It is finally Spring! The grass is turning green, the leaves are returning to the trees, and the spring sports activities are in full “swing.” Along with the season of growth and rebirth come injuries. During this time of year I receive a lot of questions regarding injuries in youth, teen and young adult baseball/softball athletes, coaches, and weekend warriors. Yes, even coaches that are throwing batting practice need help. Whether it be from a lack of movement/participation in activities during the winter, utilizing different muscles now, applying stresses to the body that have not been applied since last season or overtraining while preparing for the upcoming season. No matter the cause, you need a solution and you need it quickly in order to be able to participate during the championship portion of the season. Most individuals that I see have attempted to improve their symptoms with ice, heat, and/or stretching techniques while seeing at least one healthcare practitioner with no improvement. And even though there are many guidelines (pitch counts, days rest, etc) in place in an attempt to avoid overuse injuries, it is inevitable that injuries will still occur.
Soooooooo, “What can we do for you?”
Here are a few thoughts regarding the treatment of these individuals and how our Physical Therapists at King Physical Therapy & Fitness can help.
The area to investigate first is typically the shoulder, but as you read further this may not be the most important area to intervene. A total arc of motion is recommended to be able to achieve optimal mechanics. Rotator cuff strength is imperative and even a specific warm up is recommended from our therapist in order to be able to fully recruit and utilize the shoulder musculature immediately when throwing (Wilk 2009). A thorough evaluation will assess the integrity of the joint and associated ligaments and tendons. The shoulder blades (scapulae) play an extremely important role and strength here is imperative to maintain congruency in the shoulder joint and provide adequate support during extreme shoulder motions (Provencher 2014).
The medial elbow ligament (Ulnar collateral ligament, aka “Tommy John” injury) may be involved in overuse injuries and may require a rest period if it is not taken care of immediately at the onset. By evaluating motion and strength throughout the body a full program can be initiated to reduce stress through this area.
The Hips, Lower Body, and Core
This is the area that may be able to make to the most impact for prevention and recovery in all athletes and specifically in this case throwing athletes. Limited hip motion and strength may be associated with an increased risk of shoulder injuries in throwing athletes (Scher et al. 2010). Hip, core, and lower body motion and strength causes increased stress on the shoulder (Kibler 2006) and limited hip flexor flexibility and weakness in hip abduction was seen in 49% of arthroscopic labral tears (Burkhart 2000). Needless to say interventions to improve these areas is crucial.
Do not let your pain linger and seek help immediately. Did you know that you can see your Physical Therapist without a referral? Did you also know that even if your insurance is Out-of-Network you can still seek care with us out of pocket? Call for more details.