Pitch counts and rest day requirements exist for a reason in Little League Baseball. Between a player’s motivation to excel and a coach’s motivation to win the games, it’s easy to overwork an athlete’s pitching arm.
Major League Baseball coaches and players don’t have to adhere to any throwing guidelines. However, the pitch counts are still closely monitored. Injuries to the shoulder, elbow, and wrist are particularly common in pitchers at all levels of play.
David Lintner, MD — a world-renowned sports medicine specialist — is the head team physician for the Houston Astros, where he treats injuries of all kinds, including baseball throwing injuries. At our Houston Methodist Orthopedics & Sports Medicine clinic in Houston, Texas, Dr. Lintner recommends against throwing if you’re in pain.
Generally, Dr. Lintner starts with the most supportive and least invasive therapies for baseball throwing injuries and other sports-related injuries. These may include:
If your injuries don’t respond to these first-line treatments, surgery may be necessary.
Do you have a baseball-throwing injury? The following are a few of the most common injuries and their treatment options.
When you throw, your ulnar and humerus bones strike against each other, which can wear away the cartilage that protects them. Then, your body may try to compensate for the loss of cartilage by creating abnormal protrusions of bone called bone spurs.
Dr. Lintner may use minimally invasive arthroscopic surgery to remove the bone spurs.Many throwers can avoid surgery by calming down the irritated joint with NSAID medications or occasionally a cortisone injection.
When your muscles and supporting tissues are strong and flexible, they take the brunt of the shock from the force of your throw. However, as you throw more and more, your growth plates may be stressed, leading to a stress fracture through the growth plate. This is more common if you recently had a growth spurt.
This is sometimes called “Little League Elbow” or “Little League Shoulder”. You may need to rest your arm while your stress fractures heal with the aid of bracing and rehab. Only rarely do these problems need surgery, usually only if the bones have separated.
Rotator cuff injuries account for 45% of sport-related injuries in college baseball athletes. The rotator cuff is a set of tendons that help your shoulder joint stay stable as you exert great force on it during a throw. A significant rotator cuff tear can take you out of the game for an entire season. Most of the time, NSAID and appropriate exercises will suffice. See a video on DrLintner.com (https://www.youtube.com/watch?v=HUalow6s1X4) for Level 1 exercises, and https://www.youtube.com/watch?v=U6EyIlmEi7c for Level 2.
Dr. Lintner uses minimally invasive arthroscopic surgery to repair stretched or torn tendons in your rotator cuff. He may add PRP or mesenchymal cells from your body to accelerate healing. Iof surgery is needed.
Sprains and strains
Sprains and strains are common. Athletes are particularly prone to strains and sprains due to the tremendous forces and pressures on their bodies, particularly during throwing.
Sprains and strains can generally be handled with first-line supportive therapies, as outlined above. The RICE and MEAT protocols are beneficial.
However, you may need surgical repair if your tissues are completely severed or severely stretched. As always, Dr. Lintner uses minimally invasive techniques as well as biologic healing accelerants to help you recover and get back in the game ASAP.
Dr. Lintner has specific rehabilitation protocols to aid in baseball-throwing injury recovery. It’s important to work with a physical therapist during your rehab period and to follow the protocol, including taking the required rest days.
The first 4-6 weeks of the rehab protocol condition your arm to throw again. It’s important to continue other exercises recommended for your recovery as you undergo the rehab protocol. Your return-to-play varies by individual and by the type of injury and the repair techniques. General guidelines are:
It’s also important to first build throwing strength before switching to hitting. Impatience during recovery could lead to re-injury and may take you out of the game entirely.
Do you have a baseball-throwing injury? Find out how to repair and rehab your throwing arm so you can return to play by reaching out to our friendly and knowledgeable staff by phone or online form. If you live far from Houston, feel free to send Dr. Lintner an MRI for a treatment recommendation.
