Injury Prevention in Baseball
Baseball. America’s national pastime.
One of the most popular sports in the country, and as you very well know, also one of the most exciting.
Then when we consider that most high-level baseball athletes can throw a ball at more than 100 miles per hour (and most can also hit a ball moving at that unbelievable speed), it quickly becomes apparent that it is one of the most physically demanding.
Unfortunately, these impressive feats aren’t without risk – in fact, baseball injuries are some of the most common sporting injuries in the country.
What are the sports-specific injuries that affect baseball athletes?
Given the unique nature of the game, baseball athletes are predisposed to several key injuries that rarely appear in other sports. With this in mind, you don’t often see too many hamstring strains in baseball (Conte, 2016).
In fact, the most common injuries are as follows:
- Shoulder (20.6%)
- Elbow (19.6%)
- Back and spine (13.7%)
- Wrist, hands, and fingers (10.1%)
- Lower leg and knee (9.8%)
- Upper leg and thigh (9.5%)
Within this, it is important to note that the most common individual injury is the dreaded medial ulnar collateral ligament (MUCL) injury – which often results in the need for reconstructive surgery of the elbow, leading to a huge amount of time lost from the sport.
Many would argue that this is, in fact, the worst of all sport-specific injuries in baseball.
Making the matter even worse is the fact that it is an overuse injury, meaning that in some capacity, it is preventable.
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What are the risk factors for baseball injuries?
First and foremost, those most commonly injured in baseball are pitchers – which explains why elbow and shoulder injuries are the most common.
As such, simply being a pitcher could very well be considered the biggest risk factor for getting a baseball injury.
However, there are certainly a few other risk factors that require consideration here.
These risk factors include (Olsen, 2006; Melugin, 2018):
- Overuse: the pitching motion places an incredible amount of load through both the shoulder and the elbow joint. If this isn’t monitored appropriately, and too many balls are thrown in too short amount of time, injury risk increases drastically.
- Arm fatigue: somewhat different to the above, arm fatigue refers to the immediate fatigue caused during a single training session, or during a single game. The accumulation of excessive fatigue alters throwing mechanics, which can cause a sharp increase in injury risk.
- High pitch velocity: individuals who throw at a faster velocity appear to be at a greater risk of injury. This is because the faster the ball is thrown, the more torque that goes through the elbow joint. This increase in torque places further stress on the joint.
- Travel: when players travel interstate for games, they appear to be at a greater risk of injury than when playing at home.
- Early maturity: in youth games, those children who are more physically mature tend to get overused in more prominent positions (such as the pitcher). This significantly increases their risk of injury.
- Poor strength: a lack of muscle strength within the trunk and shoulder can impair your ability to produce and absorb force efficiently. In this scenario, more load is distributed through the passive structures that make up the joint, which can increase the risk of a joint injury occurring.
- Lack of flexibility: finally, a lack of flexibility and reduced joint range of motion has been shown to result in poor throwing mechanics, which can also contribute to heightened injury risk.
While a large number of risk factors may seem like a negative, they should actually be viewed as a positive – as having the knowledge as to what causes injury, means we also have the knowledge on how to prevent it.
How to prevent baseball injuries
So, how to prevent baseball injuries?
Using the above information, we can take some very simple steps to immediately lower the risk of a baseball injury occurring at any level (Fleisig, 2012).
First and foremost, players should not pitch for more than 8 months of the year. This means taking a full 4 months off from pitching during the offseason to reduce the risk of an overuse injury occurring.
Additionally, pitch counts should always be implemented throughout the season to ensure that an individual is not throwing too often, and that arm fatigue is not present within the timeframe of an individual game.
Pitching technique should be developed appropriately, as this ensures an improvement in throwing efficiency. This will subsequently reduce the load distributed through the passive structures of the joints, which reduces the risk of those joints becoming injured.
And somewhat obviously, in the presence of arm pain, pitching should cease, and a physician should be contacted immediately. This will ensure early detection of what could potentially become a serious injury if left unaddressed.
Lastly, we can also focus on exercise that improves strength and flexibility, which is paramount in any baseball injury prevention program (Sakata, 2018).
A great research group has recently developed a new program known as the Yokohama Baseball-9 program (or YKB-9, for short) that has been designed with this intent. This amazing program consists of 9 key strengthening exercises, and 9 key stretching exercises, that can be used 2-3 times per week.
