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Sore Arms: What You Need To Know* - 10/15/2007
son/daughter has a sore (elbow or shoulder).
With more games
being played, due, at least in part, to the expansion of travel ball and
fall leagues, arm problems for young ball players are becoming more
prevalent. According to Dr. Glenn Fleisig of the American Sports Medicine
Institute (www.ASMI.org) there are two
major “thresholds” where he sees more arm problems:
Are the number of games your kids are playing approaching that of these
highly skilled, physically mature adults?
As for throwing
85+ mph, well, of course, we want pitchers to throw this hard, and harder.
At this level of velocity, however, the structures of the arm undergo
greater forces and stress. If not properly cared for, problems are
– too many practice sessions and games, too many innings pitched. All of
which adds up to insufficient recovery time.
2)Improper mechanics - Overhand throwing is a bio-mechanically un-natural act, even when done with what are considered to be good mechanics. When things are not being done properly, problems increase dramatically.
– inflammation of a tendon. The white areas on each end of the muscle
are its tendons, which connect muscle to bone. Considered to be a rare
Tendinosis – a more serious condition characterized by degeneration (not inflammation) of the collagen fibers in the tendon due to excessive wear and tear. More common, and more difficult to treat, than tendonitis.
Healthy vs. Broken Down Tendons
Comparing Tendinosis To Tendinitis
Syndrome - the diagnosis given for
shoulder pain that is the result of tissues that get "pinched"
or "impinged." This pinching
occurs when the shoulder joint no longer stays centered in the socket as
the arm is raised, as in the overhead throwing motion of a baseball or
softball player. Can be caused by imbalances of strength and flexibility
between various muscles in the shoulder.
Can be caused by inflammation from too much repetitive activity, like throwing, or from a breakdown of tendon fibers known as tendonosis (see above).
Post-activity pain, such as that which is ordinarily felt after training
or competition, should dissipate within 24-48 hours. Pain persisting
beyond this time should be referred to appropriate medical authority.
At this point, trying to "tough it out" can lead to more serious
When arm problems occur, this is the course that will likely have
to be followed:
1) Stop any
activity causing pain. Recovery time will vary; can take weeks to months.
2) When pain
is gone, begin appropriate strength and conditioning work to re-hab the
3) After a
minimum of 6-8 weeks of S & C work, begin activity (throwing) again.
There are NO shortcuts through this process. It is better to err on the
side of extra recovery time rather than rushing back prematurely and
risking re-injury. The good news is that appropriate strength and
conditioning can help ball players to both prevent as well as recover from
1. Khan KM, Cook JL, Taunton JE, Bonar F. Overuse tendinosis, not tendonitis. The Physician & Sports Medicine 2000;28(5):38-48.
*This report is not intended to diagnose or treat a medical condition.
It is presented for informational purposes only. If you are experiencing
arm pain/problems, seek the advice of appropriate medical authority.