Baseball Throwing Injuries and Treating the Entire Kinetic Chain


Baseball is one of America’s greatest sports.  It is often the first sport we played as young children. It taught us the concept of team, winning and losing, and the discipline of practice.  It is a sport that has captured many hearts no matter the level of competition: high school, travel team, professional, or just a friendly game with friends and family. On the flip side, baseball has developed a shadow due to the magnitude of shoulder and elbow injuries that are sustained by its athletes. In fact, an incredible 58 percent of injuries sustained in baseball are of the upper extremity leading to a 75 percent total time lost competing by the athlete. 2
In the act of throwing a baseball, an athlete will transition through five phases of throwing. These include the windup, early cocking/late cocking, acceleration, deceleration, and follow-through stages. 3 These five phases incorporate a transfer of potential energy through the lower extremity, core, and ultimately to the shoulder and hand for the release of the baseball. If this potential energy transfer is disrupted or dysfunction anywhere in the kinetic chain, it will cause the athlete to improperly generate the force and power necessary to reach the balls’ destination through the shoulder alone.
The improper loading and increased stress placed through the shoulder joint over time due to poor mechanics often lead to micro-trauma and potential sheering effects of the superior labrum. The stability of the shoulder joint relies heavily on a healthy labrum. If micro-trauma is not addressed and mechanics are not corrected, it may lead to a SLAP (Superior Labral Anterior-Posterior) lesion within the athlete’s throwing shoulder. A SLAP lesion is among the most common shoulder injuries in baseball and can have damaging effects on an athlete’s participation in sport. 1
When an injury occurs at the shoulder of the throwing athlete, it is not only the responsibility of the physical therapist to get the athlete back on the field but to create longevity so they can continue to play as long as they want. It is a disservice to the player if the treatment plan does not address the entire kinetic chain. Providing optimal treatment to the shoulder girdle along with addressing an athlete’s true core is key. The true core is much more then abdominal strength and incorporates hip and gluteal strength, trunk stability, and rotational flexibility along with single-leg balance.  It is when these components are working effectively and efficiently together that an athlete will return to sport in a pain-free manner.
Treatment of the entire kinetic chain provides the athlete with the greatest opportunity for reduced re-occurrence of injury at the shoulder while returning to full participation, meeting the ultimate goal of both the athlete and physical therapist in the rehabilitation process.

BONUS! Here are a few active muscle releases that you can implement into a daily routine to assist in proper mobility!

  1. Pectoralis Major release:
  2. Subscapularis release:
  3. TFL release:
  4. Hip Flexor release:


  1. Burkhart SS, Morgan CD, Kibler WB. Shoulder injuries in overhead athletes. The “dead arm” revisited. Clin Sports Med2000;19(1):125-158.
  2. McFarland EG, Wasik M. Epidemiology of collegiate baseball injuries. Clin J Sport Med 1998;8(1):10-13.
  3. Seroyer ST, Nho SJ, Bach BR, Bush-Joseph CA, Nicholson GP, Romeo AA. The kinetic chain in overhand pitching: its potential role for performance enhancement and injury prevention. Sports Health. 2010;2(2):135–146.