Sports Performance
go to IU Health.org Print This Page

Baseball/Softball

Baseball and softball are sports that demand intense physical performance from their players. Due to the mechanics of throwing and the number of throws, pitchers—especially young pitchers—may experience upper extremity pain, especially of the elbow and shoulder. Players may also experience proprioceptive issues due to overuse of the arm muscles and joints. Learn about the symptoms of common baseball injuries, why injuries occur and ways to prevent them.

Why injuries happen and how to prevent them

How to Prevent Common Baseball/Softball Injuries

Athletic injuries occur because the body is being overworked and/or maintenance practices such as warming up and resting, are not performed. The following precautions should be taken to prevent elbow/shoulder injuries and proprioceptive issues (kinesthetic sense that deals with sensations of body position, posture, balance and motion) in baseball/softball pitchers and other players.

  • Warm-up and strength training: Players should maintain a good exercise program, to improve strength in the upper and lower body and core muscles and prevent injury. Strength-training exercises should be incorporated into practices to improve muscle strength and increase flexibility. Every practice and game should begin with a proper warm-up routine. Each warm-up should begin with a light jog followed by a minimum of a 10-minute dynamic full body stretching routine to improve blood flow and tissue flexibility. This general warm-up should then be followed by light throwing in close proximity, and progress, in distance and force. Warming up the body before physical activity, and building muscle and strength, greatly reduces injury in all sports and athletics.
  • Pitch count: Due to the development of the growth plate (soft area of cartilage that determines the future length and shape of the mature bone) and elbow strain, pitchers should limit the number of pitches per game, based on their age. Exceeding the recommended pitch count can lead to injuries. Below are the Little League Baseball Pitch Count Guidelines, though the USA Baseball Medical and Safety Advisory Committee suggests 10 less pitches per age range:
    • 17-18 year olds: 105 pitches per day
    • 13-16 year olds: 95 pitches per day
    • 11-12 year olds: 85 pitches per day
    • 9-10 year olds: 75 pitches per day
    • 7-8 year olds: 50 pitches per day
  • Types of pitches/mechanics: Certain pitches, such as a curveball or slider, and the mechanics involved with performing these pitches can strain and possibly injure the elbows of younger athletes. The USA Baseball Medical and Safety Advisory Committee suggests the following starting ages for certain pitch types:
    • Fastball: Age 8
    • Change-up: Age 10
    • Curveball: 14
    • Knuckleball: 15
    • Slider: 16
    • Screwball: 17
  • Providing adequate periods of rest: At the very least, a pitcher should have a full 24 hours of rest between pitching games and should never start a game and then return to finish the game. According to the Little League Baseball Guidelines, pitchers league age 14 and under must adhere to the following rest requirements per pitch count per game:
    • 66 or more pitches: 4 calendar days of rest
    • 51-65 pitches three: 3 calendar days of rest
    • 36-50 pitches: 2 calendar days of rest
    • 21-35 pitches: 1 calendar day of rest
    • 1-20 pitches: No (0) calendar day of rest is required

Pitchers league age 15-18 must adhere to the following rest requirements:

  • 76 or more pitches: 4 calendar days of rest
  • 61-75 pitches: 3 calendar days of rest
  • 46-60 pitches: 2 calendar days of rest
  • 31-45 pitches: 1 calendar day of rest
  • 1-30 pitches: No (0) calendar day of rest is required

In addition, it is recommended that a pitcher have a full 3 months rest at the end of the baseball season. It is also advised that pitchers only play one sport per season to prevent injury.

  • Reducing the number of games per season: With weekly weekend tournaments, kids are currently playing more games than ever before. Over a period of 4 days (Thursday through Sunday), adolescents can play a minimum of 4-5 games and a maximum of 7-8 games if their team wins. Reducing the number of games per season helps reduce the number of injuries in players.

Elbow/Shoulder Pain and Proprioceptive Issues

Baseball/Softball – Elbow/Shoulder Pain and Proprioceptive Issues

Baseball and softball are sports that demand intense physical performance from their players. Due to the mechanics of throwing and the number of throws, pitchers — especially young pitchers — may experience upper extremity pain, especially of the elbow and shoulder.

Elbow/Shoulder Pain

In children and adolescents, most elbow and shoulder injuries are overuse injuries that occur because the growth plate has not fully developed. The growth plate is the soft area of cartilage that determines the future length and shape of the mature bone. When the growth of each bone is complete, the growth plate closes and is replaced by solid bone. Since growth plates are the weakest areas of the growing skeleton, they are vulnerable to injury, especially in young pitchers who are repeatedly throwing 50 or more pitches per game.

When a high stress load is applied to the elbow, the ligaments and/or tendons will pull on the growth plate and pull it away from the bone, causing a fracture or growth plate injury. This type of injury is typically referred to as “Little League Elbow.” Very similar to Little League Elbow is “Little League Shoulder,” which affects the front or side of the shoulder, resulting in damage to the affected tissue and possibly cartilage that has pulled away from the bone.

In more mature athletes, injury to the elbow and shoulder can still occur even when the growth plate is fully developed. Repetitive throwing can cause stress to the upper extremities, pulling the bone away from the elbow or shoulder and straining ligaments.

Symptoms

Coaches should take a pitcher out of the game to rest immediately if they notice any of the following symptoms:

  • Fatigue
  • Tired arm
  • Pitches becoming less accurate
  • Player rubbing or shaking arm

If symptoms persist for more than two days after a proper rest period, a physician should be consulted.

Proprioceptive Issues

Proprioception is the kinesthetic sense that deals with sensations of body position, posture, balance and motion. This natural human sense allows pitchers to throw a baseball without having to think about what their arms and legs are doing, for example.

Injuries to the elbow and shoulder may result in or be a result of proprioceptive issues in pitchers due to overusing the arm muscles and joints. An indicator that a pitcher’s proprioception may be affected is the loss of ball control while pitching or the noticeable loss of balance and body awareness on the mound. A simple way to prevent or rehabilitate the body when experiencing proprioceptive issues is to incorporate balance-related activities during strength training. Balancing exercises build core strength in the abdomen, back, sides and glutes, which are very important to keep strong in any athlete, including baseball/softball players. In order to reduce stress and injury to the arms, throwing with force should involve the full body.

Share