Youth sports have become progressively more competitive. What was once a weekly game of baseball or softball has turned into multiple games in a week and even multiple games a day. With more practices, games, and off-season training, the potential for overuse injuries continues to grow.
What Injury Is Most Common in Baseball?
Elbow and shoulder injuries are the two most common overuse injuries in baseball players.
Shoulder and elbow injuries are often due to tears in the tendons, the ropey tissues that connect bones to muscles. They make the joints move when the muscles flex. Other injuries involve the bones or muscles themselves.
It’s a common misconception for baseball players to think that the more they throw, the stronger they will become. In reality, the opposite is true. Overuse increases the risk of injuries.
What Are Other Common Baseball Injuries?
Baseball injuries are often position-specific. For example, pitchers often have shoulder and elbow injuries, while position players have more hamstring injuries.
Other common injuries include:
- Ankle sprain. Playing the field, sliding into bases, and constantly being on the move makes ankle sprains a common injury for baseball players. A sprain occurs when there is stress or a tear to the ankle ligaments. Symptoms include pain, swelling, bruising, and tenderness to the touch.
- Tennis elbow. Characterized by inflammation of the tendons on the outside of the forearm, tennis elbow is caused by repetitive motions, such as throwing. Symptoms include burning pain on the outside of the elbow and tenderness to the touch.
- Rotator cuff injury. A common injury for pitchers, a torn rotator cuff (a network of four muscles) is the result of tendons wearing down over time. Symptoms include persistent pain, popping, or clicking when moving the shoulder, and limited range of motion.
What Are Common Pitching Injuries?
Even though pitching is a relatively stationary position, baseball pitching injuries are quite common. The repetitive throwing motion makes pitchers as prone to injuries as any other players on the field and perhaps even more so.
Although pitchers can develop injuries within the lower body, most problems develop in their throwing arm. The most common baseball pitching injuries tend to involve the rotator cuff.
Other injuries common to pitchers include:
Oblique strains
The oblique muscle runs the length of the torso and helps the body rotate, making it an essential muscle in a pitcher’s delivery. Oblique strains typically involve six to eight weeks of recovery.
Labral tears
This shoulder injury involves damage to the labrum — a ring of firm tissue around the shoulder socket that helps stabilize the joint and keep your arm bone in the socket. It is also known as a SLAP tear, which stands for “superior labrum, anterior to posterior” – in other words, the top part of the labrum, from the front to the back.
SLAP tears cause deep pain in the shoulder, especially when moving your arm over your head. Your shoulder may also pop, click, or catch.
Elbow tendonitis
Tendonitis can affect multiple areas of a pitcher’s arm, but it most commonly occurs in the elbow. Recovery time is based on severity, but athletes are typically able to return to healthy status within a few weeks.
Ulnar collateral ligament injury (Tommy John)
Injury of the ulnar collateral ligament (UCL), a band of collective tissue in the elbow, is the most common type of ligament injury among throwing athletes.
UCL injuries are a result of repetitive elbow use. If you damage your UCL, you may need ligament reconstruction. This procedure is known as Tommy John surgery because it was first performed on Dodgers pitcher Thomas Edward John Jr., in 1974.
During a Tommy John procedure, a surgeon attaches a tendon to serve as a reconstructed UCL. This tendon is either harvested from another part of the body or from a tissue donor. The purpose of the surgery is to stabilize the joint, reduce or eliminate discomfort, and restore function.
Recovery from Tommy John surgery is usually season-ending. It can take as long as two years for a pitcher to fully recover. Position players can return to the field faster after the procedure — usually in nine months to a year.
Rotator cuff tendonitis
The rotator cuff is a group of tough, flexible fibers (tendons) and muscles in the shoulder. Rotator cuff tendonitis occurs as a result of tissue in the rotator cuff being irritated from overuse or degeneration and may result in difficulty fully rotating the arm without pain.
How Can You Avoid Pitching Overuse Injuries?
To help avoid pitching overuse injuries:
- Ensure proper throwing technique. Throw with your whole body. Your legs and core have much more power and stamina than your arm, so take advantage of it.
- Focus on strength training and conditioning. Baseball-specific training, cross-training, and conditioning in the off-season and a maintenance program in-season will help you maintain your strength and stamina. Inadequate off-season training increases the rate of injuries.
- Limit the number of teams you play for each season. Try other sports that challenge different muscles to limit overuse.
- Listen to your body. Soreness is your body’s way of telling you it needs some time to recover.
- Warm up properly before throwing.
- Use ice immediately after throwing to reduce inflammation.
Today, there are guidelines regarding how many pitches youth and adolescent pitchers can throw depending on their age. Each league or organization should establish rules to ensure that players must follow the guidelines while playing in that league. There are also rest recommendations.
Parents, coaches, and pitchers are strongly encouraged to be mindful of these parameters to reduce injury risk — especially if the pitcher is playing on multiple teams at once.
If an overuse injury does occur, the best course of treatment is to immediately rest, apply ice, do gentle stretches, and take ibuprofen if needed. If the pain persists longer than 48 hours, seek medical attention.
Editor's Note: This article was originally published on , and was last reviewed on .