3 Factors that Contribute to Arm Injuries in Softball Players

Written on December 4, 2016 at 7:31 am, by Eric Cressey

Today's guest post comes from Cressey Sports Performance coach, Nancy Newell. Nancy is a rock star when it comes to working with our softball players, and today you'll see why. Enjoy! - EC

The conventional belief in fast-pitch softball has been that the underhand throwing motion places minimal stress on the shoulder and pitching-related injuries are therefore rare. As such, unlike its baseball counterparts, the Amateur Softball Association (ASA) has zero pitching regulations in place to monitor pitches thrown per game, innings played, rest between appearances, and number of required pitchers per team. This mindset puts these young athletes at a higher risk of injury. Here’s why:

1) Significant forces and torques are experienced at the shoulder and elbow.

It’s true the forces and torques experienced at the shoulder for females do not match the forces produced with overhand pitching in males. Males typically have bigger frames (height x weight) and muscle mass to produce higher forces than their female counterparts, so we should expect to see higher forces in males verse females. However, the forces produced by females relative to their height and weight are significant enough to cause injury to their bodies over time.

During the deceleration phase, baseball pitchers create forces at the shoulder measured as high as 108% of body weight in professional pitchers. Softball pitchers on the other hand have to resist glenohumeral distraction forces of up to 80-94% of bodyweight while also controlling a maximum internal rotation torque velocity greater than 5,000 degrees per second. The combination of high rotational forces at the shoulder and elbow place a stressful workload on the biceps tendon, pectoralis major, and subscapularis to resist internal rotation and forward translation of the humerus along with pronation of the forearm. Consequently, Shanley et al. noted up to 80% of all girls playing high school softball reported having shoulder injuries (discomfort, pain, or strains). Barrentine et al. (college pitchers) and Werner et al. (youth pitchers) both demonstrated that compression forces needed to resist distraction at the shoulder were close to 1x body weight.  Furthermore, the Werner group noted, "Excessive distraction stress and joint torques at the throwing-arm elbow and shoulder are similar to those found in baseball pitchers."

Note from EC: as an interesting aside, another study from the Werner group demonstrated shoulder stress almost 20% lower in elite (Olympic) softball pitchers even though their velocity was significantly (5mph) higher. This parallels what we see in high-level baseball pitchers; the best athletes out there find more efficient ways to pitch, and understand how to effectively distribute stress across multiple joints. They're also generally stronger, and therefore able to tolerate higher training and competition loads. This is just a friendly reminder that your untrained 14-year-old isn't highly trained, biomechanically efficient, or skeletally mature.

2) Pitch counts are extremely high.
 
Young female athletes are now specializing in softball year round and playing at least 52 and sometimes upwards of 72 games per year. These athletes play for their high school team (12 games); participate in summer ball or tournament play which have around six 3-day showcases with up to nine games per tournament (30-54 games); fall ball (10 games); then attend numerous winter clinics.

A 2016 Lear et al. study helped shed some much needed light on daunting pitch count numbers being thrown by young women. It has been reported that high school softball pitchers may average about 99 pitches over 5 innings of work. Lear additionally stated, “In tournament play, youth players may throw every game of a weekend tournament, reaching upwards of 1,200 pitches in a 3-day event.”

Dr. James Andrews, a renowned orthopedic surgeon and authority on the topic of throwing injuries, had this to say in his 2013 writing of Any Given Monday: “There is a common belief that the throwing underhand is a natural way to keep a player safe from injury, but this is definitely not true. The repeated movement and velocity of pitches thrown, even in the windmill style, are now even tearing the ‘Tommy John ligament,’ resulting in a UCL injury. Pitching limits matter in softball as much as they do in baseball.”

3) Kids are lacking in the strength and conditioning department.
 
Compounding these issues is the fact that many young athletes do not get exposed to strength training until their freshman year of college, resulting in poor rotator cuff strength, scapular control, and a lack of both muscular and kinesthetic awareness. These factors, coupled with kids spending less time outdoors and more time on their couch absorbed in a digital reality, is not helping the situation either. Just to put this in perspective, WebMD noted that 85% of kids aged 14-17 own cell phones and spend an average of 6 hours per day checking social media and playing games. Without a solid foundation of strength and conditioning, young athletes are at a higher risk for injuries to begin with; with a program, their bodies are more prepared for the demands their sport places on them. Take three of those hours staring at a screen and devote them to a consistent strength and conditioning program and we have a different story.

Closing Thoughts

Softball pitchers will continue to be negatively impacted by the effects of overuse unless associations above implement a change. Until then, softball pitchers need to focus on:
 
• Getting stronger
• Tracking pitches thrown
• Effective and honest communication with coaches and parents
• Putting the softball down for a few months

About the Author

Nancy Newell (@NancyNewell2) is a strength and conditioning coach at Cressey Sports Performance in Hudson, MA. Nancy earned her Bachelors Degree in Fitness Development from the State University of New York at Cortland. You can read more from her at www.NancyNewell.com.