Let’s Play Ball!!

With the success of the Blue Jays making it to the playoffs last summer, baseball and softball clubs around the country are reporting a 20-25% increase in player registration this summer. With this increase in new players comes the need for education for parents, coaches and athletes on injury prevention and safety guidelines, in regards to throwing and pitching injuries commonly seen in baseball players. Statistics report that 25-40% of baseball players will experience shoulder pain during a single baseball season. What can you do to ensure that you don’t get stuck in the dugout resting an injury?

Why do throwing injuries occur?

  • Poor throwing biomechanics;
  • Overuse: Playing on multiple baseball teams/playing year-round/lack of rest between pitching;
  • Pitching with arm fatigue and soreness;
  • Lack of proper conditioning;
  • Lack of proper warm up

Common throwing Injuries:

A wide range of shoulder injuries can occur from throwing, but the most common include:

  1. Biceps/Rotator cuff muscle tendonopathy, tears and impingement:

Direct trauma can occur to the biceps or any of the rotator cuff muscles during the throwing action. However, the majority of throwing injuries result from overuse and repetitive strain on the soft tissue surrounding the shoulder. Regardless of whether the injury occurred suddenly or over time, there is usually a muscular imbalance in terms of strength and flexibility, which predisposes the shoulder to injury with repetitive throwing motions.

Athletes can prevent these injuries with a proper strengthening and flexibility program in order to restore adequate muscle balance. In addition, being taught proper throwing technique and ensuring adequate recovery between games and practices are key to preventing these injuries. If your league doesn’t have pitching guidelines, check out the guidelines outlined here.

  1. Labrum

The labrum helps improve stability and shock absorption in the shoulder. It can be injured as a result of direct trauma or due to repetitive strain, as seen with pitching and throwing. Research has shown that baseball players who have a decrease in the amount of shoulder internal rotation, as a result of tightness in the posterior shoulder capsule, are 25% more likely to develop a labral tear. A physiotherapist can help assess whether an athlete has an imbalance in the shoulder and provide exercises in order to help stretch what is tight and strengthen what is weak.

  1. Shoulder instability

Shoulder instability generally results from a history of repetitive microtrauma to the shoulder. As a result, the structures around the shoulder joint become loose and if the muscles are not providing enough stability, then the head of the humerus (shoulder joint) will shift out of its socket. If the head of the humerus does not stay centered during the throwing action than abnormal strain is put on structures that eventually lead to injury. A large focus of the rehabilitation is strengthening the shoulder and scapular stabilizers.

How can physiotherapy help if I am not currently injured?

The therapists at Sheddon Physiotherapy and Sports Medicine can help identify baseball players at risk for developing injuries, based on muscle imbalances, lack of flexibility and improper firing patterns. Studies have shown that muscular imbalances in the rotator cuff muscles are related to throwing injuries, and that a conditioning program isolating specific muscles can significantly reduce the amount of shoulder injuries experienced during the season. However, 50% of the force required for throwing comes from the rest of the body (not the arm). Therefore, isolating only shoulder muscles during a conditioning program is only half of the puzzle. A proper conditioning program also needs to address core strength, lower body strength and the integration of full body exercises to develop power. All athletes are given an individualized conditioning program in order to address their specific weaknesses to prevent injury.

Take home message:

  • Baseball players, coaches and parents need to be educated on proper throwing techniques and safe pitching guidelines
  • Identifying high-risk baseball players before the onset of injury is important for prevention.