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Fast-Pitch Softball Pitchers Experience a Significant Increase in Pain and Fatigue During a Single High School Season

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Fast-pitch softball is one of the fastest growing sports, but there is little research regarding pitcher fatigue. Currently, there are no pitch limits or game counts.


To study the effect of fatigue on youth fast-pitch softball pitchers during a high school season, we hypothesized increased games pitched during the season would correlate with increased player-reported pain and fatigue and decreased with upper extremity strength and range of motion (ROM).


This prospective cross-sectional study evaluated pre- and postgame shoulder and elbow strength, ROM, pain, and fatigue in 17 high school fast-pitch softball pitchers. These measures were recorded at two games, one at the beginning and one at the end of the season. Pitch count and number of games pitched during the season were recorded. We compared pre- and postgame measurements and measurements made at the beginning and end of the season.


Supraspinatus, forward flexion strength, and external rotation strength in abduction decreased significantly postgame compared to pregame. Pregame pain and fatigue increased with a greater number of games pitched during the season. Forward flexion, supraspinatus, and external rotation strength decreased with increasing number of games pitched during the season.


Fast-pitch softball pitchers experience increased pain and fatigue during a single game and over the entire season. The increase in fatigue may predispose the player to injury. Further studies are needed to understand the relationship of pain and fatigue with predisposition to injury.

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Correspondence to Justin S. Yang MD.

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Conflict of Interest

Justin S. Yang, MD, Jeffrey G. Stepan, MD, MSc, Lucas Dvoracek, BS, Robert H. Brophy, MD, and Matthew V. Smith, MD have declared that they have no conflict of interest. Rick W. Wright, MD reports institutional research grants support from Smith Nephew and National Institute Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases, and book royalties from Wolters Kluwer Lippincott Williams & Wilkin, outside the work.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

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Informed consent was obtained from all patients for being included in the study.

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Level of Evidence

Level IV: Prognostic Study

Work performed at the Department of Orthopedic Surgery, Washington University in St. Louis.

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Yang, J.S., Stepan, J.G., Dvoracek, L. et al. Fast-Pitch Softball Pitchers Experience a Significant Increase in Pain and Fatigue During a Single High School Season. HSS Jrnl 12, 111–118 (2016).

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