Common Baseball Injuries and Prevention Tips

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Published:  July 7, 2022
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Reviewed and contributions made by Daniel Kline, DPT, SCS, ATC

Baseball season is in full swing. While the most common baseball injury is a hamstring injury (a fun fact provided by Daniel Kline, DPT, SCS, ATC), the most commonly associated injuries are conditions of the shoulder and elbow. As a result, we have compiled some of the most common shoulder and elbow injuries baseball players experience. We have also provided some guidance on how to avoid them through stretching, strength training, recommended throwing guidelines and proper rest.

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Common Baseball Shoulder Injuries

Baseball is known for its shoulder injuries, particularly in pitchers who are at much greater risk for overuse. Such injuries include the following.

Baseball Shoulder Impingement

An impingement occurs when soft tissue becomes pinched between the humeral head and the acromion (i.e., the top bony part of the shoulder). It can also occur from soft tissue being pinched by the humeral head and the glenoid in the back of the shoulder. Posterior impingement is common and more sport specific to throwing athletes. This type of impingement occurs because of posterior muscle tightness surrounding the shoulder joint.

“SLAP” Tear in Baseball

SLAP stands for Superior Labrum Anterior Posterior and is a condition also known as a “labrum tear”. The labrum provides stability and connection within the shoulder. When a tear occurs, the upper arm bone becomes unstable, and then the bicep tendon loses connection to the shoulder blade socket as a result.

Muscle Strains

Occurs when muscles or tendons (the bands that attach muscles to bones) experience a quick pull, twist or micro-tear. Also referred to as a “pulled muscle”.

Little League Shoulder (Proximal Humeral Epiphysitis)

The athlete feels pain in the upper arm/shoulder because of an inflamed and/or irritated growth plate. This injury can result from repetitive throwing and overuse and is commonly seen in the adolescent thrower between ages 8 and 12 years old.

Common Baseball Elbow Injuries

In addition to shoulder injuries, many baseball players experience elbow discomfort. Below are the two most well-known and discussed elbow injuries.

Ulnar Collateral Ligament (UCL) Injury

The most common elbow injury is to the UCL. (It is also known for its surgical corrective technique, “Tommy John” surgery.) The UCL is made of up three bands that help create stability in the arm/elbow. When the UCL is injured, the athlete may experience pain inside the elbow or tingling/numbness in the pinky or ring fingers.

Little League Elbow

Like its shoulder counterpart, Little League Elbow happens because of overuse. In this instance, the growth plate near the elbow is injured or inflamed. This is most commonly seen in the adolescent thrower between ages 10-14 years old.

Baseball Stretches for Injury Prevention

While a dynamic warm up plays an important role in prepping the body for activity, proper stretching before and after activity, and especially throwing, can help prevent injury. Each of the recommended stretches described below can improve shoulder health when completed 2-3 times/day in 3/30-second intervals.

Cross Body Stretch

Research shows that the cross body stretch shows a strong link to injury reduction. This variation is a lying down version, which increases range of motion and mobility in the back of the shoulder because the scapula is stabilized.

Instructions include:

  1. Lay down on your back.
  2. Lean toward right shoulder, stabilizing the shoulder blade against the surface of the ground.
  3. Using your left hand, grab your right elbow and pull it across your body, with your biceps moving towards your mouth.
  4. Repeat stretch on your opposite side.

NOTE: If this movement causes a “pinched” feeling, first try lowering the stretched arm across your body. If this stretch causes pain, discontinue and consult with your PT or ATC for appropriate body positioning.

Prayer Stretch

A popular stretch that focuses on the shoulders and the upper back.

Instructions include:

  1. Begin on your hands and knees and then sit back towards your heels, bringing your chest towards the floor.
  2. Extend the arms as far as possible overhead.
  3. Complete 3 repetitions, holding each repetition for 30 seconds.

Doorway Stretch

The doorway stretch focuses on both the major and minor pectoral muscles.

Instructions include:

  1. Begin in a standing position in the middle of a doorway.
  2. With your elbows bent, place your forearms on the side of the doorway at a 90- degree angle from your sides.
  3. Keeping your shoulders relaxed, gently step forward until you feel a slight stretch in your shoulders.

As with any kind of exercise program, it is crucial to properly warm up and cool down to guard against injury. In addition to these stretches foam rolling and/or using a lacrosse ball on soft tissue can help mobilize the lats and posterior shoulder.

