10 Common Mistakes that Cause Pitching Injury

There are 10 common mistakes that most of the pitchers in this game make at some point in their pitching careers which can or will lead to injury and can be avoided with some basic knowledge of science driven pitching mechanics.
Let's face it, pain and injury is a serious problem for pitchers at all levels of the game. Baseball is a game that involves periods of apparent inactivity punctuated by the highest recorded angular velocities of human movement. (6) Due to this hostile environment the threat of injury is that snake in the woods that is hunting you down and you are just hoping you do not run into it. Every pitcher is just praying that this pain or discomfort in the arm is not going to be a career changer. I really don't want to scare you here because I am here to help and the best way for me to start helping you is by acknowledging the risks involved.

Working towards the goal of pitching at a high level is risky when it comes to arm health. You are going to have to put some serious wear and tear on the joints if you want to have a great career. The better chance you have of surviving this is knowing what is at stake and how to prevent injury along the way.

Pitching Injury Statistics

Here is a list of factors to help you develop a good understanding of what we are dealing with as pitchers in this game. These statistics are taken from research performed by organizations like the American Sports Medicine Institute (ASMI).

1. 1 out of 20 pitchers at the average age of 17 years experienced a serious injury in their pitching career. This is from a study of 481 pitchers from the ages of 9-14 who's pitching career was documented for 10 years of play. 2 of these pitchers had surgery before they turned 13 years old. (7)
2. Pitchers who pitched more than 100 innings in at least 1 year were 3.5 times more likely to be injured during this same study. (7)
3. Two previous studies of American youth league pitchers found that elbow pain was present in 18% of pitchers aged 11 and 12 years. (7)
4. 58% of high school pitchers in one study experience elbow pain. (8)
5. One study has examined the prevalence of shoulder pain among young pitchers, and they found that 26.5% had had shoulder pain by the end of a youth league season. (9)
6. 38% of high school pitchers experience shoulder pain. (8)
7. The risk of shoulder pain is 2.5 times greater for pitchers who throw more than 75 pitches per game. (4)
8. The risk of elbow pain is 3.5 times greater for pitchers throwing more than 600 pitches per season. (4)
9. Rest should be incorporated in all programs; athletes who participated with arm fatigue were almost 6 times more likely to suffer from elbow pain and 4 times more likely to have shoulder pain that those who did not have arm fatigue. (10)
10. Roughly half of youth pitchers report elbow or shoulder pain at least one time during the season. (10)
11. For each additional 25 pitches thrown after reaching the 50 pitch count, the percentage of pitchers experiencing pain increases. (4)

The Pitching Destructor

If you are going to avoid these risk factors or survive this climb in your pitching career then your biggest hurdle is going to be the conventional pitching coach who has not taken the time to learn this information and more than likely because he could care less about this critical information. Because of this problem there are too many pitching instructors out there who are completely unqualified to coach a pitcher how to increase pitching velocity while preventing injury. They are what I like to call, "Pitching Destructors." They believe just because they played this game at some high level that this means they are qualified to coach it. Some of the worst instructors I have ever met, are some of the best athletes I have ever seen. Just because you can play the game doesn't mean you can coach it and just because you can coach the game doesn't mean you can play it. It goes both ways!
That being said, I hope if you are a player who has been taught by an unqualified pitching destructor or you are a pitching destructor yourself, then I hope you get the point and are ready to learn. I am not just going to teach you what I learned when I played this game, then I would be the pitching destructor, what I am going to give you is what I have spent the last 10 years behind this computer screen doing for about 8-10 hours a day, which is collecting loads of advanced knowledge of the science of high velocity pitching to help the young pitchers of today, on top of my playing and coaching experience. So don't kill the messenger, I didn't make this stuff up!

The 10 Most Common Mistakes that Will lead to Pitching Injury

This is a list of common mistakes that pitchers make which lead to injury. This is a list of common mistakes from all levels of the game. These mistakes are more common in the lower levels but this doesn't exempt any level of pitching from learning these critical pitching injury factors when trying to avoid injury.

