Spring is here and many kids have returned to the baseball diamond. So what happens when you hear your young athlete complaining of elbow or shoulder pain only after a few practices? Just part of getting back into the "swing" of things, right? Beware that this may not be the case! 

Shoulder and Elbow Injuries

Shoulder and elbow injuries in the pediatric and adolescent population are increasingly prevalent due to the competitive nature of today's youth population. According to a recent position statement by the National Athletic Trainer's Association, overuse or repetitive trauma injuries represent approximately 50% of all pediatric sports-related injuries. Listed below are a few tips on how to monitor and prevent debilitating elbow and should issues in the overhead throwing athlete. 

Prevention is key! It is best of ease back into the activity. 

When returning to throwing after a break, it is important to ease back into the activity. A general rule of thumb, is to increase throwing by 10% each week to avoid overload to the arm. A pitcher should not throw for more than 8 months out of the year with a limit of 80 pitches per outing. Additionally, a thorough exercise program for shoulder range of motion, entire body strengthening emphasizing the core and lower extremities, and coordination/neuromuscular proprioception for the shoulder and legs should be incorporated pre-season and also performed throughout the season as well. 

Education

Athletes, coaches, and parents should be educated of overuse injuries. Risk factors that are most common include:

1. Elbow or shoulder pain with throwing
2. Fatigue 
3. Decreased performance including accuracy and velocity 
4. Need to use anti-inflammatories prior to pitching 

Rest

Dependent of how many pitches were thrown at game speed, rest is adjusted accordingly ranging from 1-4 days until the overhead throwing athlete should return to game speed throwing. Ask your physical therapist or athletic trainer for more information. 

Common Injuries

1. Little Leaguer's Elbow-Pain near the underside of the elbow with throwing and tenderness to the area with pressure.
2. Little Leaguer's Shoulder- Injury to the growth plate of the upper arm due to repetitive twisting motions associated with throwing. 
3. Posterior Impingement- Pain in the back of the shoulder during the late phase of cocking (when the arm is up and out to the side) right before the acceleration phase.  

Screening

If you are experiencing or know someone who consistently complains of elbow and shoulder pain during or after throwing, contact your physical therapist. A quick screen may help save your season. Your physical therapist can monitor your activity levels including pitch counts and address musculoskeletal deficiencies to allow you to stay in the game.