Shoulder Tendinitis

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Has anybody or your DD come down with a case of tendinitis? What age were you/they when it occurred? How long did you have to rest before the pain went away? Did it come back?

I ask because I think my 10U catcher has come down with it. She will see a doctor tomorrow to get an official diagnosis. 10 seems young to have it but she throws, on average, three days a week and has more or less, non stop since June of last year. Two weeks ago her throws to second no longer reached 2nd base...she complained of some pain in her bicep/tricep area but said she could play. This past weekend her throws were worse and yesterday she pointed to her should as the culprit. She has full range of motion after icing down the area and has no pain unless she is throwing...that is why I think it is tendinitis and so does the nurse at the doctor's office.

advice? stories? scolding of bad dad for not noticing earlier?

 

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It can happen at any age... basically it is overuse of the muscle... rest, rest and rest for it.

Best to get her to a doc to look at it - or you could go old school and shoot some cortisone / steroids in it and play on.... (JUSTTTTTTT KIDDING!)

Wishing her a quick recovery - that is the beauty of youth, she will come back quick.

 

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Has anybody or your DD come down with a case of tendinitis? What age were you/they when it occurred? How long did you have to rest before the pain went away? Did it come back?

I ask because I think my 10U catcher has come down with it. She will see a doctor tomorrow to get an official diagnosis. 10 seems young to have it but she throws, on average, three days a week and has more or less, non stop since June of last year. Two weeks ago her throws to second no longer reached 2nd base...she complained of some pain in her bicep/tricep area but said she could play. This past weekend her throws were worse and yesterday she pointed to her should as the culprit. She has full range of motion after icing down the area and has no pain unless she is throwing...that is why I think it is tendinitis and so does the nurse at the doctor's office.

advice? stories? scolding of bad dad for not noticing earlier?

When she is allowed bring her by and lets look at her throwing mechanics.

I would start there first and it is not uncommon especially with girls!

From the net.... According to Meyers, 38% of all upper extremity injuries are specific to the shoulder in softball. When compared to the number of other injuries, shoulder injuries are currently the number one upper extremity injuries in softball. On that note, some sports media have claimed (anecdotal) that the fast pitch motion (underhand pitch) in softball is safer on the shoulder joint (than overhand). However, the research suggests that under- and over- hand throwing both add similar stress to the shoulder. (1,2,4) Nevertheless the majority of the stress for over hand throwing is in the deceleration movement (release portion of the throw) which puts the most stress on soft tissues and connective tissues involved in external rotation of the shoulder.(4)



Where is she finishing after she throws the ball? Does her ball hand finish across her body or is she snapping the wrist?



From the net...Anatomically, women are slightly different than men especially in the elbow angle, which is called carrying-angle.Women have a slight angle outward at the elbow thus making it more difficult for them to throw overhand or swing through the ball.As this elbow angle increases past ten degrees, these women are found to be more successful in throwing underarm.

 

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When she is allowed bring her by and lets look at her throwing mechanics.

I would start there first and it is not uncommon especially with girls!

From the net.... According to Meyers, 38% of all upper extremity injuries are specific to the shoulder in softball. When compared to the number of other injuries, shoulder injuries are currently the number one upper extremity injuries in softball. On that note, some sports media have claimed (anecdotal) that the fast pitch motion (underhand pitch) in softball is safer on the shoulder joint (than overhand). However, the research suggests that under- and over- hand throwing both add similar stress to the shoulder. (1,2,4) Nevertheless the majority of the stress for over hand throwing is in the deceleration movement (release portion of the throw) which puts the most stress on soft tissues and connective tissues involved in external rotation of the shoulder.(4)



Where is she finishing after she throws the ball? Does her ball hand finish across her body or is she snapping the wrist?



From the net...Anatomically, women are slightly different than men especially in the elbow angle, which is called carrying-angle.Women have a slight angle outward at the elbow thus making it more difficult for them to throw overhand or swing through the ball.As this elbow angle increases past ten degrees, these women are found to be more successful in throwing underarm.

Thanks, Howard!

She is being trained to follow through across her body. She does struggle with the elbow outward on her throws, however. I think having you evaluate her would do wonders for her mechanics.
She knows to bend her front knee when throwing but falls back into bad habbits...and has a tendency to fall off to her left side when making a strong throw. Any help you could offer would be appreciated.

