I recently evaluated a youth baseball pitcher who was referred to me from another patient I treated.  His original dx was muscle strain of shoulder.  Now before going into the evaluation I performed, lets talk about what ideally should be included at a minimum for a youth baseball pitcher.  

-  Differential Dx:  Youth pitchers don't get torn cuffs or SLAPs as often as older pitchers.  Instead x-rays are almost a must to differentiate Little League shoulder and other growth plate injuries.  

-  Pitcher:  How many pitches per game? How many innings per game/season? How many teams are they playing on? What is their specialty pitch? What kind of pitches do they throw each game?  What kind of thrower are they- where is their arm slot? 3/4s, etc, Has their velocity increased or has their throwing mechanics changed recently?

- When do they have pain? First pitch or after many?  Pain at rest?  Past injuries at shoulder or elbow?  Does their velocity drop significantly?  

-  Who is the coach/pitching coach?  

- Objective:  Shoulder ROM (GIRD?), Muscle imbalances (strength, stiffness), Lower extremity & core assessments, if appropriate- look at their pitching mechanics, special tests, laxity (bilateral?)- remember some laxity is normal, cardiovascular endurance

** The above is not any specific order **

What else do you include in your youth pitchers evaluations?  

- Brian

Really great discussion between Gray Cook and Kelly Starrett on movement.  Topics include movement behavior, coaching cues and the importance of it, and how important it is to look at the FMS the right way.  Check it out!