The Spine with the Baseball and Softball Athlete, by Dr. R. Chris Glattes, MD

Baseball season is here, but hopefully the “Boys of Summer” have been already hard at work during the off-season to protect their backs. Baseball and softball are still some of the most popular sports that our young athletes pursue and injury prevention must be pursued in a pro-active fashion, not in a reactive manner. The popularity of travel leagues and winter leagues can really extend the season and potentially put young athletes at higher risk for overuse injuries. Kids honestly don’t rest as much now as they did in previous generations while growing up, which is a common complaint I hear from concerned parents in our office. Using the off season to rehabilitate and correct any deficiencies through cross-training, and conditioning is critical in the current state of competitive youth sports.

Some studies looking at which players hurttheir backs the most in baseball and softball provided some really interesting data. Who do you think would complain the most about low back pain?  I thought it would be the catchers. I was dead wrong. In fact, catchers complain the least about their backs. Infielders actually have the most visits to the orthopedist for injuries to the back and spine as any other position. The researchers thought it had to do with the flow of the game versus the flow of typical practice. Catchers are constantly moving from standing to a good squat position, maintaining flexibility in the spine and hips, all the way down to the Achilles tendons and the plantar fascia on the bottoms of their feet.  A good squat position requires a strong core to protect the spine.  This is consistent whether they are in a practice or in a game. What do the infielders have to do?  Their practices consist of fielding multiple ground balls typically flexing their spines in repetitive fashion. However, at game time you may just have to take a few balls, but the position demands you to move from the ready position to a bent forward position in a split second with great explosiveness. This requires the players to be well-trained off the field to make these variable transitions easier.

The swing is a whole different story. An effective, injury-free swing requires absolute perfect connection from the eyes to the ground and back up, as a hitter winds up and uncoils throughout the swing phase into the follow-through. The number of muscles involved during the swing is incredible, with different groups being active during different parts of the swing. The one part of the body that puts is all together however are the core muscles, including the gluteal muscles around the hips, the muscles of the low back and the abdominal wall.  Something has to connect the ground stance and power of the legs, especially the hamstrings, to the upper torso and the shoulders. A hitter who can engage his or her core without having to think about it is critical. So how can a hitter protect his back and learn about core engagement? Physical therapy and personal training utilizing weight resistance and functional movements are the key.

Taking the time to do core stabilization exercises such as the “dead bug”, abdominal crunches, planks, bridging, wall sits and physioball exercises can help train the deep core muscles to engage without having to think about it. When a 90 mph pitch is coming your way, engaging the core needs to be an instantaneous event. The only way to accomplish this is to train it. Identifying flexibility issues and working on fast twitch muscle engagement for speed and explosiveness are all things that a good therapist, or personal trainer can provide.

The most common injuries we see in baseball are probably injuries to the intervertebral disk and injuries to the spine joints. A stress injury called a spondylolsysis in the adolescent athlete is also very common and is related to over-use and improper conditioning. Although most injuries we see in baseball and softball don’t require surgery, oftentimes “prescribed rest” and active rehabilitation during that down time is the only way a spine can heal. Sometimes unfortunately this can end a season early, so prevention is the key during the off-season and dedication to maintaining flexibility and core strength is the best way to attack a potential problem.

Take the time before and after practice to do your core exercises and you will be well on your way to an injury free season and successful summer season.

– R. Christopher Glattes, MD

Elite Sports Medicine and Orthopaedic Center is a regional leader in sports medicine and orthopedic care.  We treat baseball and softball injuries and athletes from the youth player through college and the MLB athletes.

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