Injury Prevention Programs for Throwing Injuries in Softball Players: A Systematic Review

Abstract

Context: Throwing-related injuries occur commonly in softball players. Preventative programs can be implemented to assist in identifying and correcting risk factors that could potentially lead to injury and therefore time missed from both practice and games. Objective: The purpose of this study was to determine if position-specific injury prevention programs have been developed to decrease the risk of throwing-related injuries in softball players. Data Sources: A systematic review was performed using the PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) guidelines. PubMed, PMC, and EBSCO were searched for articles on injury prevention programs using the following key terms: softball, injury prevention, throwing injuries, pitcher, and shoulder. Study Selection: Studies that involved fast-pitch softball and included female participants as well as rehabilitation programs were included. Articles that highlighted slow-pitch softball or did not include female participants were excluded. Level of Evidence: Level 1. Data Extraction: The initial search identified 1605 articles. After implementing a filter, 131 articles remained. Thirteen articles were screened out as duplicates. After screening for inclusion criteria, 7 articles remained and were included in the systematic review. Results: Decreased range of motion (ROM) in both the upper and the lower extremities, unbalanced muscular strength, and fatigue were identified as risk factors for throwing injuries in softball players. Within the upper extremity, strength and ROM of the rotator cuff muscles, biceps, and extensors of the forearm were emphasized. The main focus of the lower extremity was the strength of the gluteal muscles and ROM of the lumbopelvic-hip complex. Only 1 study detailed an injury prevention program for softball players. The prevention program outlined was generalized for all softball players and was not position specific. Conclusion: There is a paucity of information about injury prevention programs for softball players. Of the evidence analyzed, balanced strengthening of the upper and lower extremities while maintaining dynamic range of motion was frequently utilized in developing an injury prevention program.

Prevalence and incidence of injuries among female cricket players: a systematic review and meta-analysis

“…The hand, wrist, and finger injuries were the second most common injury in women playing competitive bat-and-ball and ball-and-stick sports 13 . Sports such as cricket and softball carry a high risk of injury to the hand, wrist, and fingers because of the risk of acute impact from the fast-moving ball 53,54 . Although batters wear gloves and wrist guards and wicketkeepers wear gloves, the impact of the hard ball can cause tissue damage regardless of whether the player is wearing gloves 55 .…”

“…Muscle changes from repetitive use of scapular muscles can affect the scapula's position and increase the risk of shoulder injury 61 . Neuromuscular shoulder injury-prevention exercise programs 62 are specifically designed for throwing athletes to strengthen and condition the shoulder muscles, and to improve throwing mechanics 54 . Therefore, a cricket-specific neuromuscular shoulder injury-prevention exercise program can improve shoulder strength and balance, core stability, and muscle control, consequently allowing female cricket players to achieve maximum performance while minimizing the risk of an injury.…”

“…13 Sports such as cricket and softball carry a high risk of injury to the hand, wrist, and fingers because of the risk of acute impact from the fast-moving ball. 53,54 Although batters wear gloves and wrist guards and wicketkeepers wear gloves, the impact of the hard ball can cause tissue damage regardless of whether the player is wearing gloves. 55 The risk of injury to the hand, wrist, and fingers 56 might be elevated in fielders because these players do not wear gloves.…”

Differences in the Medical Advisability of Online Pitching Recommendations for Youth Softball Players Based on Website Source

“…27 Unlike the Pitch Smart guidelines for youth baseball, outlined and endorsed by organizations from Major League Baseball and USA Baseball to Little League Baseball, the softball guidelines have yet to be formally adopted by USA Softball. 10,19,21 The purpose of this study was to assess the source and medical advisability of online pitching recommendations for youth softball players to highlight the risk of misinformation. It was hypothesized that many popular websites would contain content discordant with current medical guidelines regarding underhand softball pitching recommendations.…”

Biomechanics Related to Increased Softball Pitcher Shoulder Stress: Implications for Injury Prevention

“…36 The high rate of shoulder injury is theorized to result from overuse attributed to the dynamic and repetitive nature of softball pitching and the high shoulder stresses exhibited throughout the pitching motion. 5,18,29,34,36,40,42 Injury reports have shown that softball pitchers regularly experience anterior shoulder pain as well as biceps and labral pathology, 31,35 which might suggest that the biceps-labral complex is under great stress during the windmill pitch. In some cases, throwing shoulder distraction force (force directed away from the shoulder and along the length of the upper arm) can exceed 100% of a pitcher's body weight 5,20,26,42 ; therefore, this force has become a suspected cause of throwing shoulder pain.…”