Common Pitching Injuries

Common Pitching Injuries

The majority of injuries are overuse injuries. These, commonly, can be tendinitis of the shoulder or elbow. Stress reactions of the bone may also occur. The most devastating injuries are ligament ruptures.

Preventing Pitching Injuries

 It is impossible to remove all of the risk inherent with throwing and pitching. The best ways to miminize the risk are to work on conditioning and proper form. Conditioning and proper throwing mechanics are vital to successful pitching, and to avoid injury. Another important step is to adhere to pitch count limits. Two major risk factors for throwing injury are are too many pitches and not enough rest.

Conditioning and Proper Mechanics

Most team coaches and pitching coaches have conditioning exercises that aim to improve strength, power, and endurance of the shoulder, arm, and trunk musculature. A thrower exercise program can be available upon request. Proper mechanics are also vital. A coach is very helpful to determine if any changes are recommended. Video throwing analysis is also sometimes very helpful.

If Pain Develops

In most cases, common sense must prevail. Pain is the body's way of warning against further, worse, injury. A brief period of rest, ice, possible over the counter anti-inflammatory medication is performed first. After several days, when symptoms have abated, a gradual return to throwing can occur. If symptoms persist for several weeks despite rest, it might be reasonable to see a physician.

Diagnostic Tests

The most important items to make the diagnosis are the history of the problem and the physical examination. Many diagnoses may be made based strictly on history and symptomatology. X-rays may be used to evaluate bony anatomy of the shoulder and elbow. Frequently, X-rays of the other shoulder or elbow may be obtained for comparison. Magnetic Resonance Imaging with or without injected dye can be used to help define possible abnormalities of tendons or ligaments.

Injections

Sometimes injections or surgery are required, but this is in the minority of cases. Most problems will improve with temporary restrictions and conditioning/physical therapy. An occasional, judicious injection of medication such as cortisone may be considered in some cases of refractory discomfort. Surgical intervention, most commonly and arthroscopically performed procedure, is rarely indicated.

Mark A. Pollard, MD

Sports Medicine Surgeon

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