Return to Throwing after Shoulder or Elbow Injury

Area of Science:

• Sports Medicine
• Biomechanics
• Rehabilitation Science

Background:

• Throwing athletes develop unique physical characteristics due to high physical demands.
• Rising injury rates in baseball highlight the need for effective return-to-throw protocols.
• Current literature lacks specific criteria-based progressions for elite throwing athletes.

Purpose of the Study:

• To address the void in literature regarding criterion-based progressions for athletes returning to throwing.
• To outline key considerations for rehabilitation professionals designing return-to-throwing programs.
• To emphasize the importance of a structured, criteria-based approach for safe return to high-level play.

Main Methods:

• Review of current evidence on throwing biomechanics and injury contributions.
• Emphasis on understanding the entire pitching motion, from balance to ball release.
• Integration of principles of tissue loading, range of motion, and strength.

Main Results:

• The core and lower extremities play significant roles in the baseball pitch.
• Pitcher-specific characteristics, including range of motion and scapular position, are crucial.
• A comprehensive program includes normalized range of motion, strength, scapular mechanics, plyometrics, and interval throwing with workload tracking.

Conclusions:

• A criterion-based progression is essential for athletes returning to throwing after injury.
• Rehabilitation must consider the entire kinetic chain and biomechanical demands of throwing.
• Careful monitoring and gradual progression prevent re-injury and facilitate return to peak performance.