This article is a clinical review that summarizes research on the most common injuries in softball and how they can be prevented. Briskin (2012) reviewed previous studies on softball biomechanics, injury surveillance, and sports medicine to describe both overuse injuries (especially in pitchers) and acute injuries that occur during games. The review includes information from youth, high school, college, and adult softball players and compares softball injuries with baseball injuries when appropriate. The article also discusses injury mechanisms, treatment options, and recommendations for injury prevention, including changes to equipment, pitching workload, and conditioning programs.
They found:
Overall Injury Patterns
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Lower-extremity injuries accounted for about 42% of softball injuries.
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Upper-extremity injuries accounted for about 33% of injuries.
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The most common game injuries included:
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Ankle sprains
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Knee injuries
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Upper leg muscle strains
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Shoulder strains in pitchers.
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Preseason vs. In-Season Injury Risk
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Preseason practice injury rates were significantly higher than regular-season practice injury rates.
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This suggests athletes may be more vulnerable when returning to play after time away from competition.
Pitching Injuries
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Windmill pitching places large forces on the shoulder and elbow, similar to those seen in baseball pitching.
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Shoulder distraction forces can approach 70–98% of body weight in collegiate pitchers.
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Youth pitchers experience similar patterns, although with slightly lower forces.
Unique Pitching Injuries
The review highlights three injuries that are especially common in softball pitchers:
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Proximal biceps tendinitis
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Caused by the high biceps activity just before ball release.
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Ulnar stress fractures
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Often related to repetitive pitching and, in some cases, drop-ball mechanics.
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Ulnar neuritis
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Can occur from repetitive elbow stress or from the elbow striking the hip during pitching.
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Sliding Injuries
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Sliding accounts for 21–45% of all softball injuries.
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Common sliding injuries include:
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Ankle sprains
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Fractures
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Muscle strains
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Dislocations
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Abrasions
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Head-first slides carry a greater risk of head and neck injuries than feet-first slides.
Equipment and Safety
The review found evidence that:
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Breakaway bases reduce foot and ankle injuries.
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Batting helmets with face masks improve protection.
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Protective headgear for defensive players may reduce injuries from batted balls.
Injury Prevention
The article recommends that softball players should:
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Learn proper pitching mechanics at a young age.
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Develop strength throughout the kinetic chain, especially the core and gluteal muscles.
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Avoid pitching while fatigued.
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Build workload gradually.
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Include offseason conditioning and interval throwing programs before returning to competition.
Implications: The author concludes that softball should not be considered a low-risk sport simply because it uses an underhand pitching motion. Research shows that windmill pitching places large stresses on the shoulder and elbow that are similar to those seen in baseball pitching. Because softball pitchers often throw many more pitches than baseball pitchers and usually have few restrictions on pitch counts, they may be at greater risk for overuse injuries. The review emphasizes that injury prevention should focus on more than just the arm. Proper mechanics, strong core and hip muscles, good preseason conditioning, gradual increases in throwing volume, and monitoring fatigue are all important for reducing injury risk. The author also recommends equipment changes, such as breakaway bases and protective headgear, to reduce acute injuries. Finally, the review calls for more research on pitch counts and workload guidelines so that softball pitchers can be protected in the same way that baseball pitchers are.
Key Takeaways
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Windmill pitching creates shoulder and elbow loads similar to baseball.
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Pitching volume—not just pitching mechanics—is a major contributor to injury risk.
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Efficient proximal-to-distal sequencing (core → trunk → arm → hand) is essential for both performance and injury prevention.
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Core and glute strength are critical because they help generate and transfer force through the kinetic chain rather than overloading the arm.
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Pitchers should not throw through fatigue or pain, and preseason conditioning is important to reduce the higher injury rates seen early in the season.
Also…
I love the concept of flows and fluid movements. I believe that reducing dynamic complex movements such as pitching to only positions or deconstructed movements aren’t beneficial to performance and can lead to injury. This is an example of flows from the weight room that is interesting, although I am not sure I would be capable. That said, send me a post of a pitching flow that you like!
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