High school pitchers who go full-speed the first day or week of spring training may be headed down the road to serious injury.

"A large number of high school athletes take the winter off and just go out and start throwing as hard as they can," said Matt Holland, a physical therapist with The Methodist Center for Sports Medicine in Houston. "The problem is that their arms are not in baseball shape and they open themselves up to serious shoulder and elbow injuries."

The rotator cuff is a group of muscles that act to stabilize the shoulder especially during the throwing motion. An inflamed rotator cuff (tendonitis) can cause pain when lifting your arm and will most likely dramatically affect a player's performance on the field. Problems with the rotator cuff can not only damage the rest of the shoulder, but may also lead to elbow and other arm problems that shorten the careers of many pitchers.

"Pitchers should play catch for a few minutes every day for about 6 weeks leading up to the beginning of practice, starting from about 60 feet for 10 to 15 minutes and then gradually increasing it back to 90 feet," Holland said.

Pitchers will also need to gradually increase the number of pitches they throw in a game over the first few weeks of the season. They should spend a great deal of time, especially if they did nothing in the winter, working on their throwing mechanics and strengthening the rotator cuff and shoulder blade muscles, their core muscles (upper thighs, hips, buttocks, abdomen, hips and lower chest), legs and trunk area. This is where they gain most of their power, taking some of the pressure off the arm, he said.

"Many kids believe that a big chest and big biceps will make you throw harder. However, it's just the opposite," Holland said. "Pitchers need strong, but flexible arms. If they are going to take part in a strength training program, it is imperative that they take part in low-weight, high-repetition exercises that focus on the muscles needed to throw a ball."

Research has shown that high pitch counts and too many curve balls at a young age, before the arm is properly developed, are big factors relating to shoulder and elbow pain for young pitchers.

"A lack of proper stretching of the shoulder is also a big contributor to shoulder and elbow problems," Holland said. "Making sure you take the necessary time to properly stretch and strengthen the shoulder, as well as getting the arm conditioned before the season starts can mean the difference between playing and sitting in the stands and watching this season."

Source: Methodist Hospital, Houston

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