2. Shoulder and Elbow Injury Prevention in Baseball
March, 3rd 2016
Jeff Kraayeveld ATC, AT/L
Kristin Tognetti, DPT, MTC
Helen McDevitt, MSPT, OCS
Dr. Gregory Gramstad, MD
Dr. Anthony Wei, MD

3. Purpose Baseball injuries treated at Rebound Injury mechanisms
Shoulder/elbow injury prevention
Rebound Performance Throwing Program

4. Common Baseball Injuries
Elbow
Ulnar Collateral Ligament sprain or tear
Surgical (Tommy John Surgery)
Non-Surgical (Rehab)
Tendonitis
Posterior Impingement
Shoulder
Rotator Cuff Injuries
Labral Injuries
Multi-Directional Laxity

5. Injury Perspective of the Athlete
Subjective Data
Pain during or after throwing
Feeling a “POP”
Loss of control
Loss of velocity
Numbness or tingling

6. Causes of Shoulder and Elbow Injury in Baseball
Overuse
> 8 months of baseball participation
Playing with multiple teams, showcase's
Catcher/ pitcher position combination
Muscle Weakness
Increases stress on shoulder and elbow
Fatigue = Poor Mechanics = Injury
Flexibility vs. Stability
Tight posterior capsule vs. weak posterior muscles

7. Arm Soreness Muscle soreness is normal in throwing athletes
Avoid maximum effort when sore
Difference between muscle soreness and joint pain
Joint Pain = Red Flag
Bullpen use for mechanics and location, NOT VELOCITY

8. Research on Pitching Loss of Motion Loss of 8.5 degrees of IR
Loss of 9.5 degrees of total motion
Loss of 2.4 degrees of elbow extension
Loss of motion is still present even 24 hours after throwing.
Relief pitcher vs. starting pitcher

9. Signs of Fatigue Increased time between pitches Loss of control
More upright at ball release
Elbow drop

10. Risk Factors for Pitchers
Fatigued pitching and increased injury risk
36 times more likely to develop injury
Pitching >100 innings per year
Too many pitches without adequate rest
Pitching on consecutive days
Playing with multiple teams concurrently
Radar gun usage
70-90% more likely to be injured when specializing early
Most collegiate players are multisport athletes

11. Pitch Count Considerations
Age
Daily Max (Pitches in Game)
Required Rest (Pitches)
0 Days
1 Days
2 Days
3 Days
4 Days
15-16 95
1-30
31-45
46-60
61-75
76+
17-18
105

12. Guidelines
4 months off from competitive pitching every year, at least 2 months off from overhead throwing
Proper warm up
Consistent pitch counts and rest periods
Avoid playing with multiple teams concurrently
Avoid pitcher / catcher combination
Avoid pitching in multiple games on same day
Monitor signs of fatigue
Follow safe practices at showcases

13. Prevention Off-season rest Flexibility vs. stability (strength)
Proper weight lifting (technique and lifts)
Proper stretches
Proper throwing mechanics

14. Stretches

15. Upper Extremity Dynamic Warm Up
Paddles
90/90 IR/ER
90/90 Butterfly's
Goal Posts
Genies
Interlock Push
Circle F/B
Swim F/B
Push side/side
Interlock Pull
Pull Side/Side
90/90 Box
Thumb Up Push Down
Palm Down Push Down
Thumb Down Push Down
Thumb Up Push Up
Palm Down Push Up
Thumb Down Push Up
Palm Press Prayer
Push Palm Together
Thumb Up Press
Thumb Down Press
Rotate Forward
Rotate Backward
Press R to L
Finger Press
5, 4, 3, 2, 1
Spider 5, 4, 3, 2, 1
Spider Forward
Spider Backward
Spider Side/Side
Palm Forearm Press
Press
Thumb Out Press
Thumb In Press
Elbow Rib Squeeze
Wipers
Overhead Prayer
Rear Presses
Palms Out
Palms In
Hands Together

16. Mechanical Flaws Inverted W Elbow Drop / Shoulder Height
Upright Trunk / Trunk Tilt

17. Inverted W

18. ESPN - The Magazine (2012)

19. Elbow Drop / Shoulder Height

20. Upright Trunk / Trunk Tilt

21. Resources Websites Apps www.pitchsmart.org www.playball.org
Throw Like A Pro
Hudl Technique

22. Offered at Rebound Doctors Dr. Gramstad Dr. Wei Sports Clinic
Dr. DaSilva - Tuesday 3-5pm during high school season
Rebound Performance Throwing Program
12 visit over 6 weeks
In-season
Off-season
Group setting

23. Throwing Program Baseball related band and plyometric exercises
Pre-throwing warm up education
Proper form for exercises and drills
Shoulder blade/ rotator cuff strengthening
Video analysis - Hudl
Take home pictures and videos with voiceover
Research based throwing mechanics

24. Contact Jeff Kraayeveld ATC, AT/L.
Rebound Physical Therapy at Pacific Crest
601 SE 117th Ave. Suite 210
Vancouver, WA 98683