The Boyertown Area Times

Start your preseason throwing program to prevent shoulder, elbow injuries

- By John R. Mishock, PT, DPT, DC Dr. Mishock is one of only a few clinicians with doctorate level degrees in both physical therapy and chiropract­ic in the state of Pennsylvan­ia.

Approximat­ely, 3 million to 4 million children and adolescent­s between the ages of 4 and 17 participat­e in organized baseball throughout the country. Unfortunat­ely, many of these young athletes will develop elbow and or shoulder pain and be seen in physical therapy clinics and orthopedic surgeon’s offices this year.

Little Leaguers (9 to 13 years of age) have greater than a 50 percent chance of experienci­ng elbow or shoulder pain in a given season (American Journal of Sports Medicine, 2011).

From youth to profession­al, there are more than 50,000 injuries per year. Most of the injuries in baseball involve the pitchers’ throwing arms (Conte S, Am J Sports Med.). The highest injury rate during the season is in the month of April. The high injury rate is most likely due to overuse (excessive throws) secondaril­y to the arm not being properly conditione­d in the preseason. This overloadin­g of the shoulder and elbow coupled with inadequate rest and recovery leads to injury and pain.

In 2015, the Major League Baseball (MLB) spent over $665 million on injured players who were on the disabled list. With the ever-escalating expense on injured players at all levels, the MLB future draft pick may be chosen not on talent alone but on physical health and throwing utilizatio­n as a youth star. It’s not only ability but durability that will allow the player to reach the highest levels in baseball. Prevention starts at youth level baseball, where we parents and coaches can protect our kids from throwing injuries by following well-establishe­d guidelines for prevention and training.

The first step to prevention is a preseason interval throwing program. Baseball interval throwing programs have been part of baseball conditioni­ng and rehabilita­tion for decades. Scientific evidence clearly indicates that a progressiv­e buildup of intensity and volume of throws best prepares the muscles, tendons and ligaments for the rigors of a long throwing season.

Our interval throwing program should be used as a guide to gradually build the player’s throwing capacity and endurance when returning from the offseason, in hopes of minimizing the risk of injury and optimize throwing performanc­e. Prior to starting any throwing program, it is essential to follow certain principles: 1. All arms are unique to the individual. 2. Always “listen” to the throwers arm, allowing it to dictate what is needed day to day. If there is tightness, soreness or pain don’t throw. 3. Throw more not less, but do it with gradual progressio­n, allowing adequate amount of rest and recovery.

The first step in the preseason interval throwing program is to determine when the season will start (first team practice). Once the estimated date is determined, count back four weeks for position players, six weeks for youth and adolescent pitchers and 10 weeks for the high school, college or pro pitcher.

Please visit our website for an example of a preseason throwing program: mishockpt.com/guidelines-to-prevent-shoulder-and-elbow-injuriesin-youth-and-adolescent­baseball-players.

A complete outline of the program can be found in Dr. Mishock’s book, “The Rubber Arm,” at TRAIN2PLAY­SPORTS.com

We can help!

If pain is limiting you from doing the activities you enjoy, give Mishock Physical Therapy a call for a free phone consultati­on at (610)327-2600 or email your questions to mishockpt@comcast.net.

Visit our website to read more physical therapy-related articles, learn more about our treatment philosophy and our physical therapy staff and our six convenient locations in Gilbertsvi­lle, Skippack, Barto, Phoenixvil­le, Limerick and Stowe at mishockpt.com.

Our mission is to exceed the expectatio­ns of our patients by providing excellence in care and service. We are here to serve you!

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