Important pitching limits and rest days for young pitchers – ThedaCare


ThedaCare physical therapist explains how to help prevent muscle weakness and overuse injuries

With recent health studies indicating that more than 50% of youth sports injuries are related to muscle overuse, it’s important for parents and coaches to know how much young softball and baseball players engage in throwing and throwing activities.

“Muscle overuse and weakness is the leading cause of many injuries we treat in young athletes,” said Aaron Nelson, PT, DPT, CMTPT, physical therapist at ThedaCare Orthopedic Care. “Many injuries result from weakness in the muscles of the shoulder girdle/shoulder blade and insufficient stability of the muscles near the spine to support the high-level task of dynamic overhand or underhand throwing.”

He noted that many parts of the body are involved in throwing and throwing, including the athlete’s arm, shoulder, spinal support muscles, neck, hips and knees.

According to the National Institutes of Health (NIH), the prevalence of injuries (among young people) can be attributed to the combination of an underdeveloped musculoskeletal system, increased participation in competitive sports to a younger age and increased duration and intensity of training.

Some of the most common injuries affecting young players include:

  • Growth plate injuries
  • Shoulder pain or “Little League Shoulder”
  • Rotator cuff problems
  • Ulnar collateral ligament injuries (little league elbow)

Nelson observed that many children play multiple sports, while others may focus on a specific activity.

“Those who play multiple sports may not have the opportunity to participate in open gyms or other activities to prepare their arms for throwing,” Nelson said. “While athletes focusing on a sport like baseball or softball, may need general body toning in addition to preparing their arms for pitching.”

He noted that it’s not just pitchers who can sustain pitching injuries.

“All of an athlete’s throws should be considered part of the ‘throw count,'” he said. “What is helpful is the development of wearable technology that is now available that keeps track of throwing activity. These are being used more often.

Nelson recommended the Pitch Smart program ( as a guideline on how often and for how long young people of different ages should throw pitches. If children are playing on multiple teams, their parents/guardians should keep track of their overall throwing activity.

Nelson also cautioned that it’s important to consider all the throws a player can make.

“Especially in Little League games, kids can play all over the field,” he explained. “They can pitch for a while and then play in the infield or outfield. Even the throws they make before the game or during different drills during practices should be factored into the throw count to determine when they need a day off.

Injury Prevention

As with most sports, a good warm-up before a game is essential, and Nelson advises a full-body warm-up for softball and baseball.

“A pre-game warm-up should include light jogging, lateral movements, high kneeling, core rotation and upper limb strengthening to get blood flowing to all muscles,” he said. declared. “There are also programs to help kids prepare their arms for throwing. The exercises target the muscle groups in the shoulders and arms that tend to be weak, including the smaller muscles that otherwise might not train well.

He added that improving throwing also requires strengthening activities.

“We started adding weighted balls to our exercise program for pitchers, starting small with 100 grams (100g), working up to 1000g for youth, 2000g for high school and l college, adding weight as their strength increases,” he said. “We want to make sure kids focus on the small muscles in their arms and shoulders. If we add weight too quickly, the large muscle groups tend to take over and the small muscles don’t get the workout they need.

Nelson also stressed the importance of rest and good nutrition, including drinking plenty of fluids, for young athletes. He noted the recommendation that young athletes rest at least one day a week without games or practice.

It’s time to see a doctor

If an athlete is having trouble with their mechanics, they can seek help from a physical therapist who specializes in athletic training, making them a good resource. Any time an athlete experiences sharp pain while throwing, it’s time to seek medical attention.

“There shouldn’t be any pain with the throw, whether it’s in the neck, shoulder, elbow, forearm or back,” he said. “The pain is not normal; muscle pain is normal, but pain should be checked.

Next, he advised if parents and coaches notice any changes in a child’s throwing mechanics, they should talk to them about what they are experiencing.

“Maybe they’re not throwing across the infield like they did, or having a harder time throwing throws than they normally can or it seems like they’re changing their mechanics for no reason. known,” he said. “It’s an indication that there may be a problem. Often children do not want to admit that there is a problem for fear of not being able to continue playing. As parents, we tend to know our children better, so when we see different behaviors or mechanisms, we should ask ourselves why.

Nelson said ignoring a problem usually only makes it worse and often ends up involving other areas of the body.

“Maybe the problem started as elbow pain because the shoulder had some weakness, but now their neck and back are involved because they compensated for the way they threw,” he said. -he explains. “If we address the original problem early, maybe we can fix their problem and get them playing while improving their symptoms at the same time. It is likely that the longer we wait to resolve a problem, the longer the treatment plan will take because there is more involvement.

Future Prospects: ThedaCare Medical Center – Orthopedics, Spine and Pain

Nelson is looking forward to the new ThedaCare Medical Center – Orthopaedics, Spine and Pain, which is expected to open soon. It will be the only comprehensive health center in the region specializing in orthopedic, spine and pain care. The 230,000 square foot center includes a medical office building, a specialty surgery center and an orthopedic and spinal hospital with 25 inpatient beds, as well as support services, such as imaging, laboratory, pharmacy retail and foodservice, for all patient care at one destination.

The services offered will improve access to specialist experts, where care teams understand each person’s medical history, lifestyle and personal goals, enabling patients to return to a better life, sooner, including young people. who could sustain a throwing injury.

“At the new center, our therapy facilities will include a regulation pitching mound, grass area and extended net so we can focus on throwing and batting mechanics,” he said. “We can create videos of an athlete’s technique, which we can slow down, and then discuss areas of opportunity for improvement. New technology will help us provide better care for our athletes and patients.

Among the many unique features of ThedaCare Medical Center – orthopedics, spine and pain, our patients will benefit from operating theaters equipped with the latest technology, private recovery rooms and state-of-the-art physiotherapy equipment and facilities. The new facility will provide patients with access to even more integrated care. From initial consultation to surgery, recovery and rehabilitation, everything will be available on the new site, making treatment even more comprehensive and convenient for patients.

ThedaCare Medical Center – Orthopaedics, Spine and Pain is scheduled to open in the summer of 2022.

About ThedaCare

For more than 110 years, ThedaCare® has been committed to improving the health of the communities it serves in northeastern and central Wisconsin. The organization provides care to more than 600,000 residents in 18 counties and employs around 7,000 healthcare professionals. ThedaCare has 180 points of care, including seven hospitals. As an organization committed to being a leader in population health, team members are dedicated to empowering people to live their best lives through easy access to individualized care, supporting the health and well-being of everyone. ThedaCare also partners with communities to understand unique needs, find solutions together, and drive health awareness and action. ThedaCare is the first in Wisconsin to be a Mayo Clinic Care

Member of the network, giving specialists the opportunity to consult with Mayo Clinic experts about a patient’s care. ThedaCare is a not-for-profit healthcare system with a Level II trauma center, comprehensive cancer, stroke and cardiac treatment programs, and primary care.


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