Throwing injuries can put limitations on the ability of some athletes to continue playing their sport. Throwing and pitching require repetitive, explosive body movements to be executed with precision and athletes perform these motions thousands of times in a season.
Many athletes play on multiple teams throughout the year and due to a combination of early sports specialization and year-round participation, many athletes are at risk for overuse injuries.
The severity of these injuries varies from minor to severe enough to require surgery. Many times, injury can be prevented by following these guidelines.
Pitch Counts, Rest, & Recovery
- Adhere to guidelines for pitch counts and rest following pitching days. Various organizations such as the American Sports Medicine Institute have rest recommendations based on the age of the athlete.
- Be aware of fatigue point and don’t exceed this number of pitches, if possible. As fatigue approaches, mechanics can break down and may expose the athlete to injury.
- Throwers should refrain from throwing and any other repetitive overhead activities (swimming, javelin, etc.) for at least 2-3 consecutive months a year. This time off from overhead activities allows time for full recovery.
- Pitchers should avoid playing catcher; this combination leads to an excessive amount of throwing that may cause injury.
Recommendations for introducing new pitches to an athlete start with the fastball at age eight, the changeup can be added at around age ten, and breaking pitches such as the curve are not recommended until athletes are more skeletally mature, usually at age 14 or 15. Waiting on breaking pitches is important, as this allows time for the athlete’s growth plates to close which helps prevent injury.
Flexibility, Strength, & Conditioning
Throwers should be flexible enough to perform optimally and should perform regular stretching after activity. Hold stretches for 30 seconds perform them on the entire body, with a focus on hips, hamstrings, shoulders, and forearms.
Strength and conditioning programs should be completed under the guidance of a qualified professional. Off-season strength and conditioning programs should focus on total body strength, power, and flexibility with an emphasis on power generation and stability of the lower extremity and core, as well as scapular stability and rotator cuff strength.
Begin pre-season conditioning and return to a throwing program 10-12 weeks before the first practice to ensure the body is properly conditioned for the season.
Prior to throwing, athletes should perform a proper routine covering each of the following:
- 5-10 minutes of moderate cardio such as jogging.
- Full-body dynamic warmup (arm swings, trunk rotations, jumping jacks, Frankenstein’s, high knees, walking lunges, inchworms).
- Shoulder and forearm stretching (Genie stretch, crossover shoulder, triceps, forearm flexors/extensors).
- Band-resisted arm maintenance exercises (internal/external rotations, forward/reverse “throws,” scapular retraction/protractions, rows).
- Warmup throwing that begins with a light toss and gradually builds up to full-power, long tosses with a crow hop.
Proper throwing mechanics are extremely important. Improper throwing technique is one of the most common factors associated with injury and any athlete who pitches or is considering becoming a pitcher should undergo a biomechanical video analysis with a qualified professional and see a qualified pitching coach for instruction.
Know When to Seek Help
Most importantly, athletes should know when to seek the help of a healthcare professional. Although soreness is common, athletes should notify their athletic trainer or see their physician if they have any pain that persists beyond a few days or begins to affect ability to perform daily tasks or be physically active.
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