Arm/Shoulder Overuse Injuries in Children

Dec 18, 2019

Foothills Sports Medicine Physical Therapy

by Foothills Sports Medicine Physical Therapy

It is the middle of November and you are at your son’s club baseball or daughter’s club softball game and you have been informed your child’s teammate is having to sit out this tournament because their arm hurts.  Or even worse, this may be your son or daughter who is needing to sit out. As a father to 3 baseball players who all play club/travel baseball, I have seen this firsthand.  It is stressful for the player, the family, and the team. It happens more often than one would think. In the blog below, we will talk about overuse arm injuries in throwing athletes. As well as some of the reasons for them and what to do about them.

Early specialization and the rise of club/travel teams

Youth sports are competitive, there is no doubt about it, and today’s parents (and kids) have the stress that their kids have to play club sports in order to stay competitive. Club or travel ball teams now dominant youth sports and have become a lucrative business model for coaches. With this development, we have also seen the rise of kids playing one sport year-round or one-sport specialization.

Here is a list of some of the reasons for specialization:

  • The more my child plays, the better they will be.
    • This statement is true, the more you practice a specific skill you will get better at it. But, being good at a sport is multi-faceted and so many things go into being “good”. The repetition of the sport is only one piece.
  • If they don’t continue to play, then they will lose their spot on the team.
    • This is the stress that all parents deal with being part of the travel team sports (including myself!). But we need to understand that this is just not true, it will not be the end of the world if your child takes a season off. It may actually be a good thing!
  • The coach of the team makes his living running travel teams.
    • As adults, we need to make a living and provide for ourselves and our families. If someone can make a living coaching the game they love then more power to them. We as parents need to remember that the coaches and organizations need to keep their teams full and playing year-round to ensure their businesses are successful. For this reason, we must be our children’s loudest and best advocate.

Individualized coaching versus a general strength and conditioning base:

This follows with early specialization and the stress placed on parents for their children being the starting shortstop on their team (or fill in the blank). If you are looking to get individual coaching lessons, there is no short supply of coaches offering these services.  The same travel ball coaches are probably offering lessons or there are numerous facilities/coaches that offer coaching lessons.  This is definitely a great resource to improve your skill set and I have used them for my kids. They need to be spending time working on strength, flexibility, balance/coordination, speed, and agility.
Our bodies need and crave variability which we can get playing more than one sport but if they only play one sport then it is even more important that we supplement activities like:

  • Strength and Conditioning Activities
    • The number one thing coaches look for at the higher levels of sports (high school and above) is the player’s physical attributes – strength, speed, and quickness. Of course, athletic ability is very important but that can be worked on; they want to see that athletes are athletic.
  • Playing Outside
    • When kids go outside and play, they run, jump, skip and perform activities that translate to them being more coordinated, agile, and not mention happier.
  • Play other sports for fun…
    • Who said that every game played has to be serious and played to win? Grab a basketball, go to the park and shoot some hoops.  Have fun!

So what do I do to keep my child from hurting his arm?

Research has shown the #1 reason for youth arm injuries is lack of rest. Kids are simply playing too much and not getting enough rest and recovery time in between playing. Here are a few tips to help keep your child’s arm healthy throughout the travel ball season:

  1. Keep an eye on their pitch count and recovery
    • There are great resources to help guide you in understanding how much rest your child should get based on how many pitches they have thrown. I recommend Pitch Smart by Major League Baseball (
  2. Develop a Routine to Take Care of their arm

    • All ballplayers need to be doing a strengthening program to address all the muscles of the shoulder to ensure they have the strength and endurance needed to handle the stresses placed on it with throwing. We at Foothills Sports Medicine are a great local resource when looking to develop an Arm Care Program (
  3. Work on strengthening your legs and core.
    • The force to throw a baseball fast does not come from your arm but actually comes from your legs and core. So if you want to throw the ball harder and take the stress off your arm then get your legs stronger!! Our FAST trainers are a great resource to help build bigger legs (

 What do I do if my child’s arm is hurting?

As a physical therapist and a father of baseball players, I get asked this question both in the clinic and at the ballpark. Here are my suggestions if your child’s arm has been hurting from playing baseball or softball.
Stop Playing and Take a Break
Seems pretty obvious but as I said earlier there can be a lot of stress involved in playing on a team from not wanting to let the team down to your child not wanting to stop playing. But if he or she has been having some complaints from some time then the first thing is to stop playing to allow the injured area (shoulder, elbow, etc.) to rest and allow the things to calm down. If things do not get better then see a physical therapist.
Go See a Physical Therapist to Assess your Child
Once you have shutdown your child from playing and they are still having pain, then the next step is to have them assessed by a medical professional as you want to rule out anything serious and then get a good plan to get them healed and back playing.
One Tip, see a professional that has experience working with throwing injuries as it does make a difference!! It is important to get the correct diagnosis and plan set up. Arizona is a Direct Access state, so that means you do not need a referral from a doctor to see a physical therapist. PTs are a great first provider to see these types of injuries as they can assess the athlete and deem if a referral to a physician is warranted.

Not All Rehab Programs are the Same…

Physical therapy is normally the first thing recommended for arm injuries in overhead athletes. Seeing a physical therapist will help ensure your child is on the correct program and will recover as quickly as possible. The other piece of the rehab program in the throwing program. It is imperative that a throwing program is implemented prior to being released to their sport to ensure their arm has been conditioned to handle the stresses. This is biggest thing that I see missed when a patient comes to see me with a recurring arm injury.
We at Foothills Sports Medicine Physical Therapy/FAST have the knowledge, skill, and compassion to help keep your baseball/softball player’s healthy and on the field. Contact a clinic near you for further information and questions.

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