As youth participation in fastpitch softball rises, so do the rates of fastpitch softball pitching injuries.
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What Causes Fastpitch Softball Injuries Among Pitchers?
Data published by the National Institutes of Health shows that the most common fastpitch softball pitching injuries happen because of an incorrectly executed windmill pitching motion. While pitching underhand is a more natural motion for the arm than pitching overhand, fastpitch pitchers must rapidly move their arm in a full 360-degree circular motion toward the hitter, which sometimes causes fatigue. Repetitive motion, fatigue, and in some cases, poor form, makes pitchers just as vulnerable, if not more vulnerable, to sports injuries as other players on the field. However, pitchers in fastpitch softball should not sustain these injuries if they use the correct form and avoid overuse. Read on to learn about other types of fastpitch softball pitching injuries.

Common Fastpitch Softball Pitching Injuries
Tendonitis
Fastpitch softball pitchers commonly experience tendonitis, or inflammation of the tendons. Tendonitis can happen in any area of the body involved in the pitching motion, such as the shoulder, elbow, rotator cuff, wrist, biceps, or forearm. Tendonitis usually develops after overuse. Aching or pain that worsens with movement may be a sign of tendonitis.
Back or neck pain
Fastpitch softball pitching requires a swift, high–velocity movement. Overuse can strain the neck, back, and spine. In rare cases, pitchers may even develop a slipped spinal disc.
Core injury
The body’s core muscles control the high–velocity movements of a softball pitch. Power generated in the legs is transferred through the torso into the shoulder and, eventually, out through the ball. The abdominal muscles, oblique muscles, and lower back muscles may all experience overuse and fatigue. A pitcher may also sustain a muscle strain to any of these muscle groups.
Rotator cuff injury
The rotator cuff is a network of four muscles within the shoulder. Repetitive motions increase the chances of rotator cuff injuries as the tendons wear down over time. Pitchers with a partially or completely torn rotator cuff may experience pain, popping, clicking, and a decreased range of motion. While this does occur in softball pitchers, baseball pitchers are much more susceptible to this injury due to the overhand pitching motion.
Osteochondritis dissecans
Osteochondritis dissecans is a joint disorder that causes pain, swelling, and “catching” or “locking” in the affected joint. Osteochondritis dissecans may develop in a pitcher’s elbow or in other joints that undergo repetitive movement. Though age ranges vary, the condition is most common among adolescents.
Tennis elbow/golfers elbow (epicondylitis)
Repetitive throwing causes many pitchers to experience tennis elbow or golfers elbow, an inflammation of the tendons that connect forearm muscles to the outside elbow in tennis elbow, or to the inside of the elbow in golfers elbow. Common symptoms include a burning pain or tenderness to the touch on the outside or inside of the elbow.
Shoulder sprains and strains
Shoulder sprains occur when ligaments are stretched or torn. Anterior shoulder sprains, which are more common in softball pitchers, may cause pain in the front of the shoulder. Shoulder sprains can occur in either the throwing shoulder or the opposite shoulder when pitching.
Knee and ankle injuries
In the game of fastpitch softball, the pitcher must drag the foot on the side of her throwing arm behind her when following through with her pitch to avoid an illegal pitch. Sometimes, when the foot catches irregularly in the dirt or on the pitching rubber, it may cause injuries to the ankle, ACL, or MCL.
Hand and finger injuries
As pitchers grip the laces of the softball, which has a circumference of 12 inches, the positioning of the fingers can sometimes create stress on or muscle pain in the hand and fingers. Grips on the ball vary as fastpitch softball pitchers throw fastballs, change-ups, curveballs, drop balls, and rise balls, each with a slightly different grip and follow-through. Friction between laces and skin may also cause sores and calluses. Calluses help pitchers over time though, as their toughness reduces friction and pain.
Other injuries to consider
On the playing field, the pitching rubber is placed exactly 43 feet from home plate, meaning that the pitcher (pitching up to 70 mph) is quite close to the batter, whose hit can come off the bat at speeds up to 85 mph. With limited reaction time, pitchers may receive injuries from a ball off the bat, prompting many fastpitch softball pitchers to wear face shields and heart guards to protect from line-drive injuries.
To learn more about sports injuries and rehabilitation, visit UPMC Sports Medicine, or call 1-855-93-SPORT (77678) to make an appointment.
About Sports Medicine
An athletic lifestyle carries the potential for injury. Whether you’re an elite athlete or a weekend warrior, UPMC Sports Medicine can help. If you are looking to prevent, treat, or rehabilitate a sports injury, our multidisciplinary team of experts can help you get back into the game. If you are seeking to improve your athletic performance, we can work with you to meet your goals. We serve athletes and active people of all ages and experience levels. Our goal is to help you keep doing what you love. Visit our website to find a specialist near you.