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Guidelines to Prevent Throwing Injuries

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In this monthly series, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.


WRIST EXTENSION
Start with the arm supported on a table and your wrist facing toward the ground. Hold the weight off the edge of the table and bring the back of your hand toward the ceiling.


WRIST FLEXION
Start with the arm supported on a table and your wrist facing toward the ceiling. Hold the weight off the edge of the table and bring your palm toward the ceiling.

ASMI GUIDELINES TO HELP PROTECT PITCHERS FROM SHOULDER & ELBOW THROWING INJURIES:

Don’t throw too much:
Daily, weekly and annual overuse is the greatest risk to a pitcher’s arm health. Numerous studies have shown that pitchers who throw more pitches per game and those who do not adequately rest between appearances are at an elevated risk of injury. While medical research does not identify optimal pitch counts, pitch count programs have been shown to reduce the risk of shoulder and elbow injury in Little League Baseball by as much as 50% (Little League, 2011). The most important thing is to set limits for a pitcher and stick with them throughout the season.

Don’t pitch through arm fatigue:
Individuals are 36 times more likely to develop shoulder and elbow injuries when routinely pitching with arm fatigue.

Don’t pitch more than 100 innings per year:
If an athlete throws over 100 innings they are 3.5 times more likely to be injured than those who did not exceed 100 innings pitched.

Don’t throw more than 8 months per year:
Athletes who throw > 8 months per year are 5 times as likely to suffer an injury requiring surgery of the elbow or shoulder. Pitchers should refrain from throwing for at least 2-3 months per year and avoid competitive pitching for at least 4 months per year.

Don’t pitch on consecutive days:
Pitchers who pitch on consecutive days have more than 2.5 times greater risk of experiencing arm pain.

Don’t play catcher following pitching:
If the player catches following pitching they are 2.7 times more likely to suffer a major arm injury.

Don’t play on multiple teams at the same time:
There is increased risk of injury due to the difficulty in monitoring pitch limits and rest time. If the player is on multiple teams, make meticulous efforts to keep track of the amount of pitches thrown to allow adequate rest.

Don’t forget the shoulder in strength and conditioning programs:
Numerous studies have shown that deficits in upper extremity strength and mobility are strongly correlated to serious arm injuries. Shoulder and forearm strengthening exercises can build strength, endurance and motor control which can prevent injury.

Be cautious with throwing curve balls and sliders:
While existing research has not consistently shown a strong connection between the curveball and injuries, Yang et al., found that amateur pitchers who threw curveballs were 1.6 times more likely to experience arm pain while pitching and Lyman et al, found that youth pitchers who throw sliders are 86% more likely to experience elbow pain.

Be cautious with the radar gun:
Radar guns do not directly cause harm to a pitcher, however, the gun may cause the pitcher to over throw beyond their normal comfort level. This could possibly create arm strain.

Following these guidelines may keep the throwing athlete safe from the debilitating shoulder and elbow throwing injuries seen on a regular basis in physical therapy clinics.

Pitching Guidelines Chart

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. They specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Their staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

   Prevent Throwing Injuries

   prevent throwing injuries

throwing injuries PTandMe

prevent throwing injuries

Guidelines to Prevent Throwing Injuries

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In this monthly series about how to prevent throwing injuries, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.


PRONE ROW
Lay on your stomach with your arm hanging off the edge toward the ground. Squeeze your shoulder blade and bring your elbow toward the ceiling while keeping your forearm perpendicular to the ground.


PRONE ROW WITH EXTERNAL ROTATION
Lay on your stomach with your arm hanging off the edge toward the ground. Turn your wrist so your palm is toward your feet. Squeeze your shoulder blade and bring your elbow toward the ceiling while keeping your forearm perpendicular to the ground. Once your arm is parallel with the ground rotate the back of your hand toward the ceiling while keeping the elbow bent.


PRONE T (HORIZONTAL ABDUCTION)
Lay on your stomach with your arm hanging off the edge toward the ground. Lift your arm straight out to your side and squeeze your shoulder blade with the palm continuing to face toward the ground.


PRONE Y (SCAPTION)
Lay on your stomach with your arm hanging off the edge toward the ground. Lift your arm at a 45 degree angle over your head with your thumb facing toward the ceiling. Squeeze your shoulder blade down and toward your spine.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. They specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Their staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

   Prevent Throwing Injuries

   prevent throwing injuries

throwing injuries PTandMe

Guidelines to Prevent Throwing Injuries

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In this third intallment of our series to prevent throwing injuries, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.


INTERNAL ROTATION WITH SHOULDER AT 90 DEGREES OF ABDUCTION
Attach band high up on a doorway and face away from door. Hold band and move your arm out sideways away from your body until your arm is parallel with the ground. Bend your elbow to 90 degrees and point your fist toward the ceiling. Rotate from your shoulder bringing your hand forward while keeping your arm parallel to the floor and your elbow bent to 90 degrees.


