Ask the UCSF Benioff Children’s Hospital’s Walnut Creek Expert

Ask the UCSF Benioff Children’s Hospital’s Walnut Creek Expert

Q: My children play baseball and softball. What types of injuries are most common for young athletes who participate in these sports?

A: Typically, the most common injuries occur in the shoulder and elbow.  Most of the power from throwing should be generated from the legs, however when kids have poor throwing mechanics they tend to use their arms too much during the throwing motion.  The downside to this is that the skeletal system of young athletes is still developing and the excess forces placed on the arm can damage or irritate the growth plates.  In the shoulder this can commonly occur as “Little League Shoulder,” and in the elbow, this is “Little League Elbow.”  These growth plate injuries can occur until puberty, but the stresses at these areas may continue to cause pain past puberty. In older kids, elbow pain can be injuries or insufficiency of the ulnar collateral ligament.  Shoulder pain can mean labral or rotator cuff injuries.  The common thread in all of these injuries is that they are overuse injuries and preventable by seeing a health care provider when pain starts.

Q: What is the best way to prevent arm injuries in my young athlete who plays baseball or softball?

A:  Most baseball/softball injuries are due to overuse.  These overuse injuries are caused by repetitive stress on the shoulder and/or elbow.  The combination of poor throwing mechanics with year round baseball/softball leads to a substantial increase of injuries in our young athletes. Recent studies on arm injuries in young baseball/softball players, report the best ways to keep your young athlete in the game are:

  • Warm-up properly by stretching, running and easy gradual throwing
  • Rotate playing other positions besides pitcher
  • Adhere to pitch count guidelines
  • Avoid pitching in multiple games in overlapping seasons
  • Don’t ever pitch with elbow or shoulder pain, if it persists see a specialist
  • Don’t play year round and don’t do any overhead throwing of any kind for at least 2 months of the year


Q: My child always tells “I feel fine,” but what are some things I should look for and why it is bad to play through pain?

A: Your young athlete will most likely not complain of pain because he/she wants to play.  Instead you might hear the athlete complain of arm fatigue or local soreness.  Even if they don’t complain there are things you can look for in your young athlete like: a more erect delivery, poor arm position/low elbow height, poor or no follow through, improper foot positioning on plant leg or something as  simple as shaking the arm frequently between throws.  Playing through any type of shoulder, arm or elbow pain is bad for your young thrower.  This pain will likely result in a change of mechanics during the throw and can in turn lead to more serious injuries.


Author bio:

Thomas Clennell, DPT
Physical Therapist

Tom  is a Bay Area native who attended UC Berkeley and earned an Bachelor’s in Integrative Biology in 2004. Tom went on to earn a Doctorate of Physical Therapy from Samuel Merritt University in 2009. He has received a certification in PNF, a manual therapy technique utilized for developing proper muscle patterns, strength and flexibility. Tom has worked in the field of Pediatric Sports Medicine since 2009 and has helped athletes from a variety of sports return to their activities, including basketball, football, swimming, soccer, volleyball, baseball, hockey and track.