1)  Elow pain

2)  Shoulder pain

3)  Back pain

These three areas are the most susceptable to pitching injuries.  Let's look at each section individually so we can help you identify some injuries.

Elbow

Tommy John - A surgery named after a former LA Dodgers pitcher who was the first to replace the ligament in his elbow with a tendon from another part of his body.  How it happens is the ulnar collateral ligament becomes stretched, frayed, or torn.  This can happen from repetitive stress of the throwing motion.  Although it is becoming a more practiced surgery to younger pitchers it is not necessarily what may be wrong.  In younger athletes a similar injury is called Little League Elbow.

Little League Elbow - Is irritation and inflammation in the elbow.  It is caused by the growth plates of the elbow being stressed by overuse.  These growth plates are made of soft carilage and are not very resistent to stress therefore they often cause irritation and inflammation.  When the pitching motion puts force on the inside of the elbow, the younger pitcher's growth plates are more likely to fail than the ulnar collateral ligament.  Therefore little league elbow does not require reconstructing the Ulnar Collateral Ligament.

Shoulder

Arthroscopy - Allows the surgeon to look inside the shoulder joint using small incisions and identify the problems. The surgeon may often be able to correct the problem using this procedure by removing loose unwanted tissue from the joint, with less disturbance to the joint. Recovery time is usually short.

Bankart procedure - An operation that tightens ligaments and repairs torn capsular detachments, restoring shoulder stability. It is often performed for athletes involved in throwing sports (pitchers) who suffer from recurrent dislocations and subluxations. It allows the patient to return to pitching because the muscles and tendons are returned to their anatomic locations.

Rotator cuff repair - A procedure that is performed to repair the tear, therefore, relieving the patient's pain and improving function of muscles and tendons that move the joint. The surgery is commonly performed on patients who complain of pain and weakness in the deltoid region that occurs with normal daily activities as well as when they are throwing. The pain is often worse at night.

Back

The causes of back pain can be complex. Some causes of back pain include muscle strains, muscle tears, or pinched nerves.

When should a pitcher throw through pain and when should he decide to shut it down?  To know the answer to the question a pitcher has to learn what is normal pain and what isn't.  This only happens through experience.  Each pitcher will have to learn the difference of pain vs. soreness.  This takes years of trying to understand your own body.  The first time a pitcher feels sore or stiff they may think something is wrong.  Once they have made the decision to throw through it and realize everything is ok, then they can identify that feeling as soreness or stiffness.  This is the process they have to do everytime they feel something wrong or different with their body.  Having a close relationship with your trainer is a good way to help make decisions on whether or not to pitch through something or to shut it down.  Once a pitcher understands his body and what is pain and what is soreness, he will then be able to stop throwing when he should.  This will make the chance for serious injury alot less because the pitcher was able to catch it before it got too bad.  Once a pitcher decides to shut it down, they should get with their trainer to talk about a rehab program.  A rehabilitation program will help get the pitcher back to the shape that he was in before he started feeling this pain.  Here is why you need to be open and honest with coaches, trainers, and yourself when it comes to a pitching injury:

Let's say you feel some pain or soreness or something that just doesn't feel right to you.  You might want to first try to see if you can throw through the problem.  Now if you complain to coaches and trainers and the doctors don't find anything wrong, well then you worry about being called soft and not a tough pitcher.  But now what if you don't say anything to coaches and trainers and the problem gets worse?  Now the coaches and trainers are going to get mad at you because you did not come to them sooner.  The bottom line is that you have to be honest with yourself, coaches, and trainers.  Hopefully they will do the same with you.  This is such a hard decision to make soley because it is normal to feel like crap after pitching.  Now your job is to figure out if it is really bad or if you are able to pitch again without it getting any worse.