1. Poor Leg and Core Strength - It is not true what you have been told. Baseball players don't get a free pass from the weight room. They are no different than any other athlete. If you don't genetically have good leg and core strength then you better develop it because studies show the link to poor leg strength and poor arm health.
   

   Results indicated that trail leg musculature elicited moderate to high activity levels during phases 2 and 3 (38–172% of MVIC). Muscle activity levels of the stride leg were moderate to high during phases 2–4 (23– 170% of MVIC). These data indicate a high demand for lower extremity strength and endurance.(2) Incorporating trunk training exercises that demonstrate sufficient trunk ranges of motion and velocities into a strength and conditioning program may help to increase ball velocity and/or decrease the risk injury. (3)

2. Over Throwing in Practice or Pre-Game - Most pitching coaches do not count pre-game or practice throws or pitches. Overuse is a major problem today with young pitchers playing year round. Studies have linked high pitch counts to arm injury and that includes all pitches.
   

   Namely, breaking pitches and high pitch counts were demonstrated to produce a significantly increased risk of elbow and shoulder pain among youth baseball pitchers from the ages of 9 to 14. (4)

   You need to use a program like the 3X Pitching Velocity Program which allows you to complete a good amount of reps using the proprietary throwing program without overusing the rotator cuff and elbow.

3. Pitcher Catcher Combo - Those pitcher's who would switch with the catcher following pitching were also more likely to be injured. This was because catchers are the position that endures the 2nd most throws in a game following the pitcher.
   

   There was a trend for pitchers who also played catcher to have an increased risk of throwing injury, but this trend was not statistically significant (P = .09). (7)

   *Pitching Mechanics

4. Poor Leg and Trunk Power - Lift up, down and out. Slow and controlled stride. Land soft on the front foot. This is a receipt for disaster. Studies link power stride speed and power to arm injury.
   

   The complex interaction of the lower extremities and core musculature in the kinetic chain reduces the kinetic contributions of the shoulder joint. Thus, the pitching motion should not be thought of as an upper extremity action, rather an integrated motion of the entire body that culminates with rapid motion of the upper extremity. Improvement of velocity can result from optimization of the kinetic chain, which likely also reduces the kinetic contributions of the shoulder to produce top velocity. Reduced kinetic stresses on the shoulder may prevent injury, leading to greater durability and health of the throwing shoulder. (5)

5. Open Stride Foot and Open Stride Foot Placement - Studies show landing just slightly across your drive line (Draw a line from your drive leg toe to the target) in a closed foot position will reduce stress on the shoulder.
   

   The maximum shoulder anterior force found during the arm cocking phase was found to be on average 350N, so if a pitcher were to place their lead leg 10cm toward the open side and 10° further open, then this would be associated with a 51N (or approximately 15%) increase in shoulder anterior force during the arm cocking phase. (6)

6. Poor Elbow Flexion - Studies show landing with a extended arm or a high cocked arm will put more stress on the shoulder.
   

   This work infers that those pitchers who have a more flexed elbow at the point of stride foot contact and a more flexed elbow at the point of ball release will have a reduction in the amount of peak longitudinal distraction force at their shoulders during the throwing motion. (6)

7. No Trunk Tilt and Low Arm Angle - Throwing sidearm may feel more "Natural" but it doesn't support pitching velocity and it can lead to more arm problems.
   

   In the simulated overhand and three-quarter arm conditions elbow varus torque was minimized with arm abduction of 90°, while overall varus torque was minimized at 100° of arm abduction with a contralateral trunk tilt of 10°. During ipsilateral trunk tilt conditions the optimum angle of arm abduction in terms of minimizing elbow varus torque was generally 100° or greater. (6)

8. Excessive Horizontal Adduction - Casting the arm or throwing with poor hip to shoulder separation puts the elbow out in front of the face during external rotation which puts a significant amount of stress on the elbow. This along with increased speeds of horizontal abduction to adduction is the number one cause of UCL tears.
   

