Fastpitch softball shoulder pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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Softball pitchers have specific injury patterns linked to the movement required for the windmill pitch.

Most of these injuries occur in the shoulder and elbow. Shoulder injuries include rotator cuff tendinitis, bicipital tendinitis, subscapularis strain, pectoralis strain,coracobrachialis strain, biceps-labrum degeneration, and trapezius strain. Elbow injuries include ulnar neuritis, ulnar collateral ligament damage, and medial and lateral epicondylitis.

The injuries to softball pitchers are a result of the torque imposed on the shoulder and arm during the windmill pitch.

One explanation may be the sequential activity of shoulder muscles during the softball pitch.

American Journal of Sports Medicine, Vol 25, Issue 3 369-374, Copyright © 1997 by American Orthopaedic Society for Sports Medicine

Shoulder muscle firing patterns during the windmill softball pitch

MW Maffet, FW Jobe, MM Pink, J Brault and W Mathiyakom
Centinela Hospital Medical Center, Inglewood, California 90301, USA.

The purpose of this study was to describe the activity of eight shoulder muscles during the windmill fast-pitch softball throw. Ten collegiate female pitchers were analyzed with intramuscular electromyography, high-speed cinematography, and motion analysis. The supraspinatus muscle fired maximally during arm elevation from the 6 to 3 o'clock position phase, centralizing the humeral head within the glenoid. The posterior deltoid and teres minor muscles acted maximally from the 3 to 12 o'clock position phase to continue arm elevation and externally rotate the humerus. The pectoralis major muscle accelerated the arm from the 12 o'clock position to ball release phase. The serratus anterior muscle characteristically acted to position the scapula for optimal glenohumeral congruency, and the subscapularis muscle functioned as an internal rotator and to protect the anterior capsule. Although the windmill softball pitch is overtly different from the baseball pitch, several surprising similarities were revealed. The serratus anterior and pectoralis major muscles work in synchrony and seem to have similar functions in both pitches. Although the infraspinatus and teres minor muscles are both posterior cuff muscles, they are characteristically uncoupled during the 6 to 3 o'clock position phase, with the infraspinatus muscle acting more independently below 90 degrees. Subscapularis muscle activity seems important in dynamic anterior glenohumeral stabilization and as an internal rotator in both the baseball and softball throws.

In those athletes who require surgery, it’s important to initiate physical therapy shortly afterwards.

For more information about shoulder pain that is due to tendonitis, visit our sister site:
Tendonitis and PRP

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