Minnesota Youth Athletics Services

Youth Sports Done Right

Overuse Injuries in Baseball

Currently, there are more options for youth sports participation than ever; ranging from travel teams, year-round opportunities, showcases and tournaments. Additionally, more and more youth athletes are choosing early sport-specialization, and at a much younger age. As a result, we have seen a stark rise in adolescent overuse-type injuries.

Overuse-type injuries can be experienced throughout the body and are often a result of repetitive stresses placed on muscles, tendons, bones, and even nerves. These loads often build up and cause microscopic damage to the tissue. Injury occurs when the body cannot recover in time to repair the damage between periods of activity.

One sport in which athletes often experience overuse injuries is baseball. In baseball, an athlete’s shoulder may be required to perform similar movements over and over, many times throughout a practice, game, and season. Now, the shoulder itself is a very complex and fascinating joint. It is incredibly mobile, but unfortunately has less inherent joint stability and requires strength in the rotator cuff and scapular muscles. Due to adolescent maturation, often the development of strength, endurance, and control in these muscle groups are not enough to keep up with the demands placed upon the joint with repetitive throwing. Regrettably injury may ensue.

There are multiple potential mechanisms for this but here are just a few:

  • Pitching while fatigued (3600% more likely to sustain an injury)
  • Poor throwing mechanics (85% of the time injuries happen without sound mechanics)
  • Excessive volume (too many pitches or not enough rest time)
  • Playing multiple positions in the same game (3x more likely to be injured)
  • Muscle weakness/tightness (weak and tight players are 2-3x more likely to be injured)

It is important to understand that with the requisite amount of repetition that comes along with improving a skill, or playing a sport, it is not uncommon to experience muscle soreness. However, it is important to be aware of the difference between “muscle soreness” and “pain.”

Some symptoms that are NOT “normal” include:

  • Pain after practice that doesn’t go away with rest, ice, and/or training modifications
  • Pain that interferes with performance/participation
  • Pain at rest or at night
  • Feeling of the shoulder being unstable, or having a “dead arm”
  • Mechanical symptoms such as catching or popping in the shoulder that is also painful

If your child is experiencing any of these symptoms, it would be prudent to consult a medical professional sooner rather than later. Many of these issues can be resolved in a short period of time if caught early but waiting often only prolongs the return to normal participation. Here are some other things for parents and athletes to consider:

  1. Excessive “Screen Time”
    • Spending too much time looking at a smartphone/tablet/computer can place the head, neck, upper back, and shoulders into less than ideal positions and put them more prone to injury.
  1. Poor posture
    • Due to the nature of throwing a baseball, certain muscle groups are often preferentially over-developed. This can manifest as having rounded upper backs and shoulder posture. This can place increased stress on the tissues of the shoulder and neck which may contribute to injury.
  1. Early sport specialization
    • Early exposure to a sport is a great thing but be aware that the repetitive nature of throwing can catch up with the athletes if there is overexposure, especially season after season without any rest.
  1. Improper/excessive training
    • Weightlifting and other arm care training are both important aspects of baseball, but it is important to note that adding more volume to already over-stressed muscles can speed up the process of overuse.

Despite our ever-expanding knowledge regarding injury prevention, there is still no guarantee of remaining injury-free while competing in athletics. However, since many baseball injuries are due to overuse, the best way to manage the likelihood of recurrent pain is with early recognition and treatment.

Let’s work together to help keep kids playing sports and most importantly, keep them healthy!


Erika Sandell-Savor DPT, SCS- Physical Therapist
Erika Sandell-Savor DPT, SCS- Physical Therapist



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Youth Sports Done Right