Lower back maintenance - A question to you cagey veterans of pitching out there.

Hi, my daughter is 14 and had been diagnosed with spondylitis. Rested her for 6 weeks doing core exercises, tried to come back pitching and pain still there. Has been resting for 4 weeks now, aggressive core training now... Threw at half speed last night, felt okay, ramped up to 3/4 speed, pain is back. Seems to be painful right before she lands her front foot. HS try outs in 1 month, feeling aggravated, worried, this girl has worked so hard, for 5 years , never having any problems of any kind, I'm also down right mad, because in Feb. I found out coach had her pitching on concrete floor. Daughter being the incoming freshman wanted to show the coach how hard she could throw, and that's when the pain started. My daughter is 5'4", 106 lbs. and throws in upper 50's. there is so much potential here. Just wanted to talk to someone who has gone through this,no one in this area has heard of this.

Celeste said:

Hi, my daughter is 14 and had been diagnosed with spondylitis. Rested her for 6 weeks doing core exercises, tried to come back pitching and pain still there. Has been resting for 4 weeks now, aggressive core training now... Threw at half speed last night, felt okay, ramped up to 3/4 speed, pain is back. Seems to be painful right before she lands her front foot. HS try outs in 1 month, feeling aggravated, worried, this girl has worked so hard, for 5 years , never having any problems of any kind, I'm also down right mad, because in Feb. I found out coach had her pitching on concrete floor. Daughter being the incoming freshman wanted to show the coach how hard she could throw, and that's when the pain started. My daughter is 5'4", 106 lbs. and throws in upper 50's. there is so much potential here. Just wanted to talk to someone who has gone through this,no one in this area has heard of this.

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Hey - know what yer going through. Gotta be strong for her.

For what its worth our UW Madison Dr had my DD out doing nothing but PT for 8 weeks. She has just started throwing again where no more than every other day and only 20 pitches. This is for the first week and then can increase the load by 25% each week until she's back (hopefully).

Our first sessions have only been walk-thru's on dirt so i am keeping her off hard surfaces.

I am giving this detail so as you can compare your doctors plans.

From what i have read it takes minimum 6 weeks for pars bones to heal and more like 8-12 to be sure.

Our doc said we could experience "pains" again and its not really a re-break. Problem is you cant re-MRI it as the imagry will still show the same area having "something" happening.

Again my DD has made it through an initial first few walk-thrus. In no way do i believe we are out of the woods with the variability of this injury.

Note that i DO believe this is a silent "career-ender" for many pitchers (girls and boys).

As with any high-end sport we as parents have to prepare our kids for potentially not being able to play their dream position that they excell at sooo much. It sucks but we all have to remember life aint fair.....

Note that our local smallish-town PT told me they are treating three other top pitchers just in our 30 mile radius.

I would be more than happy to share stories and sobs over this if ya like. Just PM me.

I wonder if the upswing is this type of injury has anything to do with hard surfaces? More and more indoor practicing takes place year round. Where we live turf fields are becoming more common. Last thing old wore out cleats and players being on there feet all weekend are not a good combination either. Atleast spend 10 bucks for some insoles.

splinterpicker said:

I wonder if the upswing is this type of injury has anything to do with hard surfaces? More and more indoor practicing takes place year round. Where we live turf fields are becoming more common. Last thing old wore out cleats and players being on there feet all weekend are not a good combination either. Atleast spend 10 bucks for some insoles.

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Our doctor in UW-Madison does not seem too aligned with the hard surfaces relationship BUT I have read plenty on this subject and there are doctors around the nation that swear there is a direct relationship to hard surfaces.

My DD is a riseballer and this aspect seems to be a somewhat common tie to these injuries too - but doctors are not as confident on this one.

BUT DD did have WAY more indoor repetitions last winter (the winter that never ended in the upper Midwest). She was either on her PC's concrete floor, or on the basketball court or wrestling room at HS. DD also battled me on her shoes she was using at the time. "Dad these are my comfortable (but broken-down) volleyball shoes that I don't care if they get wrecked pitching on concrete". (I was always offering to get her new shoes that I didn't care if she destroyed in concrete practice....

So moving forward I am NOT tolerating any broken-down shoes. New ones every three months and probably sooner in high-rep periods. DD has come to like the Lynco Sports 400 Series - L405 sports insoles. EVERY shoe is going to have these moving forward (DD with very high arches). I also made a cushioned astro-turf pitching mat for whenever she might be locked into having to pitch on hard surface. (astroturf with gel-pad backing - made my own - cheaper).

I am going to do everything I can do to get her to stay back-healthy for as long as possible during this "come-back" (I also believe through my readings that if you can avoid immediate reinjury and slow her back into action that the longer she remains healthy the less likely it will return. But goodness gracious it takes patience to not "get right back in there"..... It will end up being a whole HS & TB miss for my DD - pitching-wise. Luckily DD's committed coach called and said they are going to stick be her side and he said not to worry about trying to ramp-up for nationals this year - whew!).

