Breaking Down Shoulder and Elbow Injuries in Baseball

October 21st, 2019

Orthopaedic injuries are very common in baseball, at all levels of the sport from youth to professional athletes. Baseball is a non-contact sport, but the physical demands that players have to meet lead to serious injuries, especially shoulder and elbow injuries. 

As this baseball season closes and playoffs continue, it’s hard to ignore the injuries that plagued many professional teams over the past few months. Shoulder and elbow injuries have seemingly took over the diamond. 

According to the Orthopedic Journal of Sports Medicine, shoulder and elbow injuries among baseball pitchers are highly prevalent at all levels of the sport. Risk increases as age and level of competitiveness increase, but arm injuries in youth and collegiate pitchers are also very common. 

In Major League Baseball (MLB), an estimated half-billion dollars is lost annually as a result of professional pitchers being placed on the disabled list. “Nearly 50% of all injuries in MLB are arm injuries,” Orthopedic Journal of Sports Medicine reports. “It is generally accepted that upper extremity injuries in baseball pitchers are a result of repeated microtrauma to the musculoskeletal structures due to high-velocity repetitive loading.” 

Why are Shoulder and Elbow Injuries Common in Baseball?

Powerful pitchers with dangerous arms, including those located in New York, are constantly being sent to surgery or physical therapy after dealing with serious arm or shoulder injuries. But why is it baseball that causes so these injuries?

The overhead motion that athletes perform when throwing a baseball puts stress on these joints and causes injury, whether it’s suddenly or overtime. 

The shoulder is a ball-and-socket joint made up of three bones: the upper arm bone or the humerus, the shoulder blade called the scapula, and the collarbone, also known as the clavicle. Strong connective tissue, ligaments, tendons, and muscles surround the joint, allowing it to function properly. All of these structures work together during an overhand throw, and as one gets fatigued or weakened, other structures have to work harder. This typically results in an injury.

The elbow is a combination hinge and pivot joint made up of the upper arm bone or the humerus, and the two bones in the forearm - radius and ulna. The hinge part of the joint lets the arm bend and straighten while the pivot part lets the lower arm twist and rotate. When an athlete extends their arm for a high-speed pitch or throw, strain is put on the structures. Pain is typically felt on the inner-elbow, as this is where the majority of the stress is put.

Find out more about these injuries and why they occur in baseball players. 

Flexor Mass Strain

The flexor mass is the collection of muscles and tendons that come together in the forearm near the elbow. These muscles and tendons allow the wrist to flex and turn. If this mass is stressed or torn, it can result in a strain. A flexor mass strain can be an overuse injury or it can occur from a single event, such as just one pitch gone wrong. Although it’s not a very common injury, it is seen in professional pitchers due to their throwing. 

Shoulder Instability

Pitchers can experience what is called “dead arm,” resulting from the strain of overuse. The muscles become tired and the joint becomes unstable, so the shoulder joint is not working properly. This condition can typically be treated with rest. However, if the instability becomes more severe, the shoulder can dislocate or partially dislocate - a condition referred to as subluxation, which must be corrected.

UCL Sprain of the Elbow

The ulnar collateral ligament (UCL) is located within the elbow, on the inside, and provides stability as the arm performs the throwing motion. When the arm is overused, or undergoes impact in the elbow joint, the UCL can be strained. UCL injuries occur often in pitchers due to excessive use. 

As one of the most common baseball injuries, many competitive pitchers deal with UCL strains. They begin noticing pain in their inner elbow and loss of control during pitching. Their joint overall feels unstable. “Tommy John” surgery is a procedure that requires replacing the affected ligament by threading a healthy one through holes drilled into the bone above and below the elbow.

Thrower’s Elbow

The injury known as “thrower’s elbow” or “golfer’s elbow” is a condition called medial epicondylitis. The wrist flexor muscles become inflamed at the point where they insert in the inside of the elbow. Pain will develop on the inside of the elbow, coming on gradually, typically due to overuse. In the sport of baseball, many pitchers experience this condition when they’re throwing hard or using improper technique. If rest does not alleviate pain, surgical treatment must be performed. During this type of surgery, a portion of the injured tendon is removed. 

Learn more about some of the most common injuries in baseball here. If you’re dealing with pain in your shoulder or elbow, Rothman Orthopaedics can help. Seek treatment before your issue gets worse and causes more harm.

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