EXTERNAL ROTATION WITH SHOULDER AT 90 DEGREES OF ABDUCTION
Attach band high on a doorway and face toward the door. Hold band and move your arm out sideways away from your body until your arm is parallel with the ground. Bend your elbow to 90 degrees and point your fist toward the door. Rotate from your shoulder bringing your hand away from the door while keeping your arm parallel to the floor and your elbow bent to 90 degrees.


SHOULDER INTERNAL ROTATION AT SIDE
Attach band to the doorway at chest height. Stand perpendicular to the doorway with the arm you are exercising closest to the door. Keep your arm at your side with a towel roll under the arm and bend the elbow to 90 degrees. Bring your hand toward your stomach while keeping the elbow bent to 90 degrees.


SHOULDER EXTERNAL ROTATION AT SIDE
Attach band to the doorway at chest height. Stand perpendicular to the doorway with the arm you are exercising furthest from the door. Keep your arm at your side with a towel roll under the arm and bend the elbow to 90 degrees. Bring your hand away from your stomach while keeping the elbow bent to 90 degrees.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. We specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Our staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

   Prevent Throwing Injuries

   prevent throwing injuries

throwing injuries PTandMe

avoid pitching injuries

Physical Therapist Tips on Avoiding Injury to Your Throwing Arm & What to Do in Case You Do

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Throwing a baseball or softball is one of the most demanding motions on the human body in sports. For each throw, the athlete generates high levels of energy in the arm and body to accelerate the baseball and softball to a high velocity. Just as it is important to understand proper biomechanics to improve performance, it is important to understand the stresses placed on the throwing shoulder and elbow by the throwing process.

Physical Therapist Tips on how to avoid pitching injuries

• Teach young athletes to be mindful of how their bodies feel. Pain is the first sign of a problem, and athletes of all ages need to pay close attention to any type of muscle twinge, tightening, or burning sensation.

• Coaches should carefully observe their pitchers’ techniques. Success on the field may be fleeting if the pitches ultimately are damaging a young player’s shoulder.

• Conditioning and strengthening exercises are most effective after mechanics are learned and put into action. If possible, begin a conditioning program at least a month before the season begins. A basic stretching regimen should be used before a player ever picks up a baseball.

• Players should start with short tosses and gradually work up to throwing the ball a greater distance. Increasing the velocity should be the final step.

• If the arm region is sore or tight, apply ice to the area for 10-15 minutes to help diminish the amount of blood that might otherwise leak into the muscle. When there is microscopic tearing of the muscle tissue, blood is leaking into the surrounding muscular tissue, causing pain and muscle spasms. Using ice will help reduce the pain, spasms, and inflammation associated with this condition.

• Before age 10, only fast ball and change-up should be permitted.

This information about how to avoid pitching injuries was written by University Physical Therapy, an outpatient physical therapy group with eight locations in New River Valley, Virginia. University PT is THE choice for outstanding sports rehabilitation, physical therapy and occupational therapy services. For more information click here.

causes of pitching arm injuries

The Most Common Causes of Pitching Arm Injuries

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The most common causes of pitching arm injuries to high school, college and professional pitchers are overload, overuse, lack of proper conditioning and improper throwing mechanics.

• Overload is the result of throwing too many pitches during one outing. Maximum pitch counts for various age groups, or for an individual pitcher’s normal strength and stamina, are effective in preventing overload.

• Overuse is the result of pitching too often and not having an adequate recovery time or a good arm maintenance program (stretching, running, strengthening, throwing) between pitching assignments. Coaches and trainers should be aware that each individual pitcher varies in arm strength, arm fatigue, arm tightness and soreness and require different recovery time needs. Make certain you provide your pitcher with a good active recovery program between pitching assignments.

• Proper conditioning involves the entire body; the legs and core muscles as well as the throwing arm. Coaches should supervise a proper stretching and warm-up procedure that is performed daily before throwing a ball.

• Pre-season is one of the most frequent times for arm injuries. Pitchers throw too much and too hard, too early. Also, they have not ingrained their normal rhythm and often are attempting to learn new techniques or new pitches. Another major factor of injury during pre-season is that pitchers are not working with a normal in-season rotation schedule and do not get enough recovery time from a lot of necessary drill work that involves throwing (pick-offs, defensive plays, etc.).

• Improper throwing mechanics. If a pitcher has improper throwing techniques, with the body or arm, there is a great chance of early fatigue of the throwing mechanism, and of course injury. The more power and force generated, the greater the chance of injury. In a competitive situation, most pitchers will not admit they are fatigued, experiencing minor pain or have a minor injury. It is important that you, a coach, trainer or physical therapist be able to recognize changes in the pitcher’s mechanics, performance, or mannerisms.

night pitcher

This information about common causes of pitching arm injuries was written by University Physical Therapy, an outpatient physical therapy group with eight locations in New River Valley, Virginia. University PT is THE choice for outstanding sports rehabilitation, physical therapy and occupational therapy services. For more information click here.