Back to the shoes & surfaces science : I read a very good report on the "Kinetic Chain". In this report it scientifically represented the forces that a pitcher gets subjected to in the act of slamming the foot down into the ground to anchor for the pitch. The keys takeaways I had were:
1. people with high arches have WAY more slam-force transferred from the foot through to the spine. Therefore the specific insoles for high-arch people (my DD) can dramatically reduce the shock induced upon the spine. (even though the slam-force is NOT necessarily in the exact same geometric direction of what doctors traditionally think stresses the pars interarticularis the most. BUT I do not think doctors have yet evaluated and proved without a doubt what force from what direction stresses the pars the most. Because of this I am fully on board with avoiding this force as much as possible.)
2. The Kinetic Chain was also evaluated in reference to the lower core strength and the resulting posture from it. My DD, although very much a work-out girl and thinking she was "buff" did NOT have lower core strength and honestly every resource at her HS does not even promote the right lower core strengthening I now believe every pitcher should build up. DD definitely had a forward tilt on her pelvis, as many people do, and this is could be due to genetics and weakness. This pelvic angle I believe is also potentially part of the culprit here. More angle forward on the pelvis I believe induces more stress on the pars. It is really cool to see DD these days as this forward-tilt in her pelvic posture is slowly but surely straightening up. Almost as if she is getting taller..... Come on 6 feet!!!
3. Very much relative to #1 & #2 above is the proven fact again too that a strong lower core, with sturdy lumbar spine-supporting muscle-mass, acts as a further "shock-absorber" to the hits that the pars gets each and every pitch.

So if I were king of these lands, which we are all happy I am not ;-), I would mandate every SB pitcher to:
1. Off-season pitch no more than every other day.
2. Take 8 weeks off from pitching, and any other arched-back torque activity, a year. (this sort of guarantees a lumbar healing span)
3. Dramatically limit the hard-surface pitching - it messes with the true motion anyways.....
4. Change out shoes often.
5. Put a Cadillac of an insole in those shoes (the stock insoles suck)
6. Find a lower core (lumbar) strengthening program and go after it hard.
7. Then find that mystical, every-girls-different, magical break-even point where the pitcher gets allot of accuracy practice WITHOUT inducing these overuse injuries.

BTW - good insoles are $50 and not $10..... Pricing like everything else in this sport..... ;-)

After reading this thread yesterday I went out and made an astroturf pitching mat with an anti-fatigue rubber underlay. I had daughter pitching off of concrete. In another thread some of the guys had said not to pitch off of concrete but without understanding the impact (no pun intended) I was taking my sweet time in fixing it. Read this thread and 3 hours later had something to protect my DD in place. Thank you for bringing this to my attention. The turf is like .65/sq foot and the mats are $24 each (3X3). Get three of them and you have a 9'X3' foot cushioned (but not squishy) pitching lane. They lock together so they are stable. I'm also going to get her on a core strengthening program.

JJsqueeze said:

After reading this thread yesterday I went out and made an astroturf pitching mat with an anti-fatigue rubber underlay. I had daughter pitching off of concrete. In another thread some of the guys had said not to pitch off of concrete but without understanding the impact (no pun intended) I was taking my sweet time in fixing it. Read this thread and 3 hours later had something to protect my DD in place. Thank you for bringing this to my attention. The turf is like .65/sq foot and the mats are $24 each (3X3). Get three of them and you have a 9'X3' foot cushioned (but not squishy) pitching lane. They lock together so they are stable. I'm also going to get her on a core strengthening program.

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Awesome - to me this is cheap insurance versus what I and Celeste could tell you of our nightmares....

Sounds very much like what I made.

Also - make sure it's not a potentially generic "core" program that some trainers may think is sufficient. It needs to be balanced for the whole core (many forget the lumbar-lower).

Best of luck!

I really like this thread. It just goes to show that not all injuries are mechanical. It would be a huge help if PC's spent more time on teaching pitchers how to take care of themselves. I visited with a college coach and he brought up some interesting points about the direction of girls fastpitch. Saying that their was more playing of games than there was practice or physical training. Players consider pitching lessons or hitting lessons as training and that most of the players that they lose comes from program shock. They are in the best tb programs to get recruited and play in the best tournaments get to college and get into a program they are not physically and mentally prepared for. I have learned much from RB's thread and many injuries can be prevented from it. To me pitch count is a band aid to a problem that can be prevented with proper back care and training.

Hello again, I have been reading your threads and it is somewhat of a relief to know that we are not dealing with this alone. Not only aggressive core training, but trying more positive attitude also... Had a very long talk with the almighty man above, along with my father who has been gone for 19 years. Feeling desperate... I feel better, because I know that I alone cannot fix this...possibly an Army of us can. My father taught my sister and I to pitch, In the BACKYARD, and I have taught my DD to pitch in the backyard too. None of us ever had ANY issues with back pain. My dd was working on a rise, screwball and drop, all going well... But combining that with hard surface and hardly any time off, plus playing last year of 8th grade basketball, TOO MUCH! Could kick myself daily for not standing up to these coaches who want to start practicing in January. Done ranting... She pitched around 40 1/2 speed tonite, 15 , not quite 3/4 speed. No Pain... Thinking positive. Take care

Great thinking! Keep that back protected! I do really believe in this core strengthening program. We started our own with exercises off the internet(at advice of her doctor) and they were okay, but PT really targets the core working also on hips and legs. He says abs are not enough, works a lot on obliques. Keep her healthy.

Just wanted to say to Rubber Biscuit, thanks for info and you hang in there also... Keep me posted.