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 dynamics of the windmill pitch.

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

The injuries to softball pitchers are a result of the forces and torques imposed on the shoulder and arm during the windmill pitch. The forces, torques, and speed with which the windmill pitch occurs are responsible for the incidence and type of injuries sustained. The athlete must be rehabilitated successfully to withstand the listed values imparted on the upper extremity during windmill pitching.

One explanation may be the sequential activity of shoulder muscles during the 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. After healing from surgery, it's very important to start physical therapy to strengthen the four muscles that make up the rotator cuff, which stabilize and control fine rotational motion of the joint. Three easy exercises are mentioned. Start without weights, then work up to two pounds as you get stronger. For each move, do three sets of 10 repetitions. First, lie on your right side, with your left elbow bent 90 degrees, forearm parallel to the floor. Slowly raise your hand toward the ceiling, then lower it. Repeat. For the second exercise, stand tall, and raise your left arm out to the side to shoulder height, thumb pointing toward the ceiling, then lower it. Repeat. Finally, raise your arm straight out in front of you to shoulder height, thumb pointing up, then lower it again. Repeat. In addition to these exercises, your physical therapist can tailor a program to your specific needs.

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

Fastpitch softball shoulder pain