Pitching Arm Injury and Pain For Dummies

Every pitcher has more than likely experienced arm pain at some point or had a pitching arm injury. Pain is not something that should be ignored. Pain is your body’s check engine light coming on and saying, “There is something wrong!” Arm injuries have skyrocketed to epidemic levels in baseball in both the professional and amateur levels. So, what is the cause of this arm pain and how can you eliminate it? ASMI has found the three main causes of pitching arm injury are overuse, poor mechanics, and poor physical fitness. You need to address all three if you want to minimize your risk of injury and enhance your performance. They can be addressed during a 3-4 month offseason. This allows you to take time off from throwing, address mechanical issues to optimize the kinetic chain and develop ideal physical fitness with a strength and conditioning program.

Pitching Arm Injury : Overuse

Overuse is considered one of the biggest factors to pain and pitching arm injury. Several studies have evaluated risk factors for shoulder and elbow injuries in adolescent baseball players. The risk factors include pitching year-round, pitching more than 100 innings per year, high pitch counts, pitching for multiple teams, geography, pitching on consecutive days and pitching while fatigued. Pitchers spend far too much time throwing. Taking 3-4 months off of throwing is highly recommended in many studies. This time would ideally be spent developing a more well-rounded athlete through strength and conditioning, nutrition, improving joint mobility, and refining pitching mechanics with low stress medicine ball drills. Instead of playing or throwing throughout your offseason, you would be addressing all three of the main causes of injury: overuse, poor mechanics and poor physical fitness. At Topvelocity, we have many examples of athletes who have used this exact approach to add more muscle mass, increase athleticism (vertical jump, broad jump, 10 yd dash) and hone the use of the kinetic chain in their pitching mechanics. Not only does this enhance a player’s performance and increase pitching velocity, but it also significantly reduces the risk of pitching arm injury.

Pitching Arm Injury : Poor Pitching Mechanics

Poor pitching mechanics are essentially a break in the kinetic chain that disrupts the flow of energy from the lower body to the upper body. This not only decreases performance, but it significantly increases the risk of injury as the throwing arm needs to overcompensate to apply force to the ball. Here is an excerpt from a study called, The Kinetic Chain Revisited: New Concepts On Throwing Mechanics and Injury by Samuel K. Chu (4).

The throwing motion is a fluid, continuous movement that starts with the lower extremities and core, which provides a base of support and helps generate kinetic energy that translates through the throwing arm, eventually culminating with the ball release from the hands and fingers. An efficient and effective throwing motion requires optimized anatomy, physiology, and mechanics in all of the segments of the kinetic chain. Accordingly, deficits or “breaks” in the kinetic chain can lead to injury or impaired throwing performance. Several studies have investigated shoulder injuries in the overhead throwing athlete, addressing the biomechanics and role of the kinetic chain in injury and training principles for the overhead throwing athlete.

Pitchers need a full joint by joint evaluation to find where they are breaking down in the kinetic chain. Finding your specific dysfunction will help to prevent injury and enhance performance. Baseball spends so much time trying to address the arm, but little time looking at the entire body. Baseball players are no different than any other athlete. Just like our friends Dr. Sean and Dr. Jeremy @activeliferx say, “we would treat a pitcher, in the evaluation process, just like anybody else.” If you are dealing with pain or want to enhance performance EVALUATE THE ENTIRE KINETIC CHAIN!!! Video Production ?: @stevenguadagni #baseball #pitching #ncaabaseball #perfectgame #usssabaseball #mlb #milb #springtraining #baseballlife #baseballislife #ilovebaseball

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Breaks in the kinetic chain manifest from poor joint range of motion and lack of strength and power throughout the entire body. More on that later, but as those deficiencies are being addressed, pitchers still need to be able to practice skill specific movements. The trick is to be able to practice key mechanical issues without the added stress of throwing.
The answer is two handed medicine ball throws. This allows a pitcher to practice specific movements to optimize the kinetic chain without overuse of the throwing arm. They can practice all of the key components of the kinetic chain: back leg drive, front leg stabilization/extension, hip to shoulder separation, trunk extension etc. As they get closer to season, they begin to blend back to the baseballs. By using this approach they can combat overuse and improve deficiencies in their pitching mechanics.

