Overhead throwing injuries are commonplace and primarily involve the shoulder and elbow. The majority of throwing-related symptoms are overuse problems, a consequence of relative excessive throwing in conjunction with:
Pitch counts, advocated by the American Sports Medicine Institute, STOP Sports Injuries, and others, are important at all ages, but pitch limits are particularly important at the youth & adolescent levels, as is adequate days rest between starts and seasons. There are well-established recommendations for pitch counts and days rest in between based on age for young throwers. In addition, no overhead throwing for 2-3 months per year is encouraged, as is avoidance of competitive pitching for at least 4 months per year.
Developing shoulder and elbow joints, and more specifically the growth plates, are at risk in youth and adolescent throwers. The repeated high forces of overhand throwing can place undue stresses on the skeletally immature joints of these young athletes. Adherence to guidelines on pitch counts, days rest between pitching stints, and thoughtful, gradual instruction on different pitch types limit arm fatigue and allow for the mastery of fastball throwing mechanics. The change-up should be the next pitch type introduced to young throwers to utilize after the fastball.
If a pitcher complains of shoulder or elbow pain, throwing should be discontinued immediately until further evaluation by a sports medicine physician. You could have a valgus extension overload.
Participation and learning the game are paramount for young athletes in maximizing their experience in sports. Young athletes should be encouraged to be involved in various sports and physical activities in developing their overall athletic skills.
Dr. B. Rodney Comisar is a board certified, fellowship-trained orthopedic surgeon who specializes in sports medicine related injuries. He has a sub-specialty certification in Sports Medicine. Dr. Comisar offers a full spectrum of sports medicine surgery, including arthroscopy and minimally invasive procedures. Dr. Comisar’s special areas of interest include: multi-ligamentous knee injuries/dislocations; ACL injuries/reconstruction; rotator cuff injuries/tears; patellar instability/dislocation; proximal hamstring ruptures; shoulder instability; and shoulder arthritis including total shoulder replacement and reverse total shoulder replacement.
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