Dear Readers,

Welcome to the second issue of our newsletter! As summer heats up, so does the action on the field. In this edition, we dive deep into the vital considerations every player should keep in mind when it comes to their health during summer ball. From managing expectations to knowing when to push through discomfort like elbow soreness, we explore how to balance the passion for the game with smart, health-conscious decisions. Congrats to all the high school and collegiate baseball players who have just wrapped up their seasons!

In Focus: Summer Ball - To Play or Not to Play

Now is the time to decide if playing summer ball is right for you. Playing in a summer league offers valuable opportunities to compete against talented players from across the country, which can be beneficial for skill development and exposure. But you may want to think twice before rushing back into play without adequate recovery from the spring season. It’s crucial to assess your physical condition after each season and distinguish between “normal wear” and possible future problem areas. Your decision to play summer ball should align with your long-term goals, and if these long-term goals include play at a high level such college or pro, then it is imperative you give your body rest when it is asking for rest to avoid long term injuries and consequences. Summer can be a great time to focus on strength, agilities and the basics, especially with the demanding fall season approaching soon after. Remember, fall ball is just around the corner, and your coaches will be expecting your peak performance come September. Are you unsure if your arm and body are ready for summer ball? This can be a great time to see your physical therapist or athletic trainer for their input.

Expert Insights: Strategies for Injury Prevention and Rehab - Should I Play Through My Elbow Pain?

Elbow pain is a complicated matter. It isn’t always an immediate cause for concern nor does it always mean you have to sit the next game out, but it should never be ignored and you should have it checked promptly by your sports medicine physical therapist, athletic trainer, or doc. There are several factors taken into account when determining if it is safe or not to return to play, or in what capacity is it safe to return to play. Are your velocity, accuracy, and control affected as well? Do you have pain only when pitching, or do you also have pain when batting? What kind of pain is it and does it linger for minutes, hours, or even days after you play? Does your pain with throwing change when you implement a proper warm-up and post-game recovery routine, and/or alter your in-season training program. Perhaps you can still hit or play at first base without risking further injury. Teenage years are critical for physical development, and although also a critical time for showcasing your talent, playing through certain injuries can interfere with normal growth patterns and increase the risk of long-term joint damage. For example, let’s say you have pain in the olecranon (the bony point on the back of your elbow) from a stress injury. The muscles and UCL in particular have to work harder to stabilize the joint. You also slightly alter your throwing mechanics to avoid the pain. With repetitive stress in this pattern over time, a pitcher while likely suffer from a UCL sprain.

Causes of elbow pain I often see:

• Little League Elbow: growth plate injury on the inner side of the elbow

• UCL Injuries: That ulnar collateral ligament aka the “Tommy John” Ligament

• Medial Epicondylitis: Irritation of the tendons on the inside of the elbow

• Lateral Epicondylitis: Irritation of the tendons on the outside of the elbow

• Osteochondritis Dissecans: A part of bone and cartilage separates from the end of the bone

• Olecranon Stress Fracture: repetitive trauma leading to a crack in the bone at the tip of the elbow

• Muscle Strains: Often from poor mechanics

• Tendonitis of the arm or forearm

  Most of these injuries are from repetitive stress (high pitch counts, not enough rest), poor throwing mechanics which place extra stress on the elbow structures, and/or muscle weakness/imbalances.

Technique Spotlight: Enhancing Shoulder Stability and Mobility - “External Rotation with Eccentric D2 Movement Pattern”

Here is what I love about this exercise: Prime rotator cuff strengthening with training of shoulder deceleration all in one.

Rotator cuff strengthening helps stabilize the shoulder joint and improve overall upper body mechanics, reducing excessive stress and compensatory movements that can contribute to elbow injuries during throwing motions. In the deceleration (forward) phase of throwing, the rotator muscles eccentrically contract to slow down the arm and mitigate high forces imposed on the shoulder and elbow.

Dr. Bell’s Tips:

1) Anchor the band at or slightly below your waist

2) Engage your core and plant your feet into the ground. Begin in a position of external rotation with your arm at your side

3) When you punch out, make sure that you punch at an angle that is about 45 degrees away from your body

4) Keep that elbow straight as you slowly (to a count of about 3-5 seconds) bring your arm towards your opposite hip

Success Story: Overcoming Adversity - Michael B.

Meet Michael, a starting pitcher on Mater Dei High School’s baseball team. He had Tommy John Surgery (Ulnar Collateral Ligament Repair) with ulnar nerve relocation and a cadaver olecranon bone graft. The first two parts of this surgery are performed frequently in the baseball world, however the olecranon bone graft is quite uncommon, and the rehab can be slow and require more discipline. Michael came to me about 9 months out of surgery with range of motion restrictions and significant weakness in his elbow and shoulder. We outlined his plan for returning to play, and Michael dominated his rehab. He was recently cleared to play in summer ball from his doctor about 1 year out of surgery! Typically this rehab will be a 14+ month progression. Great work, Michael! And Good Luck!

Ask the Expert: Your Burning Questions Answered - “What do you recommend for pitch count for my 14 year-old son?”

I love Dr. James Andrews’s research on pitch count and avoiding overuse injuries. I interned at his sports medicine clinic down in Birmingham, and still hold his work as a gold standard in baseball rehab. His findings, along with those of other experts in the field, helped develop Little League Baseball guidelines for maximal safe pitch counts by age.

Source: Little League Baseball

For more information on injury prevention, optimal rest/recovery days and recommended pitch types per age, check out his website:

Stay Connected: Join Our Community

Connect with our vibrant online community of fellow overhead athletes, coaches, and sports enthusiasts by giving us a follow on Instagram @TheTrainingRoomOC. Share your experiences, seek advice, and stay updated on the latest developments in sports performance physical therapy for overhead athletes. Together, we can elevate our performance and achieve new heights in our respective sports.

Closing Note:

Thank you for embarking on this journey with us through the world of sports performance physical therapy for overhead athletes. We hope you found this issue of "The Overhead Athlete's Edge" insightful and empowering. Stay tuned for more valuable information and inspiration in our next edition. Until then, keep honing your skills, pushing your limits, and trusting the process!

Best regards,

Dr. Sam