Pitching Arm Injury : Poor Physical Fitness

Poor physical fitness is really a combination of poor strength and power throughout the body and lack of range of motion in specific joints based individually on the athlete. This requires a full body evaluation of every joint’s range of motion (ankle,knee, hip, trunk, shoulder, elbow etc.) and a total body assessment of speed, strength, and power. Deficiencies in the evaluation need to consistently be worked on throughout the offseason. In another excerpt from Samuel K. Chu’s study, The Kinetic Chain Revisited: New Concepts On Throwing Mechanics and Injury (4), he concluded that a full evaluation needs to be done to identify deficiencies and dysfunction in the kinetic chain. Also, surgery should be a last resort! Athletes experiencing arm pain need to first work to identify and address their dysfunction in their bodies.

Throwing Mechanics and Injury examination of the kinetic chain and shoulder should be performed. Screening should include evaluation of leg stability and strength, hip range of motion, core stability, and flexibility as previously outlined and shown. A comprehensive shoulder examination should be performed, including glenohumeral range of motion, rotator cuff strength testing, and assessment for scapular dyskinesis. Based on any deficits identified on clinical evaluation, rehabilitation should be initiated to address any altered biomechanics or kinetic chain dysfunction, optimize anatomy, and improve stability of the joints. Surgery should be a last resort for athletes who have not responded to aggressive rehabilitation and continue to have pain or difficulty throwing.

Overuse and arm first approaches will continue to add to the arm injury epidemic. We believe too many people are ignoring the medical studies and advice of doctors like seen in this video. This is not just an arm problem. The whole body needs to be evaluated. Any break in the kinetic chain will lead to overcompensation and injury. ASMI recommends taking 3-4 months of the year off from throwing. This time should be spent building up the athletes entire body with strength training, nutrition, mobility/good movement patterns and addressing biomechanics to optimize the kinetic chain. Stop throwing so much in your offseason! This means high intent weighted balls, extreme long tossing, year round baseball and showcases. We are not out to demonize weighted balls they are good tool for warm ups and arm path, but high intent weighted ball approaches through offseason and inseason, we believe, are feeding into this epidemic. #baseball #pitching #baseballislife #baseballlife #ilovebaseball #tommyjohnsurgery #mlb #milb #minorleaguebaseball #perfectgame #usssabaseball #injury #weightedballs #ncaabaseball @michael_peachy

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Arm pain and injury is a full body issue. At Topvelocity, we start every athlete with a full evaluation. Once we determine the athlete’s specific dysfunction and deficiencies, they work through the entire offseason to address them. The majority of athletes will have certain joints where range of motion needs improvement to allow efficient energy transfer through the kinetic chain. Every athlete works to develop muscle mass and power through an individualized nutrition plan and Olympic lifting based strength and conditioning program to develop maximum energy transfer through their kinetic chain. This allows the athlete to enhance his poor physical fitness and gives them the potential to improve poor pitching mechanics.

Solving Pitching Arm Injury Epidemic

If you are experiencing arm pain or have had an injury, you need to find the root of the problem. This requires a full evaluation to find the dysfunction. Once you determine your deficiencies, you need a good program that forces you to address them. This needs to be done in an offseason approach! If you are experiencing arm pain in-season, ask yourself if you fall into any of the three main causes: overuse, poor mechanics, or poor physical fitness. Then ask yourself what did you do the previous offseason to address these issues? Chances are not very much.

If you enjoyed this article on pitching arm injury, check out this one on how to end the arm injury epidemic in baseball here.

References

    1. Olsen, Samuel J., et al. “Risk factors for shoulder and elbow injuries in adolescent baseball pitchers.” The American journal of sports medicine 34.6 (2006): 905-912.
    1. Andrews, James R., and Glenn S. Fleisig. “Preventing throwing injuries.” (1998): 187-188.
    1. Fortenbaugh, Dave, Glenn S. Fleisig, and James R. Andrews. “Baseball pitching biomechanics in relation to injury risk and performance.” Sports health 1.4 (2009): 314-320.
    1. Chu, Samuel K., et al. “The kinetic chain revisited: new concepts on throwing mechanics and injury.” PM&R 8.3 (2016): S69-S77.
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