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Softball Pitchers: Injury Prevention Strategies

Softball pitcher winding up to throwLittle League baseball has made great strides in reducing arm injuries but little has been done to help softball pitchers avoid the same fate.

Decades ago, concerns about rotator cuff injuries to softball pitchers were largely dismissed out a belief that the mechanics of pitching a softball were so different from pitching a baseball that there was essentially no limit to the number of throws a softball pitcher could make without significant risk of injury.

As is true in most sports these days, softball pitchers are training - or over-training - more than ever, and more and more are playing the sports all year long without a break.  Softball teams may carry only a couple of pitchers, which sometimes results in a pitcher throwing over 1,000 pitches during a weekend tournament!  While there hasn't been an epidemic of rotator cuff injuries, other problems to the shoulder and elbow have surfaced with increased play.

So why should there be guidelines for softball pitchers? This article guides a brief history of the problem, common injuries, and reasonable solutions to reduce risk.

Lack of Research in Softball Pitching

Most softball pitching recommendations have been extrapolated from baseball research. While both are repetitive throwing positions, there are some differences coaches and parents should be aware of:

  • Working harder to throw: Softball pitchers do not have the benefit of a mound to generate velocity. The landing leg undergoes a great deal of stress transmitting energy from the ground into the ball. This increases exposure of the landing hip and knee to "wear and tear injuries" such as early onset arthritis.
  • Gravity helps and hurts: After releasing a softball, the arm continues to move upward, allowing the affects of gravity to decelerate the arm. While the benefits to the rotator cuff are significant, the downward force of an accelerating arm puts tremendous stress on shoulder ligaments. When exhausted, pitchers will rely heavily on these ligaments for support, increasing the risk of overstretching the shoulder capsule and permanently decreasing stability with all activities.
  • Able to throw through fatigue - The softball pitching motion does not fatigue throwing and stabilizing muscles as fast as baseball, therefore, pitchers can throw much more. Pitchers spend far more time throwing and considerable less time resting and conditioning. This leads to overuse injuries that do not show up until an athlete is well into her 20s and early 30s. With pitchers sometimes throwing 10x more pitches week to week than baseball, the body falls victim to overuse.
  • Riseballs and sliders - Riseballs affect the elbow in a way similar to a baseball slider. The position of the elbow during release puts considerable stress on the inside and outside of the elbow joint. While pitchers may experience less UCL tears (Tommy John Surgery) the mechanical loading wears away cartilage and bone, increasing risk for elbow impingement, arthritis, and risk to nervous tissues that pass through the elbow.

Baseball pitch limits won't work

Guidelines for softball pitching have mirrored the rules for Little League baseball. As youth baseball has struggled to incorporate more pitchers onto each team, the challenge is more difficult in softball. Softball teams often center around 1 or 2 pitchers that throw almost every day. Adhering to pitch counts would mean more than half the players would have to pitch regularly. Furthermore, softball pitchers have more stamina than baseball. Even the most stellar young baseball pitcher with the opportunity to throw everyday will eventually have to rest due to arm fatigue. Softball is different. Developed pitchers can throw hundreds of pitches without breaking a sweat. The combination of athletes that seem fine and the difficulty of instructing every player to pitch regularly makes Little League guidelines very difficult to follow, therefore, they are often ignored.

Injury prevention strategies

Parents and coaches face some serious challenges with softball pitchers. The normal signs of distress or fatigue are difficult to recognize and respond to appropriately. The loss of a single pitcher could have a devastating effect on a entire team, with the result being that warning signs may be overlooked when championships are on the line.

Here are a few reasonable suggestions to reduce the risk without overhauling the current standards of play: 

  • Use more pitchers  - Having at least four pitchers on a softball team who pitch regularly will cut down the workload tremendously, compared to teams that carry only two.   While initially difficult, this strategy will immediately reduce the pressure on young arms. Also, cutting down the number and concentration of games (example - 10 games played over single weekend) would be helpful.
  • If pitch more, practice less - Some pitchers may throw over a 1,000 pitches during a weekend tournament,  not including warm-ups before games, between innings, and, in some cases, after the game (to correct flaws in mechanics). This is not smart! If a young athlete has 3 or 4 games in a week, there should be no throwing between games. While developed pitchers fatigue less often, healing still needs to occur, and healing takes rest! 
  • Throw riseballs sparingly - This advice is similar to recommendation for throwing a slider in baseball. Throwing this pitch every third toss (plus staying up all night to practice)  increases wear and tear on the arm. Try to limit this pitch to less than 10% of all throws.
  • Take a season off - Similar to baseball, there should be 2-3 months a year (in a row) where there is no throwing. Taking softball pitching indoors is easy during winter months, but rest is still necessary. For injured or overused body parts to heal adequately from a long spring through fall, time is necessary for repair.
  • Condition the lower body  - Softball pitchers put a tremendous stress on the landing knee and hip. Proper strengthening of core, hip, and leg muscles will ensure that proper body mechanics are maintained and less rotating forces are placed on the knee and back.
  • Pay attention to warning signs - A young pitcher who has no complaints after throwing 3 games in a row, but complains about pain while sleeping, or has difficulty reaching her arm over her head is raising a red flag. Just like baseball, softball pitchers want to take the mound every game. They are not likely to come out and say "I am hurting." Look  for warning signs like holding the arm, weakness when carrying heavy objects, or complaints of funny sensations in the hand. 

Keith Cronin is a physical therapist in the St. Louis area and a MomsTeam expert.   

Created October 25, 2010, updated January 4, 2012