Arm overuse a concern for pitchers of all ages

April 30th, 2018

When it comes to baseball and softball, pitchers often carry a team on their shoulders. That's not to say they're more important than any other player on the team. Rather, they literally put their shoulders (and elbows) into every throw, delivering upward of 80 pitches per game -- even at the Little League level.
Such intense pressure on the arm puts throwing athletes at risk of overuse injuries, which occur in response to repetitive strain. Still, arm injuries aren't inevitable, said Seth Blee, PT, a team physical therapist for the Washington Nationals and regional clinical director at the Inova Physical Therapy Center, the official physical therapy partner of the Washington Nationals.
Smart choices can protect players of all ages from shoulder injuries -- and increase the odds that they'll be able to stay in the game for years to come.
Focusing on form
Injury prevention starts with good mechanics, said Blee. To protect your shoulder, you have to think beyond your arm. A great pitch actually starts in your feet. As your leg pushes into the ground, energy is transferred through the hips and the torso and out to the ball at the end of your fingertips.
"The more efficiently your system works, the better the energy is transferred through your body to the ball. Any weak link in that chain loses energy, so pitchers often make up for that loss of energy in the arm," Blee said. "Overuse injuries of the shoulder or elbow can often trace back to something inefficient somewhere else in the system."
Of course, if a player has pain in the shoulder, he or she should have it checked out by a medical professional. "But don't stop there," he said. Especially if the pain persists, players should take a closer look at the mechanics of their pitch.
In youth leagues, coaches are often parents or other volunteers who might not be trained in proper throwing mechanics. It can pay to seek out throwing clinics or private pitching lessons, Blee said. "Find someone who knows mechanics, so you don't develop bad habits."
Rest and recover
Taking breaks is also critical for keeping your throwing arm healthy. In youth leagues, there are pitch count guidelines that spell out how many pitches young players should be throwing daily, and how many days of rest they should be taking after a practice or a game.
While most teams abide by the limits, Blee said, problems can arise when kids play on multiple teams. "They can throw 85 pitches [for one team] on Saturday, then show up to a travel team on Sunday and be asked to throw 50 pitches. And their coaches might not know," he said. "It's on players, parents and coaches to communicate better."
Just as the pros have an offseason, so should younger players. "It's recommended that they take about four months off from throwing each year to allow the arm to rest," Blee said. "Volume of throwing is the number one risk factor for injury."
It can be tough to convince a committed athlete to take that time off, especially when they're playing on multiple teams. Yet resting doesn't have to mean couch surfing. Players can take time off from throwing and work on other skills and abilities, such as balance, running speed and reaction time. Playing other sports can help develop useful skills, prevent overuse injuries and also keep young players from getting burned out.
"The vast majority of pro athletes played multiple sports through high school. They're not just great baseball players; they're great athletes," Blee said.
Expert advice
Whether you're a weekend softball star or the parent of a serious Little Leaguer, the best way to prevent injury is to take precautions. Inova Sports Medicine's physical therapists offer baseball screenings to assess players and recommend appropriate exercise programs. For more information or to schedule an appointment, contact Seth Blee at [email protected] or call (703) 970-6423.