Managing Arm Pain While Throwing

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The principle of “no pain, no gain” does not apply to baseball or softball, especially Little League or Travel Club Ball. Young athletes are not yet skeletally mature and the growth plates and soft tissue (i.e., tendons, ligaments, muscle, etc.) do not have the strength to withstand too much stress. The amount of force the shoulder and elbow experience during each pitch could be enough to cause injury. If a single pitch can do that, think about pitching 3-4 innings.

Your arm alone is not strong enough to throw a ball at the velocity and frequency needed to be an effective pitcher. The entire kinetic chain is needed, from the big toe to the last piece of your finger when releasing the ball. Each link – leg, hip, core, shoulder and arm – is vital to the strength of the chain. If there is a weak link, the chain will “break” and injury is likely to occur.

Pain is your body telling you there is something wrong. Some tissue is experiencing stress that it cannot handle. So if you think about the “chain”, pain is a “link” that is starting to break down. Listen to it. Never pitch through pain, especially pain in your shoulder and/or elbow. Even though it may feel like it initially, the pain is not isolated to your arm. If you have pain anywhere, this will cause the load to increase on other parts of the chain.

This is not limited to baseball pitchers. Who throws the ball more than the pitcher? A catcher.

The catcher also throws from his or her knees completely relying on their arm and not using the rest of the kinetic chain. Softball, volleyball, and tennis are other overhead sports that these concepts apply to as well.

If you or your athletes do experience pain while throwing, shut it down. If soreness/pain does not alleviate or decrease in 48 to 72 hours, seek attention from a sports medicine medical professional (MD, PT, ATC). Early intervention and diagnosis is imperative to getting better and back on the mound quickly and safely.

If you’re experiencing recurring injuries in the same, or different, parts of the kinetic chain, it may be worth getting a throwing analysis to identify potential strength or mobility limitations, as well as any mechanical flaws that may be contributing to injury. Identifying and improving these limitations should improve those “weak links”, strengthen the chain as a whole, and promote improved performance while minimizing risk of injury.

Quick Tips:

  • Do not play through pain (shoulder, elbow, or anywhere). Get it checked out if pain gets worse, lasts longer than 48-72 hours, or is recurrent.
  • Follow recommended rest and pitch/innings count
  • Play multiple sports to minimize stressing the same muscles and joints over and over.
  • Take three months a year completely off from throwing to allow your muscles and joints to recover.

Patrick Vignona is a Board Certified Clinical Specialist in Sports Physical Therapy and Certified McKenzie Practitioner, with a Masters in Physical Therapy. He is an Advanced Clinician at the James M. Benson Sports Rehabilitation Center at Hospital for Special Surgery. Patrick has 10+ years of experience in Sports Medicine and Rehabilitation. His primary interests are the Overhead Athlete, Hip Arthroscopy, Ligamentous Knee Injuries, and Return to Play for upper and lower extremities. He has played Division 1 Soccer and is an avid runner/triathlete, and is co-author on several baseball mechanics research articles.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.