Baseball Injuries: A Guide
This content was updated for accuracy and relevance on Oct 10, 2023
Baseball season is starting back up, and as America’s favorite pastime, it’s very likely you are gearing up for another long season. With long seasons come plenty of opportunities for injuries, and baseball is not new to sports injuries. Every baseball player should be aware of the various common baseball injuries that can occur as a result of overuse, inadequate training, and poor recovery and rest techniques.
What are the most common baseball injuries?
Any baseball player knows the toll it can take on the shoulders and has most likely experienced a shoulder injury or two. Here are a few common shoulder injury types:
- Rotator cuff tears: These are common injuries for baseball players at any position but are most common in baseball pitchers due to the high velocity and repetitiveness of practicing different pitches. Known as an overuse injury, rotator cuff tears develop over a period of time. In a rotator cuff tear, players typically report pain at the back or top of the shoulder, typically at the “cocking phase” or “deceleration/follow-through phase.”
- Labral tears: Think of the labrum as a structure that helps keep the shoulder socket tight, kind of like an O-ring on a valve creating a suction seal. When there is damage to this structure, it can cause shoulder pain, weakness, loss of power, or feelings of instability. Players typically experience deep pain in the shoulder at the “cocking phase.” A labral tear can be diagnosed by a physical therapist or by a sports medicine doctor. Depending on the player’s goals and extent of the injury, it may require orthopedic surgery, but in most cases can be managed by physical therapy and rest.
- Biceps tendinopathy: This is a fancy term for irritation and inflammation at the biceps tendon, which is located at the front of the shoulder. Oftentimes, pain in this region indicates that something else in the shoulder, whether it be the rotator cuff, the labrum, or instability in the shoulder, is the underlying problem. The biceps tendon is oftentimes compensating for that underlying injury and causing pain. You and your physical therapist can work together to pinpoint what the underlying problem may be and how to alleviate this pain and address this injury.
- Shoulder instability: This injury is common in baseball players due to the excessive rotation their arm is required to go through during a throw. This excessive range is what gives throwers the ability to throw fast and hard. However, this excessive range necessitates the athlete to be strong and stable throughout the entirety of this bigger range of motion. Inadequate training for this will lead to pain, weakness, loss of power, and loss of precision with throwing. Physical therapy may help the athlete by identifying what exercises should be incorporated into their training to ensure this good strength and stability, but sometimes, simply resting the shoulder is the best course of action.
Another common injury from baseball is an elbow injury. The elbow joint can often brunt the force the athlete is generating as they throw. Elbow injuries such as ulnar collateral ligament (UCL) injuries, “little league elbow,” or elbow tendinopathies are common and present as pain in the elbow that worsens with throwing, typically experienced at the “acceleration phase.”
Rest is often prescribed for an elbow injury and identifying weaknesses or altered mechanics at other joints such as the shoulder, spine, or hips is often necessary to resolve this pain. If there is a tear at the UCL, surgery may be indicated with a procedure known as Tommy John Surgery.
What is the most common pitching injury?
The most common injury a pitcher may experience is a rotator cuff tear. As an overuse injury, this injury develops over a period of time in which the athlete causes microtears or degeneration at the rotator cuff muscles from repetitive throwing throughout the baseball season. Think of tears or degeneration at the rotator cuff as the wearing out of an old towel – a small hole or thinning occurs at a particular spot where it’s been used a lot. It is not like a tear or rip in a piece of paper. Like a labral tear, a rotator cuff injury can be diagnosed by a physical therapist through their clinical evaluation or by a sports medicine doctor with the additional support of imaging. Depending on the severity of the tear, it may require orthopedic surgery, but in most cases, a rotator cuff injury it can be managed by physical therapy and rest.
How can baseball players prevent throwing injuries?
The key to any injury prevention program includes strength, endurance, and good mechanics of all joints and muscle groups.
For baseball, this centers mainly around the shoulder, but also includes the elbow, trunk, and knees. A physical therapist who is knowledgeable about baseball and who can take a complete inventory of the athlete to identify any altered mechanics that could be causing excessive force, tension, or pain at another region, is key to learning how to prevent throwing injuries.
Key components to preventing throwing injuries include:
- Establishing a proper warm-up and cool-down
- Taking adequate rest days
- Staying within pitch count recommendations
- Taking time off from the sport during the off-season; take this time to instead work on skills and techniques of different body regions
How are baseball injuries treated?
The first step of treating any baseball injury is the quick and accurate identification of the underlying cause which can be done by a sports medicine doctor or your physical therapist. Once a better understanding of the injury is pinned down, an individualized rehabilitation plan can be established between you, your doctor, and your physical therapist. Oftentimes physical therapy is all that is needed.
Typical treatments may include:
- Modifications to practices and games
- Mobility work
- Strengthening exercises for the shoulder, shoulder blades, rotator cuff, and core
- Massage, ice, or over-the-counter pain medications to address inflammation
- In most severe cases, surgery may be the choice of treatment which may include pre-habilitation and additional physical therapy post-surgery
How can physical therapy help?
Addressing the pain or discomfort is important for treating any type of sports injury. Whether or not you’ve seen a doctor for your baseball injury, consulting your physical therapist and undergoing rehabilitation physical therapy is a great step to take in managing any sports injury and getting back on the field playing the sport you love. Your physical therapist will help you outline exactly what needs to be done in the short- and long-term. They have the skills and knowledge to directly help you with any of the treatments listed above, can help you navigate what can oftentimes be a very scary and unfamiliar experience of surgery and doctor’s visits, and help guide you through the rehabilitation and recovery process. Furthermore, they have the expertise to assess any potential underlying problems that could have led to your current injury. You and your physical therapist can then develop a plan for injury prevention and make sure your whole body is ready to go when you are ready to get back on the field.
Article By: Anne Diaz-Arrastia, PT, DPT, OCS
Anne Diaz-Arrastia, PT, DPT, OCS began her physical therapy career 4 years ago. Anne loves working with the active sports population and believes in the importance of providing individualized care that is specific to the activity and sport her patients love. She currently specializes in sports, orthopedics, vestibular, and concussion management. Anne enjoys working with patients of all activity levels and ages to help them reach their goals of living life just the way they envision. She currently treats patients at The Training Room in Haddonfield, NJ.
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