Athletes and Overuse Injuries

Premier Health providers answer frequently asked questions about sports related overuse injuries.

What's the difference between overhand (baseball pitching) and underhand (softball pitching) throwing?

Dr. Jon Sulentic discusses the different mechanics involved with overhand and underhand throwing. Click play to watch the video or read the transcript.

What's the difference between overhand (baseball pitching) and underhand (softball pitching) throwing?

The differentiation between overhand throwing and underhand throwing in boys and girls, baseball and softball respectively, those differences are based on the muscles involved in those specific motions. However, the core mechanism of why it happens are very similar, and that's a developing and acceleration of the arm, redirecting its direction of throwing the ball, and then the deceleration of that moving arm so the concept is the same. It's the specific muscles that are involved. Some of the stressors on the support anatomy, the ligament anatomy, and even sometimes the boney anatomy of the shoulder are different but the general concept is the same. You're trying to propel a projectile very fast, and that is demanding to the shoulder.

Sure. Well, yeah, the question being, "What's the difference between overhand and underhand throwing?" Underhand throwing certainly is a less bio-mechanically movement as you mentioned. It is a more natural movement, and I don't know if that's the origin of the sport or why it was developed as a different throwing sport or not since the game is otherwise the same, but in typical throwing related injuries, we think of the overhand pitch, or overhand throw, primarily because of the stored energy that you need to cock the ball and then to rapidly accelerate it.

More importantly, I think, is the deceleration phase of both of those throws. Both athletes’ throwing styles are still at risk of the overuse injury because of the deceleration of the arm, but you're correct in that the other phases, the cock phase of throwing, is typically more injurious or more commonly injurious.

   

The differentiation between overhand throwing and underhand throwing, in baseball and softball respectively, is based on the muscles involved in those specific motions. The core mechanism of how the overuse symptoms happen is very similar for both movements. It involves an acceleration of the arm, redirecting the direction of throwing the ball and then the deceleration of that moving arm. The difference involves the specific muscles that are involved. Some of the stressors on the support anatomy, the ligament anatomy and even the bony anatomy of the shoulder are different, but the general concept is the same. You're trying to propel a projectile very fast, and that is demanding to the shoulder.

Underhand throwing certainly is a less biomechanically stressful movement. It is a more natural movement. In typical throwing-related injuries, we think of the overhand pitch, or overhand throw, primarily because of the stored energy that you need to cock the ball and then to rapidly accelerate it.

More importantly is the deceleration phase of both of those throws. Both throwing styles cause risk for an overuse injury because of the deceleration of the arm.

Learn more:

Source: Jeffrey James, DO, Jon Sulentic, DO, Premier Orthopedics; Justin Perkins, Premier Health athletic trainer; American Medical Society for Sports Medicine; National Institute of Arthritis and Musculoskeletal and Skin Diseases