Doug, thanks for the well wishes! Looking forward to the 24th! We will be there even is she is to be shut down for awhile.

 

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I was a catcher back in the day and was diagnosed with "Impingement Syndrome" at 16. It took a little more than two months to completely heal. No surgery was necessary. See the link:

http://orthoinfo.aaos.org/topic.cfm?topic=a00032


Len

 

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Howard has so impressed this upon me that my team has changed our strategy for our pitchers. We have 2 very strong pitchers and 1 up and coming one. If we have a 3 game PP on Sat - each girl will pitch 1 of the games - we will put them up against the teams that we think give us the best chance to win all 3.

On Sunday - if we draw a 'weak' team the #2 or maybe #3 will throw first, and we will game plan from there to make sure none of them throw more than 2 games per day and our #1 starts the championship game should we get there. That limits each pitcher to a max of 3 games pitched (15 innings or so) per weekend.

It took HC a while to get it thru to me - but it is the right thing to do.

 

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I was a catcher back in the day and was diagnosed with "Impingement Syndrome" at 16. It took a little more than two months to completely heal. No surgery was necessary. See the link:

http://orthoinfo.aaos.org/topic.cfm?topic=a00032


Len

Thanks for the info, Len...

I hope it is not that serious. I wish I could take her straight to an ortho but I have to play the insurance game and go to her primary pediatrician for a diagnosis/referral. I pray its a two to three week of rest type of thing.

 

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Thanks for the info, Len...

I hope it is not that serious. I wish I could take her straight to an ortho but I have to play the insurance game and go to her primary pediatrician for a diagnosis/referral. I pray its a two to three week of rest type of thing.

From the net as to carrying angle.... "When the arm is extended, with the palm facing forward or up, the bones of the humerus and forearm are not perfectly aligned. The deviation from a straight line occurs in the direction of the thumb, and is referred to as the ?carrying angle? (visible in the right half of the picture, right).


The carrying angle permits the arm to be swung without contacting the hips. Women on average have smaller shoulders and wider hips than men, which may necessitate a greater carrying angle. There is, however, extensive overlap in the carrying angle between individual men and women, and a sex-bias has not been consistently observed in scientific studies [3] [4] [5].


The angle is greater in the dominant limb than the non-dominant limb of both sexes [6] [7], suggesting that natural forces acting on the elbow modify the carrying angle. Developmental [8], aging and possibly racial influences add further to the variability of this parameter."


We did a sampling of 160 girls at a clinic recently by having them do the palm up and extend their hands and arms away from the body and it was an eye opener to see the variation in angle of the elbows. The elbows are much closer together for some girls and this presents a problem not only in over hand throwing but in getting extended through the ball. We see the lead arm fold over and they finish between the shoulder and neck sharply.

 

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Howard has so impressed this upon me that my team has changed our strategy for our pitchers. We have 2 very strong pitchers and 1 up and coming one. If we have a 3 game PP on Sat - each girl will pitch 1 of the games - we will put them up against the teams that we think give us the best chance to win all 3.

On Sunday - if we draw a 'weak' team the #2 or maybe #3 will throw first, and we will game plan from there to make sure none of them throw more than 2 games per day and our #1 starts the championship game should be get there. That limits each pitcher to a max of 3 games pitched (15 innings or so) per weekend.

It took HC a while to get it thru to me - but it is the right thing to do.

This is what Doug and I were talking about....

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1941294/


Shoulder injuries are another primary area of preventive concern for collegiate softball players. Although the results do not specify the number of shoulder injuries that can be categorized as chronic or overuse, shoulder strains and shoulder tendinitis were common chronic/overuse injuries that accounted for almost 10% of practice injuries ( Table 5). Furthermore, 5.5% of practice injuries resulting in 10+ days of activity time loss were attributable to shoulder tendinitis ( Table 6). A common misconception is that the windmill motion of softball pitching creates less stress on the arm than the overhead motion of baseball pitching does. However, the degree of shoulder distraction stress on elite softball pitchers during the 1996 Olympic Games averaged 80% ? 22% of their body weight (range = 50% to 149%), which is comparable to that of professional baseball players (mean = 108% ? 16% body weight, range = 83% to 139% body weight) and may put softball pitchers at risk for overuse injury. 14, 15 When 181 NCAA female pitchers were surveyed, 25% of their injuries were categorized as chronic/overuse shoulder injuries. 6 Pitch counts need to be more of a priority for coaches, pitchers, and certified athletic trainers, with an emphasis on the quality versus the quantity of pitches during practice. 6 Furthermore, position-specific interval throwing programs have been designed based on NCAA softball game data, field dimensions, common softball injuries, and general tissue-healing concepts. 16 These programs are not only important for rehabilitation but also may be a beneficial component of the conditioning regimens for all position players. 16

 

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Howard, you're a wealth of information. I see why Les and Kavin speak so highly of you.

