The Throwing Athlete

March 09, 2016

Overhead athletes pose a unique problem to medical professionals because of the complex biomechanics involved. Moreover, young athletes are becoming single sport athletes at an earlier age. Recent research suggests that early specialization of sport – particularly overhead sports put the athlete at an increased risk of injury. Arm and shoulder pain are a common complaint for coaches and parents alike. While sometimes benign, complaints of arm and shoulder pain in a young athlete should warrant evaluation if symptoms persist or are affecting his or her play. Here are some basic recommendations for the overhead athlete:


  1. Arm and shoulder pain in a thrower should be taken seriously. If symptoms persist for more than a few days, are recurrent, or cause the athlete to modify or miss activity then a medical professional should evaluate them.

  2. Adhere to pitch counts. Pitch counts are widely available for review and should be followed strictly. and the American Sports Medicine Institute have clear guidelines available to the public.

  3. Be cautious regarding early sport specialization. Many parents and athletes feel they are gaining a competitive edge when they play a single sport year round. While there are certainly circumstances where this is appropriate, recent research shows these athletes are at a higher risk of burnout and injury. Outside of a few specialty sports (gymnastics, figure skating, swimming/diving), there is little evidence to suggest that early specialization is advantageous. A UCLA sports specialization study surveying 296 NCAA Division I male and female athletes found that 88 percent participated in an average of two to three sports as a children, and 70 percent did not specialize in one sport until after the age of 12. In a similar study of Olympians in Germany, results found that on average, the Olympians had participated in two other sports during childhood before or parallel to their main sport. Both studies support the concept of sports diversification in adolescence -- not specialization.

  4. Watch the mechanics! Regardless of pitch counts, if you notice a pitcher is becoming fatigued – take them out. Injuries are most likely to occur when the mechanics break down and the kinetic chain breaks down. “Falling off the mound” is a common indicator that the thrower may be starting to fatigue.

  5. Prepare. There is evidence that suggests that a pre-season training program may reduce injuries. Proper neuro-muscular training before an intensive season should be considered. There are sports performance and sports injury programs available through Spartanburg Regional’s Sports Medicine program.


John Lucas, MD

Sports Medicine



If you are concerned about an athlete or child, then please have them seen by a medical professional with expertise in sports medicine.  Appointments at the Sports Medicine Institute with Dr. Lucas are available by calling 560-BONE.