   Fleisig (1994) found the maximum horizontal adduction range displayed to be proportional to the maximum elbow medial force during arm cocking phase at a rate of 2.4 N/°. Since the total amount of elbow medial force during the arm cocking phase was 270N in Fleisig’s study, an increase of 7° horizontal adduction would be associated with an 18N or 7% increase in this force. (6)

9. Late Internal Rotation Pronation - Casting the arm into more horizontal adduction during external rotation will also lead to late internal rotation and pronation of the throwing arm. This leaves the UCL vulnerable and applies more stress to the rotator cuff muscles.
   

   Professional pitchers predominantly use the subscapularis and latissimus dorsi for acceleration, whereas amateurs use more of the rotator cuff muscles with an active pectoralis minor and a relatively quiescent latissimus dorsi. (1)

10. Reduce External and Internal Rotation Range of Motion - Any pitcher who throws with good external to internal rotation has more external rotation in the throwing arm than the non-throwing arm. This gain in external rotation creates a loss in internal rotation but if the loss exceeds the gains of external rotation then the cuff is losing integrity and injury will occur.
    

    It has been suggested that those in whom the lost range of internal rotation exceeds their gained external rotation are at a greater risk of subsequent shoulder labral injury (Burkhart et al., 2003c) and that remediation (Burkhart et al., 2003b) and prevention (Burkhart et al., 2003b) of this lost range of motion is curative and preventive of these injuries.

3X Pitching Velocity Program

Now that you have a good understanding of the risks involved in becoming a high level pitcher and the factors causing the injuries then here is the program to help you prevent or correct these problems. It is a systematic program that will teach you the motor coordination of the efficient high velocity pitcher and help you develop the power and joint integrity of one. If you want to learn more about the 3X Programs and 3X Pitching then fill out the yellow form below to subscribe to the 30 Days to 5MPH video series NOW!

References:

1. Gowan ID, Jobe FW, Tibone JE, Perry J, Moynes DR. A comparative electromyographic analysis of the shoulder during pitching: professional versus amateur pitchers. Am J Sports Med. 1987;15(6):586-590.
2. Campbell BM, Stodden DF, Nixon MK. Lower extremity muscle activation during baseball pitching. J Strength Cond Res. 2010 Apr;24(4):964-71.
3. Stodden DF, Campbell BM, Moyer TM. Comparison of trunk kinematics in trunk training exercises and throwing. J Strength Cond Res. 2008;22(1):112-118.
4. Lyman S, Fleisig GS, Andrews JR, Osinski ED. Effect of pitch type, pitch count, and pitching mechanics on risk of elbow and shoulder pain in youth baseball pitchers. Am J Sports Med. 2002; 30(4):463-468.
5. Shane T. Seroyer, MD,* Shane J. Nho, MD, Bernard R. Bach, MD, Charles A. Bush-Joseph, MD, Gregory P. Nicholson, MD, and Anthony A. Romeo, MD. The Kinetic Chain in Overhand Pitching. Sports Health. 2010 March; 2(2): 135–146.
6. Rod Whiteley. Baseball throwing mechanics as they relate to pathology and performance – A review. Journal of Sports Science and Medicine (2007) 6, 1-20
7. Fleisig G, Andrews J, Cutter G, Weber A, Loftice J, McMichael C, Hassel N, Lyman S. Risk of Serious Injury for Young Baseball Pitchers: A 10-Year Prospective Study.Am. J. Sports Med. 2010;20(10): 1-5.
8. Kaplan KM, Jobe FW, Morrey BF, Kaufman KR, Hurd WJ. Comparison of Shoulder Range of Motion, Strength, and Playing Time in Uninjured High School Baseball Pitchers Who Reside in Warm- and Cold-Weather Climates.Am.J Sports Med. 2011; 39(2): 320-328.
9. Lyman S, Fleisig GS, Waterbor JW, et al. Longitudinal study of elbow and shoulder pain in youth baseball pitchers.Med Sci Sports Exerc.2001;33(11):1803-1810.
10. Valovich McLeod TC, Decoster LC, Loud KJ, Micheli LJ, Parker JT, Sandrey MA, White C.  National Athletic Trainers' Association Position Statement: Prevention of Pediatric Overuse Injuries.  J Ath. Tr. 2011;46(2):206-220.