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Pain When Throwing?

Are elbow or shoulder injuries preventing you from playing baseball or softball at your maximum potential? In my experience, I have seen these injuries starting as young as little league all the way up to senior softball leagues. Approximately 58% of all baseball related injuries and 75% of the total time lost from competition are due to injuries of the upper extremity. Although the shoulder and elbow account for the majority of the overall injuries sustained by baseball players, these injuries often stem from dysfunctions occurring away from the injury site. Even though you may have an injury in your elbow or shoulder; the cause of the problem may be somewhere else in the body.

During the motion of throwing there are several major muscle groups that are involved in addition to your elbow and shoulder muscles. The scapular musculature (muscles around your shoulder blade), your core muscles, and hip muscles are all significantly involved in throwing a ball.

During the phase of throwing, when your arm is reaching back, your rhomboids, middle trapezius, lower trapezius, teres major and latissimus dorsi are all working to help pull your arm back to wind up before your arm goes forward to let go of the ball. If any of these muscles fire at the incorrect time or if there is any significant strength deficit, this could lead to an imbalance in muscles and force your rotator cuff muscles to compensate. I have witnessed compensations due to weak shoulder blade muscles which over time can result in an injury to your rotator cuff muscles.

Another major muscle group involved in throwing is your core musculature (rectus abdominis, internal and external oblique and transverse abdominis). During throwing, the core muscles contract to accelerate and decelerate the rotation of your upper body. If weakened, there will be lack of control and/or trunk rotation, which will again force your arm to use more energy to obtain the same velocity as if you had normal trunk control.

In my experience in the clinic, many throwing athletes demonstrate rotational hip weakness and range of motion limitations. One needs good hip control particularly on the planting leg to allow the body to coil and generate force. If the hip muscles fatigue, as can happen in baseball/softball when the pitch count increases, inevitably the shoulder and elbow must compensate. This compensation can lead to faulty mechanics and rotator cuff injury or epicondylitis of the elbow.

What does all of this mean? Aspiring athletes would benefit from a thorough screening. This is especially true for those in the early stages of Little League or high school who have experienced soreness or want to avoid future injuries. It is advisable to seek the services of a sports oriented physical therapist. In our clinic, we often screen athletes of all ages and coordinate our corrective action plans with orthopedists, pediatricians, or internists. In Connecticut, you can be screened by a physical therapist at your convenience with or without a physician referral. Our office takes a whole body approach to each and every injury including the issues discussed above.

Michael Demetriades DPT received his doctorate degree from Quinnipiac University. He has experience in working with all ages and injuries. Michael is a previous varsity hockey and baseball player who is well versed in the modern athlete. He can be contacted in Woodbridge at (203) 389-4593.

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