I'll keep everybody posted on my DD diagnosis and I will certainly let you know, Howard, when she if free to throw again so I can bring her by and let you give your analysis.

 

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In addition to Howard's suggestions, I've always been told by doctors and athletic trainers to be sure she is doing some other activity (like shooting hoops, swimming, etc.) - things an athletic 10 yr. old should be doing anyway. Mix it up, with doctor's recommendation, so she doesn't overload a certain muscle group. IMO, 10 months of constant throwing for a 10 yr. old kid is definitely overload! As a pitcher, my DD always skipped fall ball to do other activities, and rest from throwing.

 

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sent you a PM

 

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My 13 y/o DD was diagnosed with shoulder impingment this past fall. The suggested cause was overuse. She is a pitcher and 2009 was her first time pitching all year (winter training starting in January, school ball, both rec and travel in the summer, then fall ball). She saw a sports doc and had PT, recovered in about 6 weeks. Her pitching and throwing motion was pretty good, but her pitching coach worked on a couple minor things and she has been doing much better (had a good game tonight).

One real word of warning - CHECK YOUR INSURANCE! The PT we had (as recommended by the doc) was by a sports training person, not an "official" PT person according to our insurance. She was being treated by Children's Hospital in Westerville, so not a shady group. But after the fact our insurance denied payment and we were stuck for a grand in payments. Fortunately she recovered sooner rather than later! So just double-check what your insurance will cover for PT.

 

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My dd was diagnosed with this she has been working with a therapist for about 6 weeks hopefully will be released come summer ball.

 

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Ran into this 2 springs ago when she was 12 years old. In major pain for a month,then after a game which we had to pull her out we took her in the ER. Luckily for us the nurse that took care of her knew a sports specialist that pitched in college.
It all came down to her mechanics for the reason she had bad muscle pulls. Changed them asap and havent had a problem since.

Atleast in our case it was due to mechanics.

 

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Thank you for the replies. I am quickly learning that the fastpitch community is truly all about the girls no matter the location or the organization.
Legend, thank you for the PM.

 

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Doug is considering taking better care of pitchers and that is a good thing. The same care needs to be extended to the catchers. For every pitch the pitcher throws, the catcher throws one back from her knees overhand. Then just to make sure we ask her to throw 80' really hard to a point and quickly.

Having a couple girls that can catch will help prevent this injury. Prevention is much better than any PT/surgery or rehab.

 

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Doug is considering taking better care of pitchers and that is a good thing. The same care needs to be extended to the catchers. For every pitch the pitcher throws, the catcher throws one back from her knees overhand. Then just to make sure we ask her to throw 80' really hard to a point and quickly.

Having a couple girls that can catch will help prevent this injury. Prevention is much better than any PT/surgery or rehab.

When the Hawks had their clinic Deb Hartwig whom I had meet through Don Slaught worked with me on throwing techniques as she was a catcher at CSF in California.

She was showing using RVP that two to three tenths of glove to glove time can be reduced by using a ball down and elbow up move out of the glove as it puts more MPH on the ball and less stress on the arm. She showed typical catchers throwing and then one of her students before and after.

One of the Hawks coaches sitting with me said she throws like you teach and I looked at him and said where do you think I got it from!

Some clinics are hand shaking clinics and a hand out....this was lets talk about it and then lets go put it to the test and see if it actually works like you said it would.

 

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Doug is considering taking better care of pitchers and that is a good thing. The same care needs to be extended to the catchers. For every pitch the pitcher throws, the catcher throws one back from her knees overhand. Then just to make sure we ask her to throw 80' really hard to a point and quickly.

Having a couple girls that can catch will help prevent this injury. Prevention is much better than any PT/surgery or rehab.

Excellent Point .. never gave thought to the catcher ... thanks for bringing it up.

 

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Howard - can you give me a better visual on the "ball down and elbow up move out of the glove" for the catcher? I have usually seen what I describe as an "out of the glove, back to the ear" type of move.