Baseball Injuries

Baseball Injuries

Baseball injuries tend to usually occur in the shoulder and elbow, due to the high forces involved. This is especially true in pitchers, but other positions, as well as batters, may also suffer from this kind of injury.

Medial ligament injuries at the elbow are the most common injuries in pitchers. This is damage to the ligament on the inside of the elbow, caused by repeated stress. Golfer's elbow is another injury which is common and is sometimes actually called throwers elbow. It is a degenerative condition of the tendons of the forearm muscles where they attach to the inner elbow.

Here are the six most common baseball injuries. We also have an article on how to prevent injuries in baseball on the training and advice tab.

Most common

Rotator cuff injuries

Rotator cuff strain is a tear to any of the four rotator cuff muscles in the shoulder. These muscles are important for stabilizing the shoulder joint. Symptoms of a torn rotator cuff will usually consist of sudden pain in the shoulder sometimes accompanied by a tearing feeling. This can be severe and may transmit down into the arm. Read more on the treatment and rehabilitation of rotator cuff strain.

Impingement syndrome

Impingement syndrome of the shoulder is sometimes called swimmer’s shoulder or thrower’s shoulder and is caused by the tendons of the rotator cuff becoming impinged as they pass through the shoulder joint. Symptoms include shoulder pain which comes on gradually over a period of time. Read more on treatment and rehabilitation for impingement syndrome.

Shoulder instability

Shoulder subluxation or shoulder instability occurs when the shoulder partially dislocates. The shoulder joint by its nature allows a large range of movement which means it is likely to be less stable. It may be associated with pain and or dead arm sensation. Read more on the treatment of shoulder instability.

Medial elbow ligament sprain

Medial elbow ligament sprain - The medial collateral (MCL) ligament of the elbow is situated on the inner elbow and helps to provide stability to the joint. Damage to this ligament can occur through an impact injury or an accident or from repetitive overuse, for example throwing with poor technique. Read more on the treatment medial ligament sprain

Golfer's elbow

Throwers elbow (Golfers elbow) or medial epicondylitis is an injury similar to tennis elbow but causing pain on the inside of the elbow instead. It is sometimes known as throwers elbow. Symptoms often come on gradually through overuse although acute injuries can occur to pitchers who throw too hard too soon or with bad technique. Read more on Golfer's elbow causes and treatment.

Tennis elbow

Tennis elbow also known as lateral epicondylitis, is a condition causing pain on the outside of the elbow. Symptoms usually come on gradually through overuse. Read more on Tennis elbow treatment.


Immediate first aid for acute injuries

The PRICE principles are the gold standard set for treating acute sports injuries.  The acronym stands for Protection, Rest, Ice, Compression and Elevation and should be applied as early as possible and continued for at least the first 24-72 hours.

Protection

Protection of the damaged tissue is vital to prevent further damage and enable the healing process to start efficiently and effectively. There are a number of ways to protect the injured area all with the same aim of limiting further movement and use of the joint/muscle/ligament/tendon.  One way this can be achieved is by using a support or splint.

Rest

In the early stages, rest is one of the most important components of the P.R.I.C.E principle but is often neglected or ignored. It does not only refer to the prolonged period of time that the athlete will be out of action but also to the immediate period after the injury.

An athlete must know when to stop training and allow the injured area to heal otherwise repetitive minor injuries can often result in a more severe injury that keeps the athlete out for much longer.

If an injury is sustained during sporting activity some athletes have a tendency to 'run it off'.  This implies that by continuing to participate in the exercise, the injury will simply go away. In fact, in the majority of cases, this is not true and is not advisable.

Ice

Ice therapy, also known as cryotherapy, is one of the most widely known and used treatment modalities for acute sports injuries. It is cheap, easy to use and requires very little time to or expertise to prepare.

The application of ice to an injury, in the acute phase, can substantially decrease the extent of the damage. It achieves this in a number of different ways:

  • Decreases the amount of bleeding by closing down the blood vessels (called vasoconstriction).

  • Reduces pain (pain gate theory)

  • Reduces muscle spasm

  • Reduces the risk of cell death (also called necrosis) by decreasing the rate of metabolism

Ice is usually applied to the injured site by means of a bag filled with crushed ice which is wrapped in a damp towel. The damp towel is essential as it forms a barrier between the bag of ice and the skin and reduces the risk of an “ice burn”.  DO NOT leave the ice on for more than 15 minutes as you could cause an “ice burn”.

There are a small number of areas that you should not apply ice to which include the neck, the outside bone of the elbow, the collarbone (upper end), the front of the hip (bony part) and the outer bone of the knee.  The reason for this is there is a superficial nerve just below the skin in these areas that can be damaged by applying ice to it. Always check for contraindications.

Compression

Applying compression to an injured area minimises the amount of swelling that forms after an injury in two ways and should be applied for the first 24 to 72 hours from the onset of injury. Compression can be applied through a number of methods. The most effective of these is by using a compression bandage which is an elasticated bandage that simply fits around the affected limb.

Elevation

Elevation of the injured limb is the final principle of PRICE but is equally as important as the other 4. Elevation allows gravity to drain the fluid away from the injured site. This aids in decreasing the swelling which in turn may decrease the pain associated with the oedema (swelling).

Read more on PRICE principles


Should I seek professional treatment?

If you have any of the following symptoms you should seek further medical assistance. 

  • Severe pain, especially on walking
  • Severe swelling (oedema)
  • Altered sensation in the foot – such as a feeling of “pins and needles” (paresthesia) or a “loss of feeling” (anaesthesia).
  • Unable to complete normal daily activities after the initial 72 hours.

Further medical assistance can be sought through either your local GP or a private clinician such as a podiatrist, physiotherapist, sports therapist, osteopath or chiropractor.  If you have followed the P.R.I.C.E. principles (see below) and are still unable to walk after 72 hours or still have severe pain that is not subsiding after the first 72 hours you should visit your local A&E department for further assessment.

Secondly, if you have applied for P.R.I.C.E. principles and still have weakness that lasts a long time (more than 2 weeks) or have ongoing discomfort in your foot or heel, you are highly recommended to seek advice from a specialist expert - such as a podiatrist or physiotherapist, osteopath, or chiropractor - who can provide you with advice and an appropriate and effective recovery and rehabilitation program.

Baseball Injury Prevention

Injury prevention strategies are very similar in most sports, although variations relating to protective equipment and conditioning will be present. the following is a simple guide to help you to avoid injury:

Warm-up

A warm-up is a vital part of injury prevention in every sport. It also helps to prepare you mentally and physically. Warm-ups should get the heart rate up to increase the flow of blood around the body, in preparation for more strenuous activity. It should also warm and stretch the muscles to ensure they are working to their optimum and do not sustain an injury due to being cold and inflexible.

A warm-up should consist of a minimum of 5 minutes cardio, pulse-raising exercise such as jogging, cycling, skipping etc. This should be followed by dynamic stretches. These have more recently replaced the use of static stretches. They include drills such as running with high knees, heels to bum and Cariocas, although baseball players should also concentrate to upper body warm-ups. This should be performed for a minimum of 5 minutes, up to a maximum of 20 minutes, with movements gradually becoming larger and faster. This is preferable to static stretching as it keeps the body warmer and heart rate higher, and more resembles the type of movements which are required in most sports.

Protection

Wearing the right kind of protective equipment is vital to avoiding injury in baseball. The most important position in terms of protective equipment must be the catcher. It is necessary to wear a helmet with face guard, a chest protector, throat protector, leg guards and catching mitts. The batter should also wear a helmet and batting gloves. Other protective equipment includes padded shorts and a cup.

Rest

Resting is an important part of any athletes training program! Physiological changes in the cardiovascular, respiratory, and muscular systems in our bodies, occur when we are at rest. Overtraining often results in injuries due to fatigue causing poor technique and overuse type injuries. If you feel at all unwell, tired or in pain, you should rest until better.

Training

In order to play in the higher levels of any sport, training is vitally important. Training not only the cardiovascular and muscular systems but also techniques and tactics are required to make sure the body is strong, coordinated and flexible as well as the mind is prepared and focused to name but a few.

Nutrition and Hydration

Proper nutrition is important. A bad diet will prevent you from recovering from training sessions making you more prone to injury. A balanced diet is what you should aim for:

Carbohydrate is important for refueling muscles

Protein rebuilds muscles

If you become dehydrated then less blood will flow through muscles. The muscles will be more prone to injury

Vitamins and minerals are required for a number of reasons related to recovery

Much of what is discussed above should be part of your sporting routine. A biomechanical analysis can help identify possible injury risks. Orthotic devices can help. Also, an assessment from a sports therapist or specialist can identify weak areas and possible injury risks. A course of exercises specific to your needs can give you the best chance of avoiding injury.