Youth Overhead Throwing Injuries

Youth Overhead Throwing Injuries

Over the past several decades there has been an increasing rise in the number of overhead throwing related injuries among youth participants.  Most of these injuries are overuse injuries due to repetitive stresses placed on the anatomy of the shoulder and elbow when throwing.  These injuries are seen most commonly in baseball pitchers, but also occur in other sports that involve repetitive overhead motions including tennis, volleyball and softball.

The shoulder is a unique, but complex joint.  It allows for the greatest degrees of motion, but because of this, is one of the least stable joints.  Much of the stability of the shoulder comes from the soft tissues surrounding the area.  These soft tissues are placed under a great deal of stress with overhead activities, especially with repetitive throwing.

It is this time of year with the start of the baseball season that I as an athletic trainer see a greater number of athletes present with “sore arms.”  My job involves figuring out is the athlete experiencing general muscle soreness, are they developing a repetitive use injury, or is it somewhere in between.   There are multiple layers to try to peel through to make the appropriate evaluation.  Everything from the athlete’s inability to accurately describe what they are feeling to their unwillingness to admit they are experiencing pain for fear that they will lose playing time can cloud the picture.  Once I complete my evaluation, the athlete, parent, coach and I can discuss how best to treat the condition the athlete is experiencing. 


I want to take a little time and provide information for preventing injuries as this should be the first priority.  There are multiple areas that should be addressed including:

1.        Proper strengthening prior to the season

  • Strengthening of the entire body, especially the legs and core
  • Scapular strengthening (shoulder blades)
  • Rotator cuff muscles
  • Grip/forearm strength   


2.        Proper coaching

  • Coaches should be well educated on proper throwing mechanics as well as have knowledge of what number of pitches is appropriate for what age.  The American Sports Medicine Institute has a well summarized position statement on numbers of pitches to be thrown per the athlete’s age.  It can be found HERE

3.       Proper medical supervision/access

  •  Having access to a health care professional such as an athletic trainer is helpful in recognizing an injury early on before it worsens. 

4.        Take 2-3 months a year without frequent overhead throwing.

  • There is a higher risk of injury for athletes who play multiple seasons for multiple teams in the same sport during the same calendar year.  Also competing in 2 sports during the same season that involve overhead throwing is not a good idea.

5.       Youth athletes should avoid early specialization in one sport.

  • Participating in a variety of activities as opposed to specializing in one helps to develop a more rounded athlete and decreases risk of developing muscle imbalances.

And the one I find to be the most important during the course of the season,

6.       Athletes must “listen” to what their arm is telling them.  This means that the athlete should pay close attention to how their arm feels BEFORE, DURING, and AFTER they throw.   An athlete who develops soreness, has a drop in velocity, and/or fatigues quicker than usual should not ignore these symptoms and not try to “fight through” them.

Dustin Eslinger, MA, ATC

April 7th, 2015

Posted In: General

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