How to prevent throwing, pitching injuries

The number of throwing and pitching-related injuries in America is skyrocketing. It has been estimated that 25 percent of Major League Baseball players have already had elbow surgery and 60 percent of elbow reconstruction surgeries occur in patients between 16 to 19 years old.

While overuse is certainly one reason for the epidemic of shoulder and elbow injuries and pain, poor body mechanics may be equally to blame.

In an effort to reduce the number of athletes who experience throwing injuries, teaching those without a medical background or extensive surgical experience how to identify and correct poor biomechanics, is paramount. Our Penn Sports Medicine team has designed a program which brings together coaches, athletic trainers, therapy specialists and other physicians to discuss ways to identify, treat and prevent poor biomechanics and subsequent injuries.

Some of the most important things those who are working with young pitchers need to be on the lookout for include:

  • Low elbow. In the pitch delivery, a low elbow has been shown to increase the incidence of elbow ligament damage.
  • Weak hip and core abduction. When an athlete’s hip abductors – the muscle located outside of the hip and core – the central trunk musculature – are not as strong as they should be, the body puts excess demands on the elbow and shoulder to maintain the velocity needed to strike out a batter.
  • Scapula malposition. When an athlete’s scapula – the shoulder blade – is not properly aligned in a resting position, it can increase the demands on both elbow and shoulder ligaments.

Athletes can develop certain patterns of pitching which place the elbow and/or shoulder at increased risk of incurring tissue breakdown. Special high speed cameras can record a thrower’s mechanics and sophisticated software is used to determine exactly which movements may place the athlete at risk for injury. As a result, more mechanically efficient form can be recommended which will translate into decreased soft tissue strain and a more fluid delivery.

For athletes who are serious about their pitching prowess, a kinetic chain evaluation can be very beneficial for improving power and reducing injury. This consists of evaluating all of the anatomic links of the pitching motion from the ankle to the neck. Any dysfunctions are then addressed with a specific exercise regime.

At the end of the day, most throwing injuries can be avoided by adjusting the athlete’s biomechanics and building muscle strength and balance. And as you may have guessed, better mechanics usually translates to increased pitching velocity.

John D. Kelly IV, MD, a professor of Clinical Orthopedic Surgery in the Perelman School of Medicine at the University of Pennsylvania, Director of Shoulder Sports Medicine and Director the of Penn Throwing Clinic.


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