude this potentially life-threatening source of arm pain.
For more information, please consult with your health practitioner, call an ambulance on 000, or visit a hospital emergency department to put your mind at ease.
Good News. Most Arm Pain is NOT Life-Threatening.
Luckily, life-threatening arm pain is far less likely than a local musculoskeletal injury. Arm pain caused by a localised arm muscle, tendon or joint injury should be assessed and confirmed by your health practitioner before commencing treatment.
Arm Pain Prognosis
The good news is that arm pain, and injury will normally respond very favourably to medical or physiotherapy intervention when early professional assessment and treatment is sought. Please do not delay in consulting your healthcare practitioner if you experience arm pain.
Common Arm Pain Treatments
With accurate assessment and early treatment, most arm injuries respond extremely quickly to physiotherapy or medical care, allowing you to resume pain-free and normal activities of daily living quickly.
Please ask your physiotherapist for their professional treatment advice.