Causes of Shoulder Pain in Young Pitchers

Shoulder pain in young pitchers can result from a variety of factors, including:

1. Overuse: Repetitive throwing motions, such as those involved in pitching, can lead to overuse injuries. Young pitchers who throw excessively without proper rest and recovery are at increased risk.  This can result in many problems including growth plate injuries and stress fractures, scapular dyskinesis (altered shoulder blade motion), GIRD (stiffness of the posterior shoulder capsule) and superior labral tears.  
2. Poor throwing mechanics: Incorrect throwing techniques can place excessive stress on the shoulder joint and surrounding muscles, leading to pain and potential injury.
3. Muscle imbalances: Weakness or tightness in certain muscles around the shoulder, such as the rotator cuff muscles, deltoids, and scapular stabilizers, can contribute to shoulder pain in young pitchers.  This is most commonly seen with the shoulder blade.  Muscle imbalance can lead to scapula infera (where the throwing shoulder sits lower and usually in a protracted position and scapular dyskinesis. 
4. Growth plate injuries: Young pitchers who are still growing may experience injuries to the growth plates in their shoulder joints, particularly if they engage in high levels of pitching activity.  This risk is increased during growth spurts where the growth plate in growing faster and is weakened due to this increased growth.
5. Poor conditioning: Lack of overall strength and conditioning can increase the risk of shoulder injuries in young pitchers.  60% of pitching velocity comes from the lower extremities and the core.  Weak lower extremities and a weak core puts increased demands on the shoulder when throwing.
6. Fatigue: Pitching while fatigued can alter mechanics and increase stress on the shoulder, leading to pain and potential injury.
7. Trauma: Acute injuries, such as falls or collisions during play, can also cause shoulder pain in young pitchers.
8. Inadequate warm-up or cool-down: Skipping proper warm-up exercises before pitching or neglecting to cool down and stretch afterward can increase the risk of shoulder injuries.  Posterior capsular stretching for GIRD is very important prior to throwing.  
9. Inappropriate pitch counts: Exceeding recommended pitch counts or not adhering to rest guidelines between pitching sessions can increase the risk of shoulder injuries in young pitchers.
10. Pre-existing conditions: Certain pre-existing conditions, such as shoulder instability, labral tears, or tendonitis, can predispose young pitchers to shoulder pain and injury.

It’s essential for young pitchers to receive proper coaching, maintain good pitching mechanics, incorporate strength and conditioning exercises into their routine, follow pitch count guidelines, prioritize rest and recovery, and seek medical attention if they experience persistent shoulder pain or discomfort.  At Total Orthopedics we have sports medicine experts in diagnosing and treating shoulder pain in young overhead throwers.