What’s Driving All These Shoulder Injuries?


Opening October 1, 2013
Dr. Bolin
1215 Corporate Circle SW, Suite 201
Roanoke, Va 24018

Delmas Bolin, MD, PhD, FACSM

Director, Performance Medicine of Southwestern Virginia
Head Team Physician, Radford University
Associate Professor, Via College of Osteopathic Medicine

I hear from many of you that you are so dedicated to softball that you play all year round.  There is summer ball travel league, then fall ball, then the spring season, then a couple of showcase tournaments and…  Some of you are playing on 2 teams at a time.  Does this story sound familiar?  It is all too common for young athletes to be put into “competitive overdrive.”  Younger athletes are pushed to play their sports year-round to be “good enough” for college.   Have you ever wondered why professional athletes don’t play year round?  Especially for our young developing athletes, there are some sound reasons why playing less and taking a break from playing may help you develop more.

Why do people play all year?  The reasons are numerous.  You have some talent, and a coach or two knows that you can help them win.  Several other girls are playing and if you don’t, someone else will get your spot.  You may never get it back.  Plus, this extra experience will be good for you and help you to develop over and above what you get with your local team, maybe even get you noticed by a college scout.   I know the arguments; long before I did sports medicine, I coached youth soccer and then collegiate soccer.  I used to think the same way;  now I know that there are risks to playing too much and these deserve recognition and discussion.

Overuse injuries are the first reason to consider taking a training break.  Before age 16, most girls have multiple growth plates that can be injured.  The growth plate is a spacer of cartilage that forms a scaffold in the middle of growing bones.  With repetitive motions, the growth plate can be injured and lead to stress fractures.   Your body is designed to respond to stress…to a point.  With weight lifting, your muscles get stronger and larger.  With impact sports, your body responds to the impacts by making the bones stronger.  The process doesn’t happen overnight, though.  The changes occur over weeks.  Pushing too hard, too fast, and too long leads to stress injuries.  Daily repetitive injury to the bone overwhelms the body’s repair mechanism and happens too quickly for the body to repair it as usual.  These injuries are more common in athletes who adopt a year-round playing.  The symptoms are usually a vague pain that develops at the area of injury during exercise but quickly gets better (at first) when the activity is stopped.  With increased damage, however, the symptoms persist, and can remain even after you’ve had a good night’s sleep.  X-rays are usually the first step, but are often negative.  Often, advanced studies such as a bone-scan or an MRI are needed to make the diagnosis.  Once the diagnosis is established, the treatment is…rest (and sometimes, a cast).  Most of these will make you miss 6-10 weeks (for treatment and then reconditioning and getting back to game speed).

Another reason for taking a break from training is one you may not think of…how your brain responds to training.  The concept of training is simple enough; “practice makes perfect” – some say “perfect practice makes perfect.”  What are you really trying to accomplish?  You are learning a new pitch, a new technique, or a better way of performing.  How does that happen?  In your brain,  you store a series of “neurologic patterns” – an “engram” – as you learn a new skill.  The “engram” is a program of how your brain tells your muscles to perform a task.  For example, most of you will put on a pair of pants the same way every time, or brush your teeth the same way – it is a learned behavior (an engram) and you can do it without consciously thinking about it.  So it is with learning a pitch.  You practice the new technique, it is awkward at first, and then it gets easier and more natural.  During breaks from activity, your brain stores and processes the information and streamlines it – you will often notice that you will perform a new technique a little better after a brief break in training.

In addition to facilitating healing and allowing for skill development, the best reason to consider taking a break is to avoid burnout.  I have seen a few college softball players leave the sport “because it just isn’t fun anymore.”  They have played the sport year round for several years are “done.”   Younger athletes are often shy about taking a break, fearing that another athlete will “get ahead” of them if they do something else over the summer.  That is rarely the case – ask your coaches.  Taking a break doesn’t mean doing nothing, however; cross training can help you develop improved speed and stamina while allowing your muscles to go through a completely different set of workouts. Often a skill learned in another activity can make you a better player.

No matter what your schedule, remember to keep having fun while you are working so hard to improve.  When you do take breaks, remember to stay active.  Take care of your body, allowing it adequate rest and time to recuperate.  When you come back to softball, see if you brain isn’t refreshed and a little better tuned for performance.  It’s one of the reasons the pros have an off-season.  Sometimes, less is more.