Throwing Related Arm Pain

Baseball and softball seasons are finally getting underway.  One of the common questions we get in the PT clinic, especially early in the season, is “is it normal for my arm to be sore when I throw?”  First of all it should never hurt to throw but early in the season, as the athlete is ramping up their throwing some soreness can be expected.  Today I wanted to give some guidelines for athletes and parents regarding soreness vs. pain.

Soreness vs. Pain in Baseball and Softball

It is not unusual for athletes to experience shoulder or elbow soreness after throwing.  Common places to feel soreness are in the bicep (front of the arm), near the elbow or shoulder, in the tricep (back of the arm) near the elbow, and in the back of the shoulder (which is usually associated with the rotator cuff).  Before a coach shuts down a player’s pitching or a parent calls the doctor, it is important to talk with the athlete about what he/she is experiencing.

Though it is always better to proceed on the side of caution, signs of simple soreness include:

·         Muscles feeling tired or tight.

·         Soreness that loosens up with light stretching or activity.

·         Soreness after the first few times throwing in the spring.

Signs that the soreness may be something more serious include:

·         Pain that is sharp in nature.

·         Pain that worsens with activity.

·         Symptoms that do not resolve after warming up.

Do Not Play Through Pain

Pain changes everything.  There are two primary reasons that playing through pain is a bad idea.  First, pain often is a sign that something is seriously wrong. Pain can indicate injury to structures in the arm such as the UCL (the Tommy John ligament) of the elbow, rotator cuff of the shoulder, or growth plates in bones of the elbow or shoulder.  Second, pain will alter motor control. It will diminish awareness of body position which can lead to not only decreased performance, but also to compensations which can result in injury in other areas.

Soreness Rules

The American Sports Medicine Institute has developed guidelines to follow if your athlete is experiencing arm soreness with throwing.  

·         If sore more than one hour after throwing, or the next day, take one day off and repeat the most recent throwing program workout.

·         If sore during warm up, but soreness is gone within the first 15 throws, repeat the previous workout. If shoulder or elbow becomes sore during this workout, stop, and take two days off.  Upon return to throwing, reduce number and intensity of throwing.

·         If sore during warmup and soreness continues through the first 15 throws, stop throwing and take two days off.  Upon return to throwing, reduce number and intensity of throwing.

Summary

Shoulder soreness is a common occurrence in youth baseball and softball.  Clear communication with the athlete is key to understanding exactly what is going on and what steps should be taken.  I hope these tips help keep your athlete on the field and injury free. At Complete Game Physical Therapy, now with two locations in Tewksbury and Lowell, we specialize in the treatment of athletes and active individuals of all ages, particularly athletes that participate in overhead throwing sports.  If you have any questions, please contact us at 978-710-7204 or email at gcrossman@completegamept.com.