Blog 1: Everything Baseball & Softball ⚾
Part 1: Understanding Baseball & Softball Injuries - Why Young Athletes Break Down
Welcome to Everything Baseball & Softball ⚾ where Dr. Keirstyn is going to break down all of the information required to know what injuries are most common, who is susceptible, how to prevent them and how to have longevity in these sports!
The winter training is almost done and we are just about to head into spring training. Fields are so close to opening. Pitchers are throwing. Bats are swinging. And in my office at Endurance Therapeutics, I'm already seeing the shoulder pain, elbow soreness, and lower back stiffness that comes with the start of another baseball and softball season.
If you're a player, parent, or coach reading this, you probably already know: baseball and softball injuries are common, they're often preventable, and they're increasingly affecting younger and younger athletes.
The stats are sobering: youth baseball and softball account for over $1-4 billion in annual healthcare costs in the U.S. Shoulder and elbow injuries in pitchers are at an all-time high. "Tommy John surgery" (UCL reconstruction) — once reserved for professional pitchers — is now being performed on 12-year-olds.
Why is this happening? And more importantly, what can we do about it?
Over the next three parts, I'll break down:
The most common baseball and softball injuries — and why they're happening more frequently (this blog)
Building a baseball/softball body — off-field training that prevents injury and improves performance
Playing for the long term — managing year-round schedules, recovery, and avoiding burnout
Let's start by understanding what breaks down, why it happens, and what warning signs you should never ignore.
The Unique Demands of Baseball & Softball
What makes these sports different:
Baseball and softball require explosive, high-velocity movements repeated hundreds (sometimes thousands) of times per season:
Throwing: Overhead (baseball) or windmill (softball) at high speeds, creating massive stress on shoulder and elbow
Hitting: Rotational power through hips, core, and upper body
Fielding: Quick lateral movements, diving, sliding
Base running: Sprinting, sliding, rapid deceleration
The volume problem: Many youth athletes now play year-round (travel teams, showcases, multiple leagues), never taking an off-season. This creates cumulative stress without adequate recovery — and that's where injuries happen.
Most Common Baseball & Softball Injuries
1. Shoulder Injuries (Rotator Cuff, Labral Tears, Impingement)
The #1 injury site, especially in pitchers.
What happens:
Rotator cuff strain/tendinopathy: Repetitive overhead throwing overloads the small stabilizing muscles
Labral tears (SLAP tears): The cartilage ring in the shoulder socket tears from repetitive stress
Impingement: Tendons get pinched during throwing motion, creating pain and inflammation
Biceps tendinitis: Common in softball pitchers from windmill motion
Why it happens:
Overuse (too many pitches, too many games, no rest)
Poor mechanics (arm slot issues, improper sequencing)
Weak scapular stabilizers (shoulder blade doesn't move properly)
Playing through pain instead of resting
Who gets it: Pitchers primarily, but also outfielders and catchers with high throwing volume
Warning signs:
Shoulder pain during or after throwing
Decreased velocity
"Dead arm" feeling
Pain with overhead reaching off the field
2. Elbow Injuries (UCL Tears - "Tommy John", Little League Elbow)
The injury that's becoming an epidemic in youth baseball.
What happens:
UCL tear (Tommy John): The ligament stabilizing the inside of the elbow tears from repetitive valgus stress during throwing
Little League elbow: Growth plate stress/damage in young throwers (ages 9-14)
Medial epicondylitis: Inflammation on the inside of the elbow from overuse
Why it happens:
Excessive pitch counts (ignoring guidelines)
Throwing breaking pitches too young (curveballs, sliders create more elbow stress)
Year-round throwing without 3-4 months off
Playing on multiple teams simultaneously
Poor mechanics (leading with elbow, excessive arm pronation)
Who gets it: Primarily pitchers, but also catchers and infielders with high throwing volume
Warning signs:
Elbow pain during or after throwing (especially inside of elbow)
Loss of velocity or control
Pain straightening or bending elbow fully
Swelling around elbow
3. Lower Back Pain
Common from rotational forces during hitting and pitching.
What happens:
Facet joint irritation: Joints in the spine get stressed from repeated rotation
Muscle strains: Lower back muscles overwork from poor core stability
Stress fractures (spondylolysis): Repetitive extension and rotation can create stress fractures in lumbar spine (more common in pitchers)
Why it happens:
Rotational stress from hitting and pitching
Weak core unable to stabilize spine during movement
Poor hip mobility forcing lower back to compensate
Excessive volume without adequate strengthening
Who gets it: Pitchers and hitters, especially power hitters
Warning signs:
Lower back pain during or after games
Stiffness in mornings
Pain with rotation or extension
One-sided back pain (often indicates stress fracture risk)
4. Hip & Groin Injuries
Increasingly common as pitchers and hitters generate more rotational power.
What happens:
Hip flexor strains: From explosive leg drive during pitching
Labral stress: Hip cartilage damage from repetitive rotation
Adductor (groin) strains: Common in catchers from low stance
Why it happens:
Repetitive hip rotation during pitching and hitting (usually the opposite hip to the throwing arm)
Limited hip mobility
Weak glutes and core
Catchers: prolonged squatting position
Who gets it: Pitchers, catchers, power hitters
Warning signs:
Deep groin or front-of-hip pain
Pain with leg drive during pitching
Stiffness after games
Difficulty getting into catcher's stance
5. Lower Extremity Injuries (Ankle Sprains, Knee Pain)
Research shows softball players have higher rates of lower extremity injuries than baseball players.
What happens:
Ankle sprains: From running bases, fielding, sliding
Knee pain: Catchers especially (patellofemoral pain from prolonged squatting)
Hamstring strains: From sprinting bases
Why it happens:
Quick directional changes while fielding
Sliding into bases
Catchers: overload on knees from position demands
Inadequate conditioning and strength
Who gets it: All positions, but especially catchers (knee pain) and base runners (ankle sprains)
Position-Specific Injury Patterns
Pitchers:
Highest risk: Shoulder, elbow (overuse from throwing)
Volume matters most: Pitch counts, days of rest between outings
Catchers:
Highest risk: Knee (prolonged squatting), shoulder/elbow (throw-downs to bases), hip/groin
Position demands: Repetitive squatting and explosive movements
Infielders/Outfielders:
Highest risk: Shoulder/elbow (throwing from field), ankle (fielding, base running), hamstring (sprinting)
Volume: Players who throw frequently or play multiple positions
Hitters:
Highest risk: Lower back, hip (rotational stress), wrist/hand (impact from bat)
Mechanics: Power hitters with aggressive swings
The Overuse Epidemic: Why Youth Injuries Are Skyrocketing
The research is clear: Youth baseball and softball injuries are increasing, and overuse is the primary driver.
What's changed:
Year-round play: No off-season to recover (playing on multiple teams, showcases, travel ball)
Specialization too early: Kids focusing only on baseball/softball from ages 8-10
Pitch count violations: Despite guidelines, many young pitchers exceed safe limits
Pressure to perform: Scholarships, exposure, fear of losing playing time
The result: 12-year-olds needing Tommy John surgery. 14-year-olds with chronic shoulder pain. 16-year-olds retiring from the sport they love because their bodies broke down.
Warning Signs You Should Never Ignore
For Players:
Shoulder or elbow pain during/after throwing
Loss of velocity or control
"Dead arm" feeling
Pain that doesn't resolve with a few days rest
Compensation patterns (changing mechanics to avoid pain)
For Parents/Coaches:
Player complaining of pain (even if mild)
Decreased performance without explanation
Reluctance to throw or hesitation in mechanics
Visible fatigue or altered throwing motion
Don't ignore pain. Don't push through it. Address it early.
How I Help at Endurance Therapeutics
When baseball or softball players come to me with pain or injury concerns, I don't just look at the painful area. I assess:
Throwing mechanics: Are there faults creating excessive stress?
Training volume: How much are they throwing/playing? (pitch counts, games per week, teams)
Strength and mobility: Do they have the physical capacity for their sport demands?
Recovery: Are they getting adequate rest and off-seasons?
Growth factors: Are they in a growth spurt? (increases injury risk)
My role:
Identify the root cause (not just treat symptoms)
Educate players, parents, and coaches on injury prevention
Create individualized rehab and strengthening programs
Guide safe return to throwing/playing
Collaborate with coaches and trainers when needed
If your player is dealing with shoulder pain, elbow soreness, or any of the issues we discussed, don't wait for it to become chronic. Early assessment and intervention prevent small issues from becoming season-ending (or career-ending) injuries.
Book an assessment at Endurance Therapeutics and let's identify what's happening before it sidelines your season.
📍 Endurance Therapeutics | Oakville, Ontario
📞 905-288-7161 | 🔗 https://endurance.janeapp.com/#staff_member/1
What's Coming Next
In Part 2, we'll dive into building a baseball/softball body — the off-field strength training, mobility work, and throwing programs that prevent injuries and improve performance. We'll cover arm care routines, rotational power development, and what young athletes should be doing in the off-season (hint: not throwing).
Stay tuned, and if your athlete is dealing with pain right now, get assessed before the season gets busier.