Most people do not consider baseball to be a sport with a high risk of injury. Unlike football, hockey or boxing, baseball seems harmless in comparison. While it is true that baseball is not a high contact sport, a variety of injuries can occur to players to virtually any part of their body, but most notably to the shoulder; some of these injuries can be career ending. One of the most common injuries is due to overuse of the shoulder due to the repetitive motions required for throwing. Major shoulder injuries include bursitis, inflammation or tears of the rotator cuff tendons or rotator cuff tendinitis, shoulder instability, shoulder separation and inflammation or tears of the labrum. In order to understand shoulder injuries in baseball players and particularly pitchers, one must understand the movement involved in the act of throwing. Pitchers perform a lift, cock, accelerate, then decelerate and continue as they throw the ball (see Figure 1) (source). These movements can be performed up to one hundred times per match, depending on the age and ability of the athlete. Add in weekly practice time and you'll understand how these repetitive movements can cause problems over time. The anatomy of the shoulder joint allows the pitcher to generate speed when throwing the ball. The shoulder joint fits loosely into the socket or glenoid of the shoulder (see Figure 2) (source). The further the player can bring the raised arm away from the body (abduction), the more speed the ball will have when released. Due to the lack of restriction in the shoulder joint, the soft tissues of the shoulder, responsible for maintaining stability, are placed under greater strain. These are the structures that end...... middle of paper ......nge external and internal movement while strengthening the shoulder muscles. When rest and physical therapy fail to correct an injury, surgery may be necessary. Common surgical procedures include labrum repairs, posterior capsular release, anterior capsular placement, or rotator cuff surgery. Many athletes focus on a single sport and train throughout the year, leading to an increase in overuse injuries. It is recommended that athletes not practice just one sport all year round to avoid overuse. Breaks should be taken and pitchers should not throw to multiple teams. Parents, coaches and players all have a responsibility to be alert for signs of injury and follow guidelines to prevent injury. Proper warm-up, rest periods and early detection are essential to maintaining shoulder health and all symptoms must resolve before a player returns to the field..