How to Prevent the Most Common Baseball Injuries?

This article was written in partnership with the Quebec Major Baseball League (Ligue de Baseball Majeur du Québec - LBMQ).

In 2024, baseball ranks 4th among the most played sports in Canada. With such popularity, it's important to highlight the most common causes of injuries and provide tips on how to prevent them. 

Whether it’s through repetitive movements like pitching, actions with excessive range of motion, or collisions with other players or impacts against the ground (or fences!), baseball players are exposed to various injury risks. Physiotherapists can be great allies for both injury prevention and rehabilitation when needed. 

To better understand how to optimize your physical condition for this sport, we invite you to read this article. We will address the different causes of frequent baseball injuries and how to prevent them. 

Repetitive Movements - Pitching 

Types of Injuries

Pitchers and catchers are at the highest risk for overuse injuries due to the high number of throws they make. However, other players are not completely safe, especially outfielders who must generate maximum power without being constantly warmed up. 

The shoulder and elbow joints are the most vulnerable to repetitive pitching. Common injuries include: 

• Rotator cuff tendinopathies and/or biceps tendinitis 
• Labrum tears 
• Glenohumeral instability 
• Impingement syndrome 
• Flexor tendinopathies (fingers and wrist) 
• Medial collateral ligament injury (famous Tommy John surgery) 
• Ulnar or radial nerve irritation 
• Lower limb muscle strains (pulled muscles) 

Prevention 

To prevent overuse injuries, it is essential to: 

Ballistic Warm-up 

Performing a dynamic warm-up is crucial to prepare muscles and joints for effort. Focus on each step of the throwing motion, gradually increasing the range and speed of movement. This includes movements for the shoulder, elbow, and thoracic region, as good mobility and adequate core strength are essential for effective weight transfer and to avoid overloading the upper limbs. 

Throwing Technique 

Maintaining good throwing technique, with efficient weight transfer, can significantly reduce injury risk and improve performance. Coaches and physiotherapists should regularly assess players' throwing techniques to correct potential errors. 

Strengthening Exercises 

Incorporate flexibility and strengthening exercises to stabilize joints and avoid compensations. In addition to throwing practice, specific exercises for stabilization, proprioception, flexibility, and strengthening of the muscles involved in throwing are essential. They help ensure joint stability and allow the muscles to produce movement without compensation. Core and thoracic exercises can also help prevent injuries. 

Fatigue Management 

Muscle fatigue increases the risk of injury. Follow pitch count recommendations based on age and rest time to avoid overload (see table below). Use a pitching machine for batting practice to reduce the load on pitchers. 

source : https://www.mlb.com/pitch-smart/pitching-guidelines 

Rehabilitation 

In case of injury, it is crucial to consult a physiotherapist to ensure full recovery and prevent recurrence. Here are the criteria to assess before returning to activity: 

• Full range of motion of the injured joint and adjacent joints, without pain. 
• Full strength of the injured joint and adjacent joints, without pain. 
• Ability to perform sports movements without pain. 
• Confidence of the player in resuming the activity. 

A personalized rehabilitation program can include strengthening, mobility, and stabilization exercises to ensure full recovery and prevent recurrence. Following the advice of a physiotherapist who collaborates with the coach can accelerate healing and minimize the risk of new injuries. 

Excessive or High-Amplitude Movements  

Types of Injuries 

In baseball, movements such as diving, sliding, jumping, and stretching are common. These actions can lead to muscle strains, tears, or sprains. The most at-risk joints are the shoulders, elbows, ankles, knees, and hips.  

Prevention 

Preseason Preparation  

Proper preparation before the season is essential, whether you’ve been injured before or not. A preseason training program focused on endurance, mobility, flexibility, strength, and muscle stability (including balance and proprioception) can significantly reduce the risk of injury. 

Dynamic Warm-up 

A dynamic warm-up before each game is crucial. It should target the sport’s specific ranges of motion without excess. Prolonged static stretches are not recommended, as they can reduce joint responsiveness and increase injury risk. 

Field Condition 

In high-level leagues, fields are well-maintained, but in municipal parks, the grassy surface may present hazards (holes, cracks, clumps of dirt). Checking the field condition before the game can help identify risks and prepare the ankle, knee, and hip joints for unpredictable movements. 

Rehabilitation 

In case of injuries from excessive movements, it is essential to: 

• Assess the severity of the injury with a healthcare professional. 
• Follow a rehabilitation program that includes strengthening, mobility, and stabilization exercises. 
• Avoid overstretching the injured muscle and allow adequate recovery before returning to sports activities. 

Collisions and Impacts 

Types of Injuries 

Collisions and impacts can result from contact with the ball, other players, or the bat. Common injuries include bruises, fractures, and concussions. 

Prevention 

Education and Rules 

Baseball leagues have rules to prevent batters from throwing their bat and to enforce the use of protective gear after contact. Proper education and safe habits should be taught to players to avoid these situations! 

Protective Gear 

Wearing appropriate protective gear is crucial. Catchers should always wear full equipment (helmet, chest protector, leg guards) to limit impact injuries. Players can also use face protectors and additional arm and leg protection to prevent severe injuries. 

Sliding Techniques 

Train players in sliding and diving techniques to ensure they are confident and effective in these movements. 

Rehabilitation 

In case of injuries from collisions or impacts, it is crucial to consult a healthcare professional to: 

• Assess the extent of the injury. 
• Follow a specific rehabilitation program. 
• Use pain management and recovery techniques to ensure a safe return to sports activity. 

We hope this article has provided you with the tips and recommendations needed for an injury-free season filled with hits! Whether for prevention or rehabilitation, your physiotherapist is a valuable resource for you. 

To book an appointment, click here: https://reservation.physioextra.ca/en/ 

Groupe PhysioExtra is proud to be a major partner of the Quebec Major Baseball League (Ligue de Baseball Majeur du Québec - LBMQ).

Article written by Marie-Hélène Cummins, physiotherapist