Are shoulder injuries plaguing the game of Baseball & Softball?

March 20, 2010
by Justin

Part 1

As Major League Baseball heads into Spring Training and much of the U.S.’s colleges and high schools prepare for the upcoming spring season I wanted to dive into the notion that there has been an alarming rise in shoulder injuries amongst student athletes participating in Baseball and Softball over the years.

Fortunately for us, the Official Journal of the American Academy of Pediatrics, has released a report in their March issues which illustrates a good representation on what is truly happening in America. But before we dive into the report I wanted to cover some basic topics. Before we can diagnose the reality of shoulder injuries we first need to breakdown the motion of throwing, what causes the injury, who exactly is getting injured, how to prevent injuries, how to treat shoulder injuries, when is surgery an option, and the results of surgery.

In order to truly understand what exactly is going on when a student athlete injures their shoulder we need to break down the phases of throwing. Now the Hughston Health Alert defines the act of throwing is a 4 phase approach; (1) The Wind Up, (2) cocking, (3) acceleration, and (4) deceleration. They do mention that some experts include a fifth phase, follow-through. Now according to MEDCO Sports Medicine they have defined the motion of throwing as a 6 phase process. These phases are; (1) Windup, (2) Stride, (3) Arm Cocking, (4) Arm Acceleration, (5) Arm Deceleration, and (6) Follow-Through. I would have to conclude from both of these sources most injuries appear to occur from the cocking phase to the arm deceleration phase. This is due to the amount of torque applied to the arm during those phases. As seen in MEDCO’s findings a baseball is accelerated from 4 to 85 miles per hour in just under 0.15 seconds (from initial foot contact of the stride leg to ball release). Now imagine, for an entire game one pitcher could repeat this action anywhere from 80 – 100 times. The amount of strain on the arm is profound. This is why overuse is considered the most common reason for shoulder injuries amongst baseball student athletes.

So now that we have a better understanding of where in the motion of throwing most injuries occur we can explore who exactly is getting injured. Logically, you would assume pitchers would have to make up a vast majority of these injuries. And for the most part you would be correct. According to the report published in the March 2010 issue by the American Academy of Pediatrics amongst baseball players 38% of all positional players with shoulder injuries were pitchers. While only 15% of all the shoulder injuries were pitchers amongst softball players. If you’re thinking what I am thinking then your trying to figure out how can that be? Why would aren’t the percentage of shoulder injuries by position more consistent across both sports. Well let’s get the obvious out of the way. The pitching motion; baseball pitchers throw overhand and softball pitchers have the windmill motion.  But what else needs to be considered is the fact that softball teams usually carry less pitchers resulting in more pitching appearances. Girls physically mature sooner than boys. In addition, the two groups have muscular differences. Because boys overall have greater upper body strength then girls resulting in a higher amount of stress being delivered to their shoulders during an age when boys bodies are still developing. The result is a higher rate of injury to boy’s baseball pitchers. This also explains why girl’s softball shoulder injuries are more evenly distributed by position.

What I also found from the report incredibly interesting was when these student athletes were injuring their shoulders. In a large majority of these incidents student athletes were injury their shoulders in practice (baseball at 65% and softball at 55%). Why this is I can only speculate, as a former student athlete I personally approached games with more focus and intensity. This led me to stretch more and prepare better than I would for practice. Also I imagine, hate to use the old saying, the more at bats you have the more hits you have. Ironically enough in all sports, in this instance, you typically have more practices than you have more games. And the net result would be a higher probability of a student athlete injuring themselves.

So this leads me to my next point, how do you prevent such injuries from occurring. Well if you are anything like I was as a student athlete I didn’t I never took stretching seriously. And for most of my athletic career I didn’t. But I didn’t play baseball or softball. I also didn’t take a baseball and hurl it from 4 to 85 mph in 0.15 seconds. Because of the amount of stress and because most high school student athletes muscular skeleton is still developing I can only imagine the importance of stretching and proper conditioning.  AND this means before and after ever practice and game. Now I am not an M.D. nor do I have a background in medicine but history has shown me that the best conditioned student athletes are always the most successful.

Now I recommend you speak you with your institution’s athletic trainer for details on what stretches you can do before and after each practice and game. I also recommend, from my findings, to always ice your shoulder after each practice and game as well.  Be sure to be persistent throughout the season in order to prevent injury. I referenced some publications that I read prior to this post and I recommend you do so as well. In order to give yourself a competitive advantage over your opponent’s proper preparation is imperative. Think about all the best athletes out there and the time they put behind being the best. It is this very thing they do that separates them from the rest. They are not afraid to do the little things in order to be the best.

In my next post I will explore what steps to take if such an injury does occur, when surgery is necessary, and a detailed look at shoulder surgeries.

Until next time…………….

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