Baseball and Softball Winter Arm Care Program: Start Injury Prevention Now!

Up to 74% of youth and adolescent baseball players (ages 8–18) report some degree of arm pain while throwing, and almost a quarter (23%) report injury histories consistent with overuse. (Makhni, Am J Sports Med. 2015) The most common arm injury period is pre-season and or early season practices and games. (Dick, J Athl Train. 2007) Due to the high rate of injury, this is a testament to the importance of the off-season conditioning and arm care program. Beyond exercise training, it is imperative to have a gradual progression of pre-season throwing intensity and volume. Because of the high injury rate, the baseball player of today must have durability, as well as ability.

The most common injury at the elbow is a strain of the forearm muscles/tendons on the inside of the elbow called “little league elbow.” If overuse from throwing continues, there is a chance of tearing the ligament on the inside of the elbow joint (ulnar collateral ligament), which often requires “Tommy John Surgery” to repair. During the late-cocking phase or early acceleration phase of pitching the elbow is placed under significant stress.

At the shoulder, the most common injury is rotator cuff tendonitis, “pitchers’ shoulder.” A rotator cuff is a group of 4 muscles that attaches the upper arm bone to the shoulder. The rotator cuff’s main job is to keep the arm bone centered in the shoulder joint during movement. During the deceleration phase (followthrough) of pitching, the rotator cuff muscles undergo extreme contractile force, essentially preventing the arm bone from dislocating from the shoulder joint.

Specific musculoskeletal body dysfunctions predispose the throwing athlete to an arm injury. Studies have shown that shoulder range of motion limitations, shoulder muscle (rotator cuff muscle) weakness, shoulder blade (scapular dysfunction) movement abnormalities, and “core” weakness/ poor motor control have a significant influence on developing arm injury. (Tooth, Sports Health, 2020)

The Mishock Physical Therapy Winter Exercise Program is designed based on scientific research to target the abdominals (core), shoulder, and arm muscles in throwing injury prevention. The program can be performed without a gym or personal trainer at home. It could be incorporated as part of a team workout program. A recent study demonstrated that a scientifically based exercise program could reduce shoulder and elbow injury by as much as 50% among youth and adolescent baseball players. (Sakata, Am J Sports Med. 2019)

Also, keep in mind that physically improving the athlete’s strength, power, explosiveness, and flexibility of the lower extremity and core (abdominals and hips) is essential in preventing injury and increasing throwing velocity. This type of program is outside of the scope of this winter workout program.

Strategies to keep a throwing athlete healthy during the season should be a priority for coaches, parents, and players. Injury prevention and optimal pitching performance is possible with a comprehensive approach, allowing the athlete to enhance ability while creating durability. The Mishock 10 keys to arm injury prevention.

1. Developing scientifically-based, fundamental pitch mechanics.

2. Recognizing the pitcher’s individual and unique signs of fatigue.

3. Following and tracking inning, game, season, and yearly pitch counts.

4. Judiciously using the fastball in complement with breaking pitches and changeups (5. Optimizing mobility and flexibility of key throwing muscle groups.

6. Developing strength and power of key throwing muscle groups.

7. Passive rest (optimal sleep and some sedentary activities) to allow remodeling and healing of stressed body tissues.

8. Active rest (stretching, good nutrition, massage, manipulation, and other healthy muscle manipulation like foam rolling…) to enhance recovery in preparation for the next training or competitive event.

9. Cross-training through playing multiple sports and participating in fitness activities for diversity in physical training and competitive skill acquisition.

10. Sensible utilization of a sports medicine team focused on prevention and treating injuries, including orthopedic surgeons, physical therapists, chiropractors, and athletic trainers.

Start your arm care winter exercises now in hopes of preventing throwing related injuries. Please visit our website for the FREE exercise program http://www. mishockpt.com/blog

We can help!

If pain or limited function that is limiting you from doing the activities you enjoy, call Mishock Physical Therapy for a Free Phone Consultation (610)327-2600. Email your questions to mishockpt@ comcast.net. Visit our website to learn more about our treatment philosophy, our physical therapy staff, and our 7 convenient locations in Gilbertsville, Skippack, Phoenixville, Boyertown, Limerick, Pottstown, and Steiner Medical at www. mishockpt.com.

Dr. Mishock is one of only a few clinicians with doctorate level degrees in both physical therapy and chiropractic in the state of Pennsylvania. He has also authored two books; “Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete,” and “The Rubber Arm; Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury” both can be bought on Amazon.