Few actions in sports create more drama and excitement than the final pitch or touchdown throw. From youth sports to the pros, you can probably picture it now – a throw that won or lost the game, leading to jubilant celebrations or devastating disappointment.

Throwing requires an explosive and highly coordinated movement involving the whole kinetic chain, from the toes to the fingertips. While throwing builds suspense in sports, it also exposes athletes to a specific set of injury risks.

According to Forté’s Dr. Michael Bender, head team orthopedic physician for Butler University Athletics and Park Tudor School in Indianapolis, evidence shows the most significant risk is overuse.

Overuse: The Number One Risk

Overuse injuries occur when athletes experience repetitive stress to the body without allowing adequate time for the body to heal.

“There are a lot of factors that can increase the risk of overuse for young throwing athletes,” says Bender. “The big push for year-round baseball puts pressure on kids to join travel leagues and have extra training.”

“Kids can throw too many months of the year or too many pitches or innings per game,” he continues. “They can more easily violate pitch count recommendations because they’re on multiple teams and other coaches don’t know how much they’re pitching or what positions they’re playing.”

Athletes who experience a high volume of throws combined with inadequate rest and recovery can suffer from rotator cuff issues, labrum injuries, growth plate injuries, ulnar collateral ligament (UCL) tears in the elbow and more.

“Parents, athletes, coaches and trainers should be proactive about monitoring workload more than anything,” says Bender. “Athletes can still train, get stronger and develop other parts of their game, but they need time off for their arm to recover.”

Throwing When Fatigued

The repetitive and forceful nature of throwing can also cause fatigue, the second greatest risk of injuries to throwing athletes. When muscles become fatigued, there is extra stress on vulnerable ligaments, which can lead to tears.

“We see this most often in those pitching while fatigued,” says Bender. “Those who do it regularly can have up to 36 times the injury risk.”

In addition to providing sufficient rest periods, coaches can help prevent fatigue-related injuries by developing strength and conditioning programs and gradually ramping up training intensity, especially for those returning from an injury.

High-Velocity: Putting Stress on the Body

A third leading risk factor for throwing athletes is velocity. The harder they throw, the more stress they put on their bodies, which can lead to muscle strains, tendon ruptures and ligament tears.

“High-velocity pitches get really close to the max of what ligaments can withstand,” says Bender. “We want the velocity gains to come from your lower half and whole kinetic chain to be more efficient in how you throw.”

To help avoid velocity-related injuries, athletes and coaches should focus on developing good hip and core strength to produce power.

Minimizing the Risks

While throwing can lead to various injuries, the good news is that many are preventable.

Athletes, coaches, parents and trainers who understand the greatest risks of injuries and what causes them can better protect a throwing athlete’s overall health and performance.

“We’re not trying to bubble wrap our kids,” says Bender. “We know there will always be some risk in sports, but we want to figure out how to make it fun and enjoyable while also minimizing those risks."

Forté offers services to help throwing athletes prevent and manage injuries. Its Throwing Athlete Program provides tailored rehabilitation, sport specific training and screening services specific to the overhead athlete. Request an appointment by phone at 317.812.1200.

These recommendations have been excerpted from Coaches Corner, a free monthly webinar series for coaches, athletic directors and athletic trainers. The series, developed and presented by Forté, in partnership with IHSAA, aims to arm coaching and support teams with helpful information to consider when working with their athletes. Subscribe online so you don’t miss an episode.

Today in the United States, baseball and softball are extremely popular, with about 15 million kids participating annually in “America’s Favorite Pastime.”

Many of these young athletes dream of reaching the next level – high school, college or even the major leagues. While the quest for a competitive edge can prove fun, it also requires athletes to perform unique and taxing endeavors, such as throwing repeatedly as hard as their bodies can do it.

“Throwing involves a highly coordinated and explosive movement that incorporates the whole kinetic chain, from their toes to their fingertips,” says Forté’s Dr. Michael Bender, a former assistant to the Houston Astros team physicians who is now team physician for Butler University. “It puts a ton of stress on the body.”

Historically, baseball and softball coaches have tried to minimize this stress by delaying the addition of specific pitches, such as a curveball, to a young pitcher’s repertoire. The thought was that the complex pitch would put too much stress on a developing arm.

Bender says the data proves otherwise.

“The truth is that there’s actually less stress on the shoulder and elbow when throwing a curveball than a fastball,” says Bender. “It’s been ingrained in many people that you shouldn't throw curveballs until puberty, but there really isn’t good evidence against it. Studies don't show an increased risk of injury in those who throw curveballs at a young age.”

The key, he says, is understanding when an individual can safely put together the speed, spin and location precision necessary to deliver a curveball across the plate. Good core strength, throwing technique and neuromuscular control are all signs an athlete has the physical maturity needed to do it well. Bender also recommends a simple screening exercise that helps identify if kids have the balance, core strength and stability required for such a complex motion.

“We ask kids to perform a single-leg squat, similar to a pistol squat,” says Bender. “If they don’t have the balance, if they wiggle all over or if they fall, they’re probably not ready for the challenge of standing and pushing off one leg while maintaining proper repeatable throwing mechanics.”

Once a pitcher begins to incorporate curveballs, prioritizing age-appropriate pitch counts, proper rest and recovery periods, and arm care routines can help minimize the risk of injury.

“Think big picture,” says Bender. “Parents, athletes, coaches and trainers should be proactive about monitoring workload more than anything.”

While there is no proof that throwing curveballs increases the risk of injury to throwing athletes, paying attention to an individual's specific needs and physical development is essential for protecting their overall health and performance.

These recommendations have been excerpted from Coaches Corner, a free monthly webinar series for coaches, athletic directors and athletic trainers. The series, developed and presented by Forté, in partnership with IHSAA, aims to arm coaching and support teams with helpful information to consider when working with their athletes. Subscribe online so you don’t miss an episode.

INDIANAPOLIS – Butler University's highly respected athletic program has new team members to assist in providing student-athletes with comprehensive medical care. Franciscan Health and Forté Sports Medicine and Orthopedics (formerly Methodist Sports Medicine) – long recognized as national leaders in orthopedic surgery and sports medicine – are joining their expertise and award-winning care processes to provide care for Butler University's athletic program. 

Philip A. Blaney, MD, MBA, MS, medical director of Franciscan Physician Network Sports Medicine Specialists, has been appointed head team physician for Butler University. In that role, he will provide both primary care and sports medicine services to Butler's student-athletes. Dr. Blaney completed a sports medicine fellowship with Intermountain Healthcare-Utah Valley Orthopedic Center in Provo.  Dr. Blaney was a head team physician for various high school teams and has served as a team physician for Purdue University. Currently, Dr. Blaney is also the head team physician for the Indianapolis Indians, the AAA affiliate of the Pittsburgh Pirates. 

Franciscan Health will also provide full-time athletic trainers to augment the current Butler staff, allowing for enhanced coverage of practices and events. 

"Butler University has a storied history in sports and continues to promote excellence both on the playing field and in academics," said James Callaghan, MD, president and CEO for Franciscan Health Central Indiana. "We're honored that Dr. Blaney will lead a team of clinicians who will provide stellar care to students." 

Dr. Blaney will be joined on the sidelines by orthopedic surgeon Michael Bender, MD, of Forté Sports Medicine and Orthopedics. Dr. Bender is a fellowship-trained orthopedic surgeon specializing in shoulder and elbow disorders, with prior experience taking care of athletes as a team physician at Park Tudor and Indiana State University. Dr. Bender is a member of the prestigious American Shoulder & Elbow Surgeons (ASES) society. He performs all forms of minimally invasive and open shoulder and elbow procedures for patients of all ages.  

Drs. Blaney and Bender will be supported by over 25 orthopedic surgeons from Forté Sports Medicine and Orthopedics who have sub-specialty training in foot/ankle, knee, hip, spine, hand/wrist, elbow shoulder and sports medicine. Franciscan Physician Network specialists will also support the team as needed, including providing comprehensive concussion care. 

"With the addition of Franciscan Health and Forté's talented and dedicated physicians and staff, our student-athletes will receive high-level, comprehensive medical care," said Butler Vice President/Director of Athletics Barry Collier. "We are excited for this partnership that will add even more resources to Butler's sports medicine and sports performance staff under the direction of Ralph Reiff." 

Butler University athletes will also have access to the new Franciscan Orthopedic Center of Excellence, to be located at 106th and Illinois streets in Carmel. Franciscan Health and Forté Sports Medicine and Orthopedics are partners in this venture which is set to open in early 2022. This facility will offer Butler athletes and active adults across Indiana and beyond, access to a highly focused orthopedic center of excellence for inpatient and outpatient surgery, specialty rehabilitation services and more. 

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