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A Clinician's Guide to Evaluating and Managing Shoulder Overuse Injury in Softball Pitchers.

Bordelon N, Martinez A, Zaremski J, Butler L, Holtz K, Friesen K et al. ยท JOSPT open ยท 2026

Shoulder overuse injuries affect about one-third of softball pitchers each season, typically in the throwing shoulder's biceps-labral complex due to repetitive high-stress throwing. Effective evaluation requires a comprehensive patient history and physical exam, while treatment should include rehabilitation addressing the whole kinetic chain, especially the hips and lower back, not just the shoulder itself.
Takeaway: Assess softball pitchers' shoulders using a complete evaluation process and address their hip and lower-back strength and mobility as part of shoulder injury rehabilitation.
Abstract (source)

Background: Approximately one-third of softball pitchers sustain a pitching-related injury across a single season, with the throwing shoulder being the most frequently injured site. Overuse is a commonly proposed mechanism given the repetitive and high-stress placed on the biceps-labral complex. CLINICAL QUESTION: How can clinicians evaluate and manage shoulder overuse injury in softball pitchers? KEY

Results: Clinical evaluation of softball pitchers should include a comprehensive patient history, physical examination, and appropriate imaging. Understanding injury mechanisms and risks will help clinicians assess and treat injuries effectively. Management should include a rehabilitation program that extends beyond the pitching shoulder to address the whole kinetic chain, with a focus on the lumbopelvic-hip complex. CLINICAL APPLICATION: Our model was designed by an interdisciplinary team for clinicians seeking to evaluate softball pitchers with shoulder overuse injury and develop rehabilitation programs that support return-to-play. This model can be used to implement evidence-based evaluation and management

Methods: to improve athlete care.

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