Now here’s the kicker – using this program for as little as three months has been shown to reduce injury rates by up to 50% – which is unreal.
I have also outlined the key principles of the program below.
Exercises to prevent baseball injuries
Exercises to prevent baseball injuries should prioritize:
- Strengthening the muscles of the rotator cuff
- Improving scapular function
- Enhancing posture
- Improving lower limb balance and rotational coordination.
Some of the best exercises to do this are external rotation isolation exercises, upper back strengthening exercises (think rows and prone trap raises), push-ups, trunk rotation exercises, and single leg jumps and bounds.
Stretching to prevent baseball injuries
Stretches to prevent baseball injuries should prioritize:
- Improving the elbow range of motion
- Enhancing the shoulder range of motion
- Increasing flexibility of the hip musculature
- Enhancing posture
Some of the best exercises to achieve this include massage of the elbow musculature. Additionally, you can add wrist muscle stretching, deltoid stretches, the sleeper stretch, half kneeling hip flexor stretches, and gluteal stretches.
What to do when an injury happens?
We now have a very good idea of what is required to maximize injury prevention. However, it would be unrealistic to think that this will completely stop injuries from occurring.
After all, baseball is an extremely challenging game, and injuries will occur. We just want to mitigate the risk of them occurring as much as possible.
So, what should we do when an injury happens?
Well, the good news is that the process should be the same if an injury occurs in youth baseball, high school baseball, college baseball, or even pro baseball.
An injury disclaimer
First and foremost, get checked out by a physician. No matter how severe (or how minor) you believe the injury to be, seeking professional advice should be your first point of call. This ultimately ensures that you will not worsen the injury
Related Article: The Benefits of Sports Variation
Injury phases and approaches
I’ll touch on the recommended process of treating a shoulder or elbow injury that has just occurred.
In this scenario, it is assumed that the physician has not recommended surgery (Stone, 2018).
- Phase 1 (immediately after the injury has occurred): reduce inflammation through the use of cold exposure, and evaluate the range of motion. During this period, it is OK to undertake very gentle stretching. Some light strengthening exercises will also to ensure that the muscles of the shoulder do not get weaker.
- Phase 2 (once pain and inflammation has diminished): start to focus on developing postural strength, and improving the strength of the rotator cuff. Improve range of motion at the shoulder and elbow through stretching and mobility exercises.
- Phase 3 (athlete has a full range of motion and strength levels have returned to baseline): initiate more aggressive strengthening drills. Begin to integrate more power based medicine ball exercises into training. Begin incorporating heavy lower body strength training, and core muscle endurance training.
- Phase 4 (strength and flexibility are better than pre-injury levels): return to sport and fully functional training.
This example very much revolves around how you should act when a shoulder or elbow injury occurs. The same methodology can be applied to any type of injury. The key is to be conservative in your approach. We want to make sure the athlete returns to play stronger than when they got injured.
This will greatly reduce the risk of getting injured in the long run!
Take Home Message
When it comes to the upper body, baseball is one of the most demanding sports on the planet. Hence the reason that it tends to have an absurdly high rate of shoulder and elbow injuries at every level of competition.
However, it doesn’t have to be this way.
By using some of the prevention strategies outlined in this article, you can keep baseball injuries to a minimum. It is obviously integral for success!
Conte, Stan, Christopher L. Camp, and Joshua S. Dines. “Injury trends in Major League Baseball over 18 seasons: 1998-2015.” Am J Orthop 45.3 (2016): 116-123.
Olsen, Samuel J., et al. “Risk factors for shoulder and elbow injuries in adolescent baseball pitchers.” The American journal of sports medicine 34.6 (2006): 905-912.
Melugin, Heath P., et al. “Injury prevention in baseball: from youth to the pros.” Current reviews in musculoskeletal medicine 11.1 (2018): 26-34.
Fleisig, Glenn S., and James R. Andrews. “Prevention of elbow injuries in youth baseball pitchers.” Sports health 4.5 (2012): 419-424.
Sakata, Jun, et al. “Efficacy of a prevention program for medial elbow injuries in youth baseball players.”. The American journal of sports medicine 46.2 (2018): 460-469.
Stone, Michael A., et al. “Nonoperative treatment for injuries to the in-season throwing shoulder: a current concepts review with clinical commentary.”. International journal of sports physical therapy 13.2 (2018): 306.
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