Baseball season is underway. With the pros, college and high school teams taking to the baseball diamonds and Little Leaguers soon to follow, orthopedic specialists at Rush University Medical Center are cautioning players to take precautions against throwing injuries. An analysis of pitching injuries by researchers at Rush is published in the March/April issue of Sports Health.

"Throwing a baseball is one of the fastest and most violent maneuvers that any joint in the body is subjected to. The violent and rapid motion places numerous structures in the shoulder at risk for injury," said Dr. Shane Seroyer, lead author of the report and sports medicine fellow at Rush.

Prevention of injury is the key to a long career. Pitchers, especially young pitchers, should limit the number and types of pitches thrown to minimize the risk of injury.

"For pitchers under 14 years old, we encourage fast ball and change-up pitches and discourage the use of a curveball to prevent injury," said Dr. Charles Bush-Joseph, sports medicine specialist at Rush and co-author of the report.

Bush-Joseph breaks down the number and type of pitches appropriate for various age groups.

* 9-10 years old: no more than 50 pitches/game and 75 pitches/week
* 11-12 years old: no more than 75 pitches/game and 100 pitches/week
* 13-14 years old: 75 pitches/game and 125 pitches/week
* 14 years old: begin throwing curveball pitch
* 17 years old: begin throwing slider pitch

According to Seroyer, if injury does occur, the early discovery of symptoms, followed by conservative management with rest and rehabilitation, can help to decrease the need for surgery in the future.

Shoulder pain may occur during any of the six phases of throwing, which are wind-up, early cocking/stride, late cocking, acceleration, deceleration and follow-through. According to the sports medicine specialists at Rush, diagnosing pain from overhead throwing is one of their more difficult challenges, but shoulder pain most often emanates from one of the following five sources: damaged cartilage, rotator cuff injury, abnormal scapula movement, impingement and neurovascular disorders.

Injury to cartilage (the labrum), which surrounds the shoulder joint, occurs with trauma to the shoulder joint. Labral tears are among the most common injuries for overhead throwers and generally result from the cocking and acceleration phases of overhead throwing. Cartilage also wears down with age and use.

Damage to the rotator cuff, a term given to the group of muscles and their tendons that act to stabilize the shoulder, can lead to tendonitis and muscle tears. Although one specific movement could cause injury to the rotator cuff, this type of injury is often the result of the "wear and tear" from the overhead throwing motion.

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