Baseball Sports Performance: Are Spinal Changes in Young Rotational Athletes Good or Bad? Experts Say It Depends.
By Dr. John Mishