Daughter has shoulder injury from overuse- tendinitis and mild rotator cuff tear. She has good mechanics and has started a strengthening program used for baseball pitchers. She really wants to continue to play and pitch, but doctor says more overuse will mean she is done. She can listen to her arm and body, but not sure coach will listen to her. Need some guidelines on working back up to live game speed and what is reasonable to expect from a pitcher at college level- days off, how much in season practice pitching and throwing batting practice. Lots of guidelines and restrictions for baseball, but can not find any for softball. Thanks for any advice.
Need Advice for recovery from overuse injury
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Please seek some additional advice from a medical professional.
The first thing I would say is there is no such thing as a "Mild" rotator cuff tear. A tear is a tear and I would seriously seek a second opinion if there is a doctor out there telling her she can pitch. One of my past students is currently rehabing her shoulder due to a tear in her cuff and is expected to make a full recovery. This isnt something you take lightly and I am not saying you are with your daughter. This just doesnt sound good for her future.
IMO if she continues to pitch she is at risk of further damage and going through a lot worse in the future. Then there are the long term implications of which I know nothing about but there is something to be said about quality of life as you get older. You dont want to have that shoulder be a problem for her over the long run. There are literally thousands of older athletes who are in pain every day due to the experiences of their youth as athletes. Me included.
An ounce of prevention is worth a pound of cure. It may be an old saying but it still rings true even in todays world of medicine.
Dana.
The first thing I would say is there is no such thing as a "Mild" rotator cuff tear. A tear is a tear and I would seriously seek a second opinion if there is a doctor out there telling her she can pitch. One of my past students is currently rehabing her shoulder due to a tear in her cuff and is expected to make a full recovery. This isnt something you take lightly and I am not saying you are with your daughter. This just doesnt sound good for her future.
IMO if she continues to pitch she is at risk of further damage and going through a lot worse in the future. Then there are the long term implications of which I know nothing about but there is something to be said about quality of life as you get older. You dont want to have that shoulder be a problem for her over the long run. There are literally thousands of older athletes who are in pain every day due to the experiences of their youth as athletes. Me included.
An ounce of prevention is worth a pound of cure. It may be an old saying but it still rings true even in todays world of medicine.
Dana.
I am sorry to hear of her problem. I rehabbed both shoulders about 10 years ago and it is pain that i never experienced before.
I coached at the small college level and if you came to me and told me that it is her choice to still pitch, I would have the young lady throw at a moderate pace every other day and see how she feels. My girls did not throw batting practice, so that wouldn't even be a consideration.
During games, i would have her warm up and throw maybe 50 pitches (we would come up with a number.) But, I would be so scared of permanent injury that I would be leery of using her in games.
Truthfully, my DD was done at age 16 and it just wasn't worth having her still pitch. But, her injury wasn't the rotator cuff. The sports doc told us she was done.
I hope she has a reasonable coach. I would not have her throw every day.
OT - I was in Starbucks yesterday and the woman waiting on me kept hitching her right shoulder up and sort of rotating her elbow. I though "There is a former pitcher with a shoulder problem."
I coached at the small college level and if you came to me and told me that it is her choice to still pitch, I would have the young lady throw at a moderate pace every other day and see how she feels. My girls did not throw batting practice, so that wouldn't even be a consideration.
During games, i would have her warm up and throw maybe 50 pitches (we would come up with a number.) But, I would be so scared of permanent injury that I would be leery of using her in games.
Truthfully, my DD was done at age 16 and it just wasn't worth having her still pitch. But, her injury wasn't the rotator cuff. The sports doc told us she was done.
I hope she has a reasonable coach. I would not have her throw every day.
OT - I was in Starbucks yesterday and the woman waiting on me kept hitching her right shoulder up and sort of rotating her elbow. I though "There is a former pitcher with a shoulder problem."
halskinner
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When she pitches, is her arm straight? Does she have a slight bend in the elbow?
OK. I will be the first to step up and say this; If her mechanics were good, she would not tear her rotator cuff. How did the Dr determine that it was torn? What type of scan did he/she do? Was this an MD or an Ortho Surgeon? Did the Doc refer her to a sports physical therapist? (Most will for further diagnosis confirmation).
If the shoulder stretches up at 12:00, there are two groups of muscles that CAN be strained and/or torn, the Infra-scapularis and the Supra-scapularis muscle groups. One runs underneath the scapula and the other on top. They can be damaged and are often mis-daignosed as a rotator cuff injury.
If none of these things were addressed or discussed, get another opinion and get her to a knowledgeable physical therapist that will put her through specific excercises to determine exactly what is damaged.
Hal
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"One runs underneath the scapula"
That is the one that my DD injured. She pitched by taking the ball high above her head and then going into her motion. (She was a little stubborn sometimes.) Anyway, an ortho doc diagnosed her through an MRI. His nurse said that she could pitch if he gave her a steroid and the doctor said "absolutely, not." She rehabbed and then played 1st or CF.
