By Matt Bourdeau PT, DPT
Whenever I talk to youth baseball teams about injury prevention, unfortunately this topic resonates the most with the players who are also asking for my business card because they were “shut down” by their coach due to pain, decreased velocity, decreased command on the ball, or dead arm.
Fortunately, there is hope for these players. This is the window of opportunity for them to address the three main risk factors that lead to their decline: overuse, fatigue or lack of strength, and poor or worsening throwing mechanics. This post will highlight these factors behind youth pitching injuries, and how physical therapy can help players recover to increase their pitching velocity.
The Three Risk Factors Behind Youth Pitching Injuries
The throwing motion has enough force to dislocate the shoulder every time a player throws the ball hard. As a result, the muscles contract to protect the common structures we often have to rehab with youth baseball players, including the shoulder labrum, growth plate, spine, and the infamous Ulnar Collateral ligament of the elbow (also known as Tommy Johns injury). The more throwing per inning, game, season, or year without rest will lead to decreased performance of these supportive muscles. This results in repeated microtrauma to our musculoskeletal system—better known as overuse. Your physical therapist can educate you on proper rest and throwing volume to limit the effects of overuse.
Lack of Strength
Most youth athletes going through puberty tend to be lanky, skinny, and weak compared to post-pubertal athletes, making this a challenging time for their performance. It can also lead to a high rate of injury due to a lack of muscle mass and strength to protect their joints. The stronger we can make these athletes, the more healthy mass they can gain and the better they will move. This will also make them more durable in the long run and lead to improved performance. The key during this growth period in youth athletes is improving movement quality through neuromuscular training. Simply put, we are training the body to move more efficiently, which leads to improved athleticism.
More research continues to point to decreased performance and increased injury rates as a result of pitching under increased arm fatigue. This will alter the mechanics of your throwing and often times lead to timing issues during the throwing motion. If you don’t have the foundation to improve upon, your body will fail when it is under high demand. It is imperative that your physical therapist understands the biomechanics associated with the throwing motion in order to structure the rehabilitation process based on the sport specific demands.
How Physical Therapy Can Help
How could a physical therapist improve performance pitching velocity? Don’t physical therapists (PTs) just massage shoulders and stretch you out? PTs start with reducing the risk of an injury by addressing the above factors to make you a more durable athlete and able to perform throughout the season. In short, they help to improve players’ athleticism.
Teaching our youth baseball players to move better will help them build the foundation they need for optimal performance. Now yes, I know it is not that simple. Baseball is a very asymmetrical sport and the body will start to adapt posturally, muscularly, and in certain scenarios, structurally, but we need to keep a simple approach when working with youth athletes.
Movement quality has always been a foundation of our physical therapy industry. Once our athletes have mastered the appropriate hinging, double leg tasks, single leg tasks, rib positioning, breathing patterns, overhead positions, etc., then we can begin to load the system (strength training). Building strength on a dysfunctional system will only strengthen a dysfunctional pattern of movement. Building strength is key, but we must do this in a way that is specific to their sports’ demands.
It is important your physical therapist progresses through all phases of the performance/rehabilitation process, otherwise, premature return to sport will only set you up for another injury. So at the end of the day, if we can teach our youth athletes to move better and get stronger, then we have laid a foundation for athleticism which will allow for performance (velocity) gains.