Throwing athletes are unique. Their sport – whether it’s baseball, softball or other – requires them to generate large forces in short periods of time. This puts extraordinary stress on their joints, muscles and supporting structures, and places them at risk for injury.

This is particularly true in youth athletes who are still growing and developing, with open growth plates. These factors can further influence their performance or chances of injury.

Children’s Hospital of Philadelphia (CHOP) has a dedicated Throwing Medicine team focused specifically on working with adolescent athletes diagnosed with an upper extremity injury from throwing. 

While much of our focus is on the arm and shoulder, the unique nature of the throwing motion requires athletes to utilize their entire body efficiently. This means treatment of throwing-related injuries requires a thorough evaluation of the athlete’s entire body.

At CHOP’s Sports Medicine and Performance Center, our team of throwing medicine specialists – including orthopedic surgeons, sports medicine physicians, physical therapists and athletic trainers – collaborate to optimize care and treatment for acute and chronic injuries.

We use a multidisciplinary team approach to care for each throwing athlete. Our aim is to not only treat throwing injuries, but to:

• Reduce the risk of new injuries
• Enhance each athlete’s throwing efficiency
• Safely guide youth athletes back to their desired sport

We use evidence-based throwing motion evaluations and prescribe exercise programs tailored specifically to each athlete’s unique needs.

Each athlete will have their own environmental or personal factors that can influence their potential for injury or reinjury. These factors will be discussed with each patient to create the most personalized treatment and injury prevention plan. If surgical treatment is needed, we will refer to our team of sports medicine orthopedic surgeons. Our goal is to optimize recovery for the throwing athlete and minimize time lost to injury, getting athletes back to the field quickly and safely.

Common throwing injuries we treat

• Overuse injuries such as Little League (thrower's) shoulder or elbow
• Internal impingement (shoulder)
• Shoulder labral injuries
• Shoulder instability
• Tendinitis/tendinosis
• Stress fractures and bone stress injuries
• Medial epicondyle avulsion fractures (elbow)
• Ulnar collateral ligament (UCL) injuries of the elbow
• Radial collateral ligament (RCL) injuries of the elbow
• Elbow osteochondritis dissecans (OCD)
• Elbow fractures and dislocations
• Wrist fractures
• Hand fractures

Throwing medicine evaluation and treatment planning

Children, teens and young adults who turn to CHOP’s Sports Medicine and Performance Center for throwing injuries will undergo a thorough throwing medicine evaluation to:

• Accurately diagnose their injury
• Pinpoint the cause of any pain or recurring problems
• Identify any musculoskeletal deficits that may be contributing to their injury.

This evaluation and an accurate diagnosis are important first steps to determine the best treatment options for each individual. Treatment may include physical therapy, nutritional counseling, medication, behavioral health services, and, in some cases, surgery. Our team has all the specialists you might need under one roof, and we work closely together to put together a treatment plan that works for you/your child

Because children and teens are still growing and can have open growth plates until they are skeletally mature, it’s important for young athletes to be seen by a team that specializes in the care of this group. The care required into adolescence and even young adulthood is unique and different than what adults need.

Rehabilitation for throwing athletes

During a throwing medicine evaluation, athletes will have a thorough assessment to identify any musculoskeletal deficits that may be contributing to their injury.

Our team of trained physical therapists will evaluate other regions of the body crucial to throwing mechanics, including (but not limited to):

• Lower extremity
• Core strength
• Mobility

The physical therapist will also obtain an extensive list of contributing external factors related to the injury to establish a thorough plan of care.

When appropriate, a throwing evaluation – using video analysis – will help capture potential mechanical flaws in the athlete’s throwing motion that can be addressed throughout the rehabilitation process. This helps us create a personalized treatment strategy for each patient to get the youth athlete safely back to their sport.

Rehabilitation therapy will consist of:

• Manual therapy
• Progressive strength training of both upper and lower extremities
• Throwing-specific drills
• Education of proper arm care before and after throwing

A strong emphasis will be placed on future injury prevention. This includes patient and parent education in adolescent-specific risk factors and risk mitigation strategies. Collaboration is key to success and our team will work jointly with both parents and children/teens throughout the rehabilitation process to determine the proper progression and sports reintegration process.

Our throwing medicine specialists see patients at multiple convenient locations throughout Pennsylvania and New Jersey.