Oblique strains and pulls and intercostals strains are injuries that you seldom saw or heard of fifteen to twenty years ago. The two injuries are different injuries; I think one mistake is to group them together. Now they are both a very common occurrence in baseball both in pitchers and hitters. If you look closely at the mechanism of the injuries based on the demands placed on the body in the activities that cause these injuries it is clear that both are force reduction injuries. They occur in deceleration of the trunk after a violent ballistic action of swinging a bat or throwing a pitch. As with any injury it is important to thoroughly assess what is being done in the training/prevention area and what is not being done. My observation is that the ratio of actually preparing to pitch and hit is out of balance. There is too much swinging of the bat with out the requisite lead up activities that prepare for the deceleration forces exerted in a diagonal rotational pattern. With pitchers they pitch more but throw less, by that I mean a structured long toss program where they have to extent themselves through ranges of motion outside of their normal pitching motion is not emphasized enough. The same would be true with striking and swinging activities to prepare for hitting. In addition there is more emphasis on weight training that is not specific enough to the demands of hitting and pitching. There are still too many traditional weight exercises with emphasis on load and force production mostly in sagittal plane. In addition the too much of the “core work” is still done in prone & supine postures and too isolated. Not enough emphasis on catching and activities that force the trunk to decelerate.

The ultimate reason for these injuries goes far back to what the current generation of players did and did not do when they were kids growing up. Most began playing baseball at an early age when they were identified as being talented and probably specialized early and prepared by pitching more and swinging the bat more. In essence accumulating stress without any preparation for the imposed stresses. Most did not have regular physical education as that has gone the way of dinosaur. The surest way to strengthen the intercostals and the oblique’s is to climb, hang, swing from overhead ladders and crawl all activities inherent in play and work in past generations. The current generation of players did not get this either in free play or in physical education. This should force us to reconsider how we train and prepare these athletes from younger ages on up to the professional level. I know this sounds old school but take a step back and think about how it can be done. It can be done, but it must be done in systematic manner beginning at the youngest ages with comprehensive preparation to play activities that are structured into the start of practices at every level. These activities should be as movement rich as possible including climbing, hanging, suspended swings and crawls. Mind you this is not to be done in a boot camp environment but in a structured playful teaching environment regardless of the level of development. It is not real complicated; it is very basic but necessary. That is both the long term and short-term solution.