Baseball Strength Exercises

In addition to performing regular stretches and mobility exercises, it is equally important for baseball players to gradually build strength. It is recommended that athletes perform these exercises 3-4x/week and to complete light reps after pre-throw stretching to re-activate muscles for activity.

Resisted External Rotation

This exercise strengthens the rotator cuff for external rotation as well as throwing position.

Instructions include:

  1. Stand at attention with your elbows at your sides and bent to 90 degrees with band in hand.
  2. From this position, gently “pull apart” your band until you feel resistance, keeping your arms parallel with the floor.
  3. Work up to 3 x 30 second holds before increasing the resistance or completing a 3 x 1:00 hold.

NOTE: You will need a piece of Theratubing to perform this exercise. Theratubing, is rubber tubing that is available at most sporting goods stores, online or through your local physical therapist.

Front Planks

Planks are excellent exercises to build core strength and stability.

Instructions include:

  1. Lie on the floor with your elbows and forearms on the ground. Your shoulders should be directly over your elbows and your feet perpendicular to the floor.
  2. Engage your core (i.e., keeping your muscles as tight as possible) and then push up onto your elbows and toes, maintaining a flat back and butt.
  3. Complete 3 sets, each 30 seconds each to start. You may increase your time as you progress.

NOTE: If holding this position is too difficult, you can begin with your knees on the ground and then gradually work your way onto your toes. As you increase your strength you can include other variations, such as side planks to continually build strength.

Y’s + T’s

Two exercises to build strength in the shoulders and upper back without putting unnecessary stress on the area.

Instructions include:

Complete 2-3 sets of 10, keeping your shoulder away from your ear. Work your way up to 3 x 20 reps with no weight before holding a water bottle or a can (approximately 1 pound).

  • Y’s. Lie on your stomach with your arms out in front of you, keeping your arms as close to your ears as possible. Together, raise your arms a few inches off the floor with your palms facing the floor at all times. Pause and then lower your arms to the starting position.
  • T’s. While still on your stomach, move your arms so they are directly out to the side. Your body should resemble a “t”. With your palms facing the floor, raise your arms slightly off the ground and squeeze your shoulder blades together. Pause before lowering your arms to the starting position.

NOTE: If possible, it is suggested to use a stability ball, lay over a workout bench or do one arm at a time over the side of a bed when completing these movements. If none of the above options are available, you can complete these exercises lying on your stomach on a mat or the floor.

The Importance of Rest for Baseball Players

While stretching and strengthening exercises are crucial components in athlete health and injury prevention, a third (sometimes less popular) component is equally, if not more important – rest. Research shows that athletes, particularly pitchers, are more prone to injury when they are fatigued.

Recommended Pitch Count By Age

Iit is important that coaches, parents and athletes alike are aware and follow the recommended pitch count. This is especially true if the athlete is participating and competing on multiple teams.

The table below depicts MLB and USA baseball Pitch Smart guidelines.

Age Daily Max (Pitches in a Game 0 Days Rest 1 Days Rest 2 Days Rest 3 Days Rest 4 Days Rest 5 Days Rest
7-8 Years Old 50 1-20 21-35 36-50 N/A N/A N/A
9-10 Years Old 75 1-20 21-35 36-50 51-65 66+ N/A
11-12 Years Old 85 1-20 21-35 36-50 51-65 66+ N/A
13-14 Years Old 95 1-20 21-35 36-50 51-65 66+ N/A
15-16 Years Old 95 1-30 31-45 46-60 61-75 76+ N/A
17-18 Years Old 105 1-30 31-45 46-60 61-80 81+ N/A
19-22 Years Old 120 1-30 31-45 46-60 61-80 81-105 106+

 

In addition to following pitching guidelines and taking proper rest during the season, it is also important for young athletes to play and engage in other sports and activities. It’s recommended that young athletes participate in a second non-throwing sport (e.g., soccer or basketball) or in free play to improve motor development and skills, maintain their love of sports and avoid injury or burnout.

Baseball Athletic Training and Physical Therapy

Like with any sport, strength training and stretching can aid recovery and prevent injury. Baseball is no different. However, understanding the common conditions and how to avoid and treat them allows athletes of all ages the ability to enjoy the game longer and without pain.

Our athletic trainers work with athletes of all ages and levels to prevent, evaluate and treat sports injuries. If you are in need of therapy or even just an injury assessment, schedule an appointment with us today.