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Strong Arm It: Tips for Pitchers

Baseball might be a noncontact sport, but that doesn’t mean it can’t bring injuries. In addition to such acute injuries as ankle sprains and concussions, baseball brings the risk of overuse injuries, which occur gradually from repetitive use.

“Studies suggest that these injuries may be on the rise in our young athletes,” says Lake Regional Orthopedics’ Scott Hofer, D.O., who is board certified in sports medicine and orthopedic surgery. “Pitchers, especially, are at risk for overuse injuries to the shoulder and elbow. Throwing too hard, too often and without adequate rest is almost guaranteed to bring on a serious shoulder or elbow injury.”

What Goes Wrong?

To understand why pitchers suffer shoulder and elbow injuries, it’s helpful to know how the shoulder and elbow work. The shoulder’s main joint — the glenohumeral joint — is a ball-and-socket joint. A group of muscles and tendons called the rotator cuff hold the upper arm bone (humerus) in the shoulder joint. The labrum, a ring of cartilage that surrounds the socket, increases stability, and the bursa, a fluid-filled sac between tendons and bones, provides lubrication.

Common shoulder injuries among pitchers include rotator cuff tendonitis, shoulder bursitis and tissue tears. Tendonitis happens when overworked tendons become inflamed. Often bursitis, or inflammation of the bursa, occurs with tendonitis. Rotator cuff tears and labral tears can occur suddenly but usually result from repetitive use.

At the elbow, three bones meet — the upper arm bone (humerus) and two forearm bones (radius and ulna) — in a combination hinge and pivot joint. The hinge works the arm’s bending and straightening, while the pivot makes the lower arm rotate and twist. Several muscles, nerves and tendons cross at this joint. The ulnar collateral ligament is the main stabilizer of the elbow during the overhand throwing motion.

The most common elbow problem for pitchers is an ulnar collateral ligament injury. This ligament must withstand extreme stress for the pitching motion, and when overused, it can become inflamed or even tear.

What are the Symptoms?

As with most overuse injuries, discomfort or pain in the shoulder or elbow is the first sign that something is wrong.

“Athletes should listen to their bodies and stop activities that hurt,” Dr. Hofer says. “Attempting to push through the pain can result in a severe injury. It’s better to miss one practice than the whole season.”

Can Athletes Prevent these Injuries?

Overuse injuries to the shoulder and elbow are preventable.

“It is extremely important to monitor technique, pitch counts and enforced rest cycles,” Dr. Hofer says. “Specific exercises can condition the muscles of the rotator cuff to help ensure optimal biomechanical function and help prevent or treat injury.”

If injury does occur, and rest does not bring relief, athletes should consult with a sports medicine physician for a customized treatment plan. Usually, rest and rehabilitation will heal the injury, but if not, surgical options are available.

“To avoid surgery, listen to your body and address concerns early,” Dr. Hofer says.