But, rehab takes weeks. And I am thinking that the OP is saying that his DD needs to start her season, now.
That is the one that my DD injured. She pitched by taking the ball high above her head and then going into her motion. (She was a little stubborn sometimes.) Anyway, an ortho doc diagnosed her through an MRI. His nurse said that she could pitch if he gave her a steroid and the doctor said "absolutely, not." She rehabbed and then played 1st or CF.
But, rehab takes weeks. And I am thinking that the OP is saying that his DD needs to start her season, now.
Softball players don't operate in a parallel universe where the rules of physics, anatomy and physiology don't apply.
A person with a great pitching motion can be injured. Rotator cuff injuries are repetitive stress injuries. They are caused by overuse. Perfect form does not guarantee that an injury will not occur.
We have people in this forum regularly complaining about injuries to their kids from pitching. These kids are getting hurt by coaches and parents pushing the kids too much.
I suspect that the male fastpitch pitchers who make these statements in fact never pitched as much as the college kids are expected to pitch. College kids are pitching 5 to 6 days a week, 9 months a year.
A person with a great pitching motion can be injured. Rotator cuff injuries are repetitive stress injuries. They are caused by overuse. Perfect form does not guarantee that an injury will not occur.
We have people in this forum regularly complaining about injuries to their kids from pitching. These kids are getting hurt by coaches and parents pushing the kids too much.
I suspect that the male fastpitch pitchers who make these statements in fact never pitched as much as the college kids are expected to pitch. College kids are pitching 5 to 6 days a week, 9 months a year.
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halskinner
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At what point do you draw the line at what is enough or too much pitching at any given point? There are signs that the throwing arm/shoulder is reaching the point it is tired. Those signs are ignored CONSTANTLY. When the muscles get tired, they cannot protect the ligamates / tendons like they are designed to do. If you reach that point and continue pitching in that game / day, etc, certainly you can tear a rotator cuff. HOWEVER it is highly unlikely you will do that BEFORE something lesser happens first, like a muscle tear, inflammation, etc. These are all things that you will feel happening. Keep pitching after that point, yeah, you can tear a rotator cuff, it's on the list as one of the next things that will happen if you dont stop pitching at that moment.
What were the other complaints the pitcher had that were ignored by everyone, including the pitcher? Unless this pitcher did not warm up, did not stretch, was not in any kind of shape to pitch in the first place, etc, it is unlikely she went out started pitching hard and tore the rotator cuff. Something else would have happened first to let the pitcher know something was not right and it surely was ignored.
No offense intended to the pitcher in question here. But, if you are driving a car and you are stopped at a light AND your brake pedal slowly goes to the floor as you sit there, wouldnt that be the first indicator you have a problem? Do you keep driving it thinking it will go away or get better? Or, does it take driving off a cliff when they go out completely for you to finally take it seriously? I would be very surprised to learn this pitcher had Zero complaints at all and then BLAM, all of a sudden her rotator cuff tears! There had to be warning signs something was not right.
When I hear of a pitcher tearing a rotator cuff and I can get any response at all, they almost always did the same exact thing, they threw with a straight and locked elbow and/ or they threw with the throwing shoulder extending very high and pulling on everything.
I probably should have used a more specific description in my first post so you would be more comfortable with it. Those are the mechanics I was referring to.
I do not lump all injuries into the 'overuse' category. I consider 'overuse' injuries as what happens over extended periods of time. I consider a rotator cuff tear as more of an instant offense type of injury.
I certainly do not speak for the rest of the pitchers but my softball schedule went like this;
We started working out twice a week, two hours a session, indoors in the first week of December, outdoors also when weather permitted. We played in two different leagues in our area during the week and practiced the other 2 or3 days a week, depending on whether we had a Friday night game on the upcoming weekend tournament. Our first tourney was the first weekend of March and we played tournies EVERY weekend until the end of September. Our team took October and November off but I still got together with my catcher once a week and we just played catch for an hour. Our schedule was normally around 140 games a season.
Let me ask you this Ray; If a kid pitches a game and then needs to ice her shoulder, is she going to be good to go and pitch again in say, 3 hours?
Hal
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halskinner
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"Rotator cuff injuries are repetitive stress injuries."
If you make 2 arm circles you now have repetitive motion. I ask again, at what point can/does repetitive motion injuries occur? ! year? 2 years? Halfway through their 2nd game?? I think repetitive motion is a catch-all term for some things that should not be lumped into such a category. I also think that misdiagnosis happens alot more than we want to believe they do.
If you make 2 arm circles you now have repetitive motion. I ask again, at what point can/does repetitive motion injuries occur? ! year? 2 years? Halfway through their 2nd game?? I think repetitive motion is a catch-all term for some things that should not be lumped into such a category. I also think that misdiagnosis happens alot more than we want to believe they do.
