Each year more than 2 million children between the ages of 8 and 15 participate in organized community baseball programs. The emphasis on pitching at younger ages and the advent of travel baseball programs has prompted a rapid increase in overuse injuries of the elbow and shoulder of the throwing arm.
Muscle/tendon overuse can be thought of as performing “too much” or returning “too soon” after throwing without adequate rest periods, as well as using faulty mechanics when pitching.
Baseball overuse injuries include inflammation of the tendon called tendinitis, ligament disruption, and potential injury to the growth plate of the younger athlete’s arm. These injuries are often ignored or under-treated, and the child is permitted to return to playing baseball with soreness in his/her arm.
In an effort to reduce the number of throwing-related overuse injuries, most leagues limit the number of games per week and the innings per game that a pitcher can throw. However, while limiting the number of pitches is a reasonable concept, strict adherence to pitch counts without consideration of other factors can be problematic, says Mark Schickendantz, MD, a Cleveland Clinic orthopaedist.
“What’s much more important than counting the number of innings or pitches is paying attention to any symptoms the young athlete might be experiencing. A well-trained coach can watch a throwing athlete play and should be able to pick up visual cues that might indicate that he/she is feeling pain,” he says.
“Visual cues can be particularly important if the younger athlete won’t admit to having discomfort. Any symptoms of pain in the throwing arm of a young athlete need to be taken seriously by a coach or parent. Failure to do so can lead to more serious problems.”
Baseball Pitching Injuries: Treatment and Prevention
Throwing biomechanics plays an important role in the treatment and prevention of throwing injuries. Baseball pitching requires a complex pattern of movements and coordination.
Neuromuscular coordination of the arm, rotational movements of the trunk and pelvis, and strength of the legs are all necessary components to successful pitching. Any interruption of this coordinated movement will have adverse effects and increased stresses placed on the joint and muscles.
The correct technique in pitching is vital to decreasing the potential for injury. Poor pitching mechanics is the number one cause of overuse injuries.
The Phases of Pitching
- Wind-up: initial balance point reached when the pitcher rocks back and is balanced on one leg.
- Early cocking: lead leg moves forward and the throwing arm moves up and back.
- Late cocking: lead leg reaches a flat-foot position and the shoulder is maximally externally rotated backward and elevated to 90 degrees of abduction.
- Acceleration: hips rotate forward followed by the trunk and then shoulders, generating approximately 50% of the velocity of the pitch.
- Deceleration: muscles begin to slow down the rapid arm movement following ball release.
- Follow-through: finishing in a ready position to respond to the batter.
Breaking down the technique
Common faults in pitching are best visualized by slow-motion digital video. This allows the step-by-step breakdown of each phase of pitching.
At Cleveland Clinic Sports Health and Orthopaedic Rehabilitation, we have a unique program called “Throw Right.” This program is specifically designed to address the special needs of the throwing athlete.
The program takes the injured athlete through a series of specific evaluations and treatments. It starts with a detailed examination, followed by a comprehensive rehabilitation. This includes an injury evaluation, rehabilitative exercises, total body conditioning, and digital video analysis of the athlete’s pitching mechanics.
This complete program has helped hundreds of baseball players of all ages and levels treat and prevent baseball injuries.
Curve balls: Did you know?
The curve ball can alter the arm mechanics enough to precipitate an overuse stress on the arm. It is recommended by the American Orthopaedic Society for Sports Medicine (AOSSM) that young baseball players do not throw curve balls until they are skeletally mature and have had proper pitch mechanics, usually around 14 years old.
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