dr. rose

Preventing Injuries – Baseball Pitcher

img005Overhead throwing creates a variety of challenges for baseball players, especially pitchers. Due to the biomechanical consequences of repetitive throwing, pitchers are at increased risk for a variety of shoulder and elbow injuries such as shoulder impingement, labral tears, and ulnar collateral ligament tears. These injuries can often lead to long periods of recovery and, in some cases, surgery.

One of the biomechanical changes that pitchers undergo is a loss of internal (or forward rotation) rotation in their shoulder joint. With repetitive cocking of the shoulder backward, pitchers develop tightness in an area of the back of the shoulder joint called the posterior capsule. This tightness leads to a decrease in the internal rotation of the throwing shoulder as compared to the non-throwing shoulder as seen in the images below. This is called Glenohumeral Internal Rotation Deficit or GIRD. GIRD has been shown to be a risk factor for SLAP labral tears and UCL ligament tears. Both injuries typically require surgery and recovery time of 12-18 months.


One way to avoid these debilitating injuries is to prevent GIRD. The best way to prevent GIRD or reduce GIRD, if it is already present, is through a simple stretch called the sleeper stretch. The sleeper stretch is performed by lying on your throwing side with your arm at 90 degrees from the trunk. From this position, the arm is rotated forward into internal rotation and held for 30 seconds (see images below). This stretch should be built into a pitcher’s daily routine. Over time, consistent stretching can lead to reversal of GIRD and thus a decrease in a significant risk factor for serious pitching injuries.