The Biggest Lie in Softball Pitching

Some people are almost in denial about injuries in softball. They hear that the pitching motion is more natural than overhand throwing and they want to believe it is okay for their daughter to pitch 20 innings a weekend without risk.

If that is true, why do almost half of D1 softball pitchers suffer significant lost-time injuries each year? This is one of the most intricate motions in all of sports, and one tiny movement issue is all it takes to cause problems.
If the softball pitching motion is truly natural far less injuries will occur. We agree with that. However, too many unqualified people are instructing young kids poorly and taking no responsibility for the outcome. We often stand in stunned silence as we watch some of the things new students were taught which are very unnatural. When parents have questions, they are often told that pain is normal in sports, or they just do not know where to turn for answers. If you are a softball parent, player, or coach, you need to read this very carefully.
We work with hundreds of new pitchers each year and many arrive with injury concerns. We work to find the cause of those problems and help them get back to healthy pitching. About half of the time it is simple mechanics and within one session the problem is gone. Other times, however, it runs deeper. If those issues are overlooked, the outcome can end a career or worse.
The good news is that we have been able to put all of these students back into the game. Today, we want to share some symptoms that should never be taken lightly.
1-Thoracic Outlet Syndrome-At least once a month parents call us from around the country to ask about this condition. It can cause swelling of the throwing arm, numbness, discoloration of the skin during use of the arm, and pain. This condition is often misdiagnosed as a pulled muscle or irritated tendon. It can be deadly. It can sometimes be managed, but it will not go away. Get a second, third, or fourth opinion before agreeing to a course of treatment. This is generally not related to poor form, but bad form can exacerbate.
2-Tight or painful quad or hip flexor. Pitchers are very susceptible. You cannot push through this one. It can end a career very quickly. It requires more than rest and ice. It is likely to return if the cause is not corrected. Find an expert with vast experience. This is generally not related to poor pitching form.
3-Elbow pain. Put simply, your elbow should not hurt. Normally this is a form problem, but sometimes the damage has been done and you will need medical treatment. Do not push through it. Again, this is almost always a form issue.
4-Pain under the shoulder blade/where the shoulder joins the collarbone/at the very front of the shoulder. These can be as simple as the need for a chiropractic adjustment, a need to improve scapular function through sophisticated training, or form adjustments. If you try to push through it, much worse can happen. The answer may lie with your trainer, your therapist, your doctor, your pitching instructor, or a chiropractor. Alleviating the pain doesn’t mean you have fixed the problem. It may take a multi-prong approach.
5-Popping, clicking, or catching in the shoulder with some severe pain. It may hurt when you move your arm over your head and you may feel weakness or instability in the shoulder. We tend to be more concerned with this one. It can indicate labrum problems. This one is generally not caused by form issues, but can be. More often we have seen this result from overhand throwing, impact injuries, an unqualified person teaching girls to lift weights, or it can result from other sports activities. Have an expert watch her overhand throwing and keep her away from some coach who thinks heavy overhead lifting will make her stronger. Strength training is another way girls are boys are very different. Denying that only creates more risks. Diagnosing this takes special testing and your insurance company will not like it, but be aggressive. It does not always require surgery, but can sometimes be managed through expert therapy.
6-Ankle braces or knee problems. These can be caused by sudden impact, but in the majority cases it indicates a bigger problem. Most of the time this comes from core issues. Girls are very susceptible. If the core is not corrected, the problems remain. If the core is not stable, flexible, and providing a great foundation, the results will be evident throughout the body. It is not just a matter of strength. It can be flexibility. It takes a highly trained expert. Too many people strengthen the wrong muscles, or try to strengthen the right muscles in the wrong way. Either can be dangerous.
7-Lower back pain. Young softball pitchers are particularly susceptible to stress fractures in the L5 vertebra. This is the first mobile vertebra, so this spot absorbs the impact of striding and landing over a hundred times a day in pitching. If everything is perfectly in line, she never notices it. However, if form is not perfect, “ouch”, the breakdown begins. When pitchers come to us with this problem, we have always corrected the mechanics (YES bad mechanics almost always cause this), helped them get into a strength program, and they always come out the other side pitching better than ever. This will not go away. Having therapy, without correcting the movements that cause it, is only making a bad movement stronger.
8-Clicking/popping pain in the hip. This can indicate a few things. This issue is not usually form related. Sometimes a chiropractic adjustment can help, but she may need strengthening or flexibility training to go along with it. These symptoms can be more serious, indicating labrum problems. Female teens can be far more at risk due to certain growth and development patterns. Labrum problems are hard to diagnose without expensive testing, so be prepared. Get a second and third opinion before agreeing to any treatment option. Some people think strengthening may help prevent these issues, but improper weight training can be a huge risk factor so, again, carefully monitor any weight training or exercise program for girls. The wrong people can create more risk than reward.
9-Hip Contact with elbow. The elbow is quite fragile and easily injured. If she makes hip contact 100-times a day, bad things happen. The brain instinctively knows this is bad and will slow the motion to prevent injury, try to move the hip out of the way, or counter by pitching far around the hip. Just the lightest brush, repeated thousands of times a month, is a huge risk factor. This is definitely form related. People worry about the bruising of the hip, but that is the least of your concerns. She can suffer stress fractures, ulnar issues, and serious circulatory problems that result from valve damage in the arm.
It often takes specialists to diagnose and deal with pain related to sports. If you are just getting the standard “ten days of ice, anti-inflamatories, and rest” treatment, you may only be dealing with symptoms, so the issue is likely to return.
You should never, ever feel pain on a regular basis. It not only increases the risk of injury, but indicates that your body is not in the proper condition to perform at peak, so you will not pitch at your full potential. If you or your instructor have questions, feel free to contact us.