Recently, the performance demands of softball have been questioned in relation to injury propensity [6,7,8,9]. A major difference between the management of baseball and softball pitchers relates to the size of pitching staffs. Where a baseball pitching staff will make up half of the team with as many as 17, a softball pitching staff could include as few as one with a maximum of four [7]. In 2015, researchers concluded that the sport of softball carries a high incidence of injury, after an examination of 48 pitchers and 50 position players over the course of a season [9]. Most injuries reported within the season were not related to pitching; however, of the pitching injuries observed, more than 60% of them were to the shoulder [9]. Also considering the pitching injuries seen in that study, a majority of them occurred at the beginning of the season. Thus, the researchers concluded that softball pitching may not be as safe as it has previously been assumed. Although many factors influence an athlete’s injury susceptibility, these early season injuries observed in this study suggest more evidence of overuse of a dynamic system.
An examination of softball pitchers (14–18 years) during a 2- to 3-day tournament revealed that on average pitchers threw 1.5 games per day, 82 pitches per day for an average total of 166 pitches during the competition [8]. In this study, researchers investigated subjective measures of pain and fatigue, and they found both pain and fatigue increased from day one to day three of tournament play. Additionally, eight of nine upper extremity strength test performances decreased over the course of the weekend tournament. In another examination of fatigue and pain as well as strength and range of motion in high school softball pitchers, Yang et al. found that within 6 weeks the pitchers averaged 12 ± 5.7 games, threw an average of 89 ± 25 pitches per game, had decreased shoulder strength, and reported increased pain and fatigue [10]. In another study examining pitching a single game, researchers reported that softball pitchers 15 ± 1.2 years, threw on average 99 ± 21 pitches and experienced profound fatigue in their hip and scapula musculature following a single bout of pitching [6]. Based on these studies, clinicians, coaches, and researchers should not be surprised that softball pitchers are subject to fatigue and should set parameters around the sport of softball to help protect these athletes.