The Best Way to Avoid Baseball Injury This Season
Spring marks the beginning of the baseball season, but along with the crack of the bat and smell of the fresh cut grass, we also see a significant rise in injuries. Even at the Major League level, research has shown the highest injury rates are in April and May (1). We also see this in our clinic with youth and high school athletes. In fact, we see more injuries early in the spring season than any other time of year.
The reason for this youth baseball injury epidemic is widely debated - pitching mechanics, pitch type, overuse. Opinions differ on how to prevent injuries, but it’s clear that the greatest factor for increased injury risk is pitching while fatigued. Pitching regularly while fatigued has shown to increase the likelihood of injury by 36 times (2). So today I want to offer three tips to reduce fatigue for your baseball player this spring.
Early season conditioning. As noted above, the majority of baseball related injuries occur early in the spring. This is mainly due to athletes not being physically prepared to start the season. Though baseball is not necessarily considered a physically demanding sport, it is a sport where, whether hitting, throwing or running, the athlete goes from being relatively still to maximal effort. To prepare for this off season training should include sprints, plyometrics and medicine ball work. This type of explosive exercise can help prepare the athlete for the physical demands of baseball. Proper on-ramping of throwing and hitting is also important. Especially in the Northeast with the cold and snowy weather, it can be difficult to throw or hit before the season starts. Then once the season starts, athletes often jump right into high volume hitting or throwing. This can lead to injury, specifically back problems with hitting and shoulder or elbow problems with throwing. Increasing throwing and hitting volume gradually can help mitigate this risk. A general rule is to increase volume by no more than 10% per week.
Pitch count considerations. Pitch count guidelines are now widely used in youth baseball and are being implemented in high school baseball as well. If you’re not familiar with pitch count guidelines, Pitch Smart by MLB and USA Baseball is a great resource. These guidelines can be helpful to reduce the likelihood of overuse injury, but there are additional considerations even if you are following the guidelines.
Playing on multiple teams: Pitching for multiple teams at the same time can pose a problem related to overuse. Even if a coach is following pitch count recommendations for their game, they may not know if an athlete has pitched for other teams. Clear communication between the athlete, or in most cases the parent, and the coach is pivotal to help avoid overuse.
Playing other positions: Positions that tend to require more throwing (catcher, shortstop, 3rd base) should also be considered. Though these throws aren’t necessarily tracked like pitches are, they still can contribute to fatigue. Moving a player from pitcher to any of these positions, or vice versa, should be avoided whenever possible.
Not all pitches are equal: Even if pitch counts are followed, keep in mind that not all pitches are equal. For example, 40 pitches over 4 innings where a pitcher is cruising along without many base runners is a vastly different scenario than 40 pitches over a single inning where the pitcher is struggling a little bit more and is throwing many more “pressure pitches.” Just because a pitcher has 50 pitches available under pitch count guidelines does not mean that they should continue pitching. Keep an eye out for signs of fatigue including decreased velocity, control or leaving the ball up in the strike zone.
Participation in showcases: A recent study out of Brown University revealed that participating in showcases increases the risk of injury (3). Reasons for this increase can be that showcases are not necessarily subject to the same pitch count rules followed by youth leagues and high schools. Pitchers are also often throwing with maximal effort, in front of radar guns, at these events which places more stress on their arm. When an athlete is playing in a showcase can also be a consideration. Showcases in the fall, at the end of a long season, can be tough due to fatigue. Similarly, showcases in the winter can be a concern because athletes aren’t yet ready for maximal effort competition.
Pitch counts with harder throwers: Throwing at higher velocity has shown to increase risk of injury at every level of play (4). Be especially careful with harder throwers at younger ages as their bones and ligaments sometimes have not developed enough to withstand the stress from throwing at the velocities they can generate.
Proper recovery. There are many aspects to proper recovery from training and competition. One that is probably the most important and easiest to apply is proper sleep. A 2014 study showed a 1.7X higher incidence of injury for adolescent athletes getting less than 8 hours of sleep per night (5). Getting an average of 8 hours of sleep or more is one of the best ways to reduce fatigue and risk of injury.
Another recovery consideration specific to baseball is strengthening and mobility work following pitching. A recent study out of Temple University College of Public Health showed significant deficits in shoulder ROM and rotator cuff strength lasting 3-4 days after pitching (6). This is part of the reason that athletes should be careful playing other positions that require a higher volume of throws (catcher, shortstop) after pitching. Doing some light stretching and band work the day after pitching can help restore proper range of motion and rotator cuff strength.
This is by no means a complete list of ways to reduce the likelihood of injury this season but these tips can certainly help. With proper preseason conditioning, following pitch count guidelines and proper recovery your athlete is more likely to stay injury free this season. At Complete Game Physical Therapy, we are available for preseason or in season injury risk screens, or if you are having a problem. Please give us a call at 978-710-7204 or click here to request an appointment.
References:
Posner M. et al, Epidemiology of Major League Baseball Injuries, American Journal of Sports Medicine, 2008, 39 (8).
Fleisig GS et al., Risk Factors for Shoulder and Elbow Injury in Adolescent Baseball Pitchers, American Journal of Sports Medicine, 2006, 34 (6).
Kriz JP et al, Effect of High School Showcase Exposure and Timing of Ulnar Collateral Ligament Tear on Professional Baseball Careers in Elite Pitchers, American Journal of Sports Medicine, 2023, online.
Fortenbaugh D et al, Baseball Pitching Biomechanics in Relation to Injury Risk and Performance, Sports Health, 2009, Jul; 1(4): 314-320.
Milewski MD et al., Chronic Lack of Sleep is Associated with Sports Injuries in Adolescent Athletes, Journal of Pediatric Orthopedics. 2014, March; 34(2): 129-33
Mirabito NS, The Acute Effect of Pitching on Range of Motion, Strength, and Muscle Architecture. Temple University College of Public Health, online.