Common Throwing Injuries and How to Prevent Them

by | Mar 30, 2022

The end of March and the beginning of April usually means one thing; the beginning of Major League Baseball. This also means that High School teams are starting their season as well and in a few more weeks Little League will begin their training as well. So, lets dive in and talk about common throwing injuries and how to prevent them.

By far, the most common and famous throwing injury is an ulnar collateral ligament injury. This injury occurs by repetitive valgus extension overload of the elbow and when this occurs “Tommy John” surgery is needed. The ulnar collateral ligament consist of three ligaments and the anterior band is the ligament that usually gets torn in these throwing injuries. This band is taught when the elbow is extended and is the primary resistance to valgus stress. When a pitcher throws during the acceleration phase, the trunk and pelvis have already shifted forwards towards the catcher and the arm has to catch up. Just take a look at the photo above. When the arm catches up to the rest of the body the elbow rapidly extends and a large valgus forced is produced. Overtime, this repeated force can lead to failure and rupture. Proper pitching mechanics are crucial to preventing this injury as well. Take a look at the pitcher above. Look at how is lead knee is collapsed and his back leg is far off the mound. This causes his pelvis to drop which will then cause more stress on the elbow as it has to work harder and faster to come around. A collapsed lead knee is a huge pitching flaw that can rob a pitcher of velocity and efficiency. Curve balls are also partially to blame for UCL injuries as they increase elbow extension to throw the pitch.

Little league elbow is also very common as well as medial epicondylitis. Little league elbow occurs when there is repetitive stress to the medial elbow causing and injury to the growth plate resulting in a fracture of the medial elbow. This requires a visit to your local orthopedic specialist for further evaluation. Medial epicondylitis is an overuse condition of the common flexor tendon at the medial epicondyle, flexor-pronator tendons, and triceps insertion.

The best treatment for these injuries is prevention! Proper conditioning is the most important. Maintaining flexibility and endurance in the offseason is the best place to start. Throwing in the offseason is recommended but throwing at max velocity is NOT recommended! Functional movement screens are very important to help ensure the body is moving efficiently as to not put unwanted stress on other parts of the body. The thoracic spine has a huge influence on shoulder mobility and the lower body is extremely important for pitchers! Avoiding pitching when fatigued can not be stressed enough. Pitch counts are very important especially for the younger population. Subtle signs that a pitcher is starting to be fatigued is their accuracy will decrease. Accuracy will decrease before pitching velocity! If a pitcher is throwing 75% strikes consistently and then drops to 65%, fatigue is starting to set in! Don’t rely of velocity alone! After pitching is complete, icing the elbow is a great way to combat inflammation. Light tossing and throwing during the off days and stretching are recommended, again without maximum effort. Soft tissue techniques such as muscle stripping, vibration therapy, and pin-and-stretch techniques are extremely beneficial.

If you’re experiencing elbow pain, don’t wait to be seen by your local sports chiropractor!


Hyde, T. E., & Gengenbach, M. S. (2007). Conservative management of sports injuries. Jones and Bartlett Publishers.

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