While injury patterns in youth and high school softball are similar to those in baseball, softball is different because pitchers throw underhand from a flat mound. Although less stressful to the pitcher's shoulder and elbow than throwing a hardball overhand, the windmill pitching motion still places significant stress on various parts of the body which can lead to overuse injuries.1
Of particular concern, says the American Academy of Pediatrics, is the number of innings many softball players log, especially during tournament play. As of 2011, inning limitations and rest days for softball windmill pitchers in the various age divisions of Little League apply only to tournament play. Before the advent of such limits, it was not uncommon for some pitchers to throw in multiple games during weekend tournaments, running up pitch counts between 1,500 and 2,000 pitchers in a 3-day period.
The challenge in preventing arm injuries among softball pitchers is that the site of the injury may not be where the problem actually originates, but at a more remote place on the body, the weakest link in the so-called "kinetic chain." For example, although 70% of injuries to collegiate softball pitchers were from overuse, says the AAP, only 13% were reported in the lower extremity, and the majority were shoulder or elbow injuries, even though weak gluteal muscles and lack of pelvic stabilization were the "culprit."
The AAP therefore recommends, first, that examination and treatment of shoulder pain in windmill softball pitchers include an assessment of and rehabilitation for pelvic stability and gluteal strength, and evaluation and treatment of scapular stabilization, as well as the affected shoulder or elbow, and second, that off-season and pre-season conditioning programs for softball windmill pitchers include gluteal strengthening and pelvic stabilization exercises.
1. American Academy of Pediatrics Council on Sports Medicine and Fitness, Baseball and Softball Policy Statement. Pediatrics 2012;128(3):842-856 (doi 10.1542/peds 2011-3593)(www.pediatrics.org/cgi/doi/10.1542/peds2011-3593 (accessed February 27, 2012).
Posted March 13, 2012