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Softball Pitching with a Painful Levator Scapula

Jul 20, 2011 | By Andrea Bird
Softball Pitching with a Painful Levator Scapula
Photo Credit Jonathan Ferrey/Getty Images Sport/Getty Images

Because the mechanics of the windmill softball pitch is underhand, some believe it to be less injurious than baseball pitching. However, in their article "Shoulder Muscle Recruitment Patterns and Related Biomechanics during Upper Extremity Sport" Rafael Escamilla and James Andrews show that forces on the shoulder during the windmill pitch are similar to those exerted during the baseball pitch. Softball players who are experiencing pain in their levator scapula should undertake a rehabilitation program rather than continuing to pitch through the pain.

Softball Pitch Biomechanics

There are six phases of the softball windmill pitch. The first phase begins with the windup motion to the 6 o'clock position. The second phase is 6 o'clock to 3 o'clock during which the arm moves up to 5,000 degrees per second and experiences a distractive force of 20 to 40 percent of body weight. The third phase is 3 o'clock to 12 o'clock during which the arm experiences a distractive force of up to 50 percent of body weight. The fourth phase begins with downward acceleration from 12 o'clock to 9 o'clock. During this phase, the arm reaches speeds of 2,000 to 3,000 degrees per second. The fifth phase is 9 o'clock to ball release while the last phase is ball release to follow-through. At ball release there is a distractive force equal to body weight.

Risk of Injury

Softball teams generally carry fewer pitchers than a baseball team and the best pitcher typically pitches the majority of the innings. According to Idubijes L. Rojas, et. al., in the study "Biceps Activity During Windmill Softball Pitching," a pitcher at the collegiate level may pitch up to 1,500 pitches in a three-day tournament. This demand combined with the great amount of force and torque placed on the shoulder predisposes pitchers to such overuse injuries as rotator cuff tendinitis, bicep tendinitis, muscle strain and shoulder impingement.

Levator Scapula Pain

While the levator scapula is not a commonly reported muscle for injury, it can be affected by the softball pitch. The function of the levator scapula is to elevate, downward rotate and retract the scapula. It is, therefore, involved in scapular function during the softball pitch. Overuse and/or muscle weakness of other more prominent muscles can place undue stress on the levator scapula. Injury to the shoulder, such as shoulder impingement, can create pain in the levator scapula. In "Muscle Trigger Points and Pressure Pain Hyperalgesia in the Shoulder Muscles in Patients with Unilateral Shoulder Impingement: a Blinded, Controlled Study", Amparo Hidalgo-Lozano, et. al., found increased sensitivity and trigger point activity in the levator scapula muscle in patients with shoulder impingement.

Rehabilitation

To address levator scapula pain, a comprehensive rehabilitative program needs to be implemented that strengthens the lower and upper body. Because pitching starts with lower body force, strengthening the lower body provides a solid foundation for upper body movement. Strengthening the scapular stabilizers will help maintain the integrity of the shoulder joint. Specific exercises to isolate the levator scapula are not necessary. However, several scapulothoracic and rotator cuff exercises activate the levator scapula.

Caution

As with most sport-related injuries, proper medical evaluation is imperative. Isolated levator scapula pain could also be related to cervical injury or nerve injury. Continuing to compete with levator scapula pain increases the risk of shoulder injury because of its involvement in scapular stabilization. Proper treatment is critical for resolution of pain and successful participation in sports.

References

Article reviewed by Craig Sanders Last updated on: Jul 20, 2011

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