Throwing-Shoulder Overuse Injury in Fastpitch Softball Pitchers: Clinical Guidance and a Windmill Biomechanics Review

Physical therapists and physical therapist assistants who see fastpitch softball pitchers with throwing-shoulder pain, as well as clinicians in sports, orthopedic and youth athlete settings who want an evidence-grounded overview of what two recent practitioner-facing papers report about evaluation, biomechanics and staged rehabilitation.

Physical therapists and physical therapist assistants. Athletic trainers, occupational therapists and other licensed rehabilitation clinicians who work with overhead and underhand throwing athletes may also find the material useful. Physical therapist assistants may take this course; the evaluation, diagnosis and plan-of-care decisions described in the source papers are the physical therapist’s, and the assistant’s part is the delivery and progression of the established plan under the direction and supervision of the physical therapist.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

Bordelon N, Martinez A, Zaremski J, Butler L, Holtz K, Friesen K, Downs-Talmage J, Sloma K, Neary S, Oliver GD. A Clinician’s Guide to Evaluating and Managing Shoulder Overuse Injury in Softball Pitchers. JOSPT Open. 2026:1-31. doi:10.2519/josptopen.2026.0227

Friesen KB, Butler LS, Bordelon NM, Downs-Talmage JL, Fleisig GS, Ulman S, Oliver GD. Biomechanics of Fastpitch Softball Pitching: A Practitioner’s Guide. Sports Health. 2025;17(6):1200-1213. doi:10.1177/19417381251323610

After completing this course, you will be able to:

1. Describe the evaluation approach the JOSPT Open clinician's guide sets out for a softball pitcher with throwing-shoulder overuse injury, including the patient history, the shoulder examination and the lumbopelvic-hip complex assessment.
2. Name the four phases of the windmill softball pitch as described in the Sports Health clinical review and state where that review reports the highest shoulder forces occur.
3. Explain how the windmill pitching biomechanics reported in Sports Health connect to the staged rehabilitation and return-to-pitching progression described in JOSPT Open, and state where both papers report the softball-specific evidence is still limited.

1. Start Here: How This Course Works
2. Part One: Evaluating and Managing Shoulder Overuse Injury in Softball Pitchers
3. The Softball Pitcher's Shoulder: Who Is Affected and Why Overuse Is Proposed
4. How the Clinician's Guide Was Assembled and What It Sets Out to Answer
5. Differential Diagnosis, Patient History and the Physical Examination
6. The Staged Rehabilitation Model and the Path Back to Pitching
7. Part Two: The Biomechanics of Fastpitch Softball Pitching
8. Scope of the Windmill Pitching Review and How the Literature Was Gathered
9. Wind-Up and Stride: Positioning, Ground Force and the Faults Described
10. Acceleration and Follow-Through: Where the Throwing Shoulder Is Loaded
11. Energy Flow, Functional Characteristics and Body Composition
12. Bringing It Together
13. Where the Two Papers Agree About the Softball Pitcher's Shoulder
14. Where the Two Papers Emphasize Different Things
15. Carrying the Biomechanics Into Examination and Plan-of-Care Decisions
16. What the Softball-Specific Evidence Still Leaves Open
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Bordelon N, Martinez A, Zaremski J, Butler L, Holtz K, Friesen K, Downs-Talmage J, Sloma K, Neary S, Oliver GD. A Clinician's Guide to Evaluating and Managing Shoulder Overuse Injury in Softball Pitchers. JOSPT Open. 2026:1-31. doi:10.2519/josptopen.2026.0227
2. Friesen KB, Butler LS, Bordelon NM, Downs-Talmage JL, Fleisig GS, Ulman S, Oliver GD. Biomechanics of Fastpitch Softball Pitching: A Practitioner's Guide. Sports Health. 2025;17(6):1200-1213. doi:10.1177/19417381251323610