Preventing Overhead Throwing Injuries in Youth Athletes

Youth athletes can be especially prone to certain types of injuries due to their still-maturing muscular and skeletal systems. This can be a particular concern with repeated motions leading to overuse injuries.

Youth baseball players, for instance, are at a greater risk for shoulder and elbow injuries from repeated overhead throwing motions. Although it is impossible to prevent all sports injuries, there are some steps that young athletes can take to lower their risk of an upper extremity injury, explain University Hospitals physical therapists Tyler Stephenson, PT, DPT, CSCS, and Michael Mirando, PT, DPT, OCS.

What Causes Shoulder and Elbow Injuries in Young Athletes?

There are several areas that should be considered when addressing overhead throwing risk and injury prevention:

Rotator cuff and shoulder blade strength: The rotator cuff and scapular musculature plays an important role in stability and control of the shoulder. Weakness in these muscles can lead to poor throwing mechanics, which can put stress on both the shoulder and the elbow. These muscles are often underdeveloped in youth baseball athletes and lack the strength and endurance to meet the demands of the throwing motion.

Mobility: Young athletes are often experiencing periods of rapid bone growth and development, which can result in muscular tightness or restriction. When there is a limitation in mobility of one region of the body, movement patterns can develop to compensate.

Core and leg strength: The role that the core and legs plays in the throwing motion should not be overlooked. In order for optimal transfer of energy to occur when throwing, the lower and upper extremities must be linked. This is often a challenge for the adolescent athlete due to poor core, hip, and leg strength or control.

Exercises for Preventing Shoulder and Elbow Injuries

Youth players can follow exercise programs such as the Thrower’s Ten to help strengthen the major muscles used in throwing and pitching and help prevent injuries. Exercises should be performed at least twice per week, and performing exercises prior to participation in sport can be a helpful warmup.

Download Exercise Program: Overhead Injury Prevention [PDF]

Exercises that challenge specifically the “posterior chain” musculature – which includes the gluteal, hamstring, and back muscles – can be effective in improving strength and control of the core and legs. In addition, exercises that incorporate single leg and balance activities can help prepare the athlete for the demands of sport. To target mobility challenges, some areas to focus on could include thoracic spine (mid-back) and posterior shoulder musculature (back of the shoulder).

Other Ways to Prevent Upper Extremity Injuries

Some other guidelines youth baseball players and coaches should follow to help prevent shoulder and elbow injuries include:

• Strictly adhere to pitch count and rest day protocols
• Work on proper throwing techniques and mechanics
• Warm up and cool down before and after play or practice
• Do not push through pain – if an injury is suspected, stop play to assess

Related Links

The pediatric sports medicine experts at University Hospitals Rainbow Babies & Children’s is dedicated to treating athletes of any age – from toddlers through adolescence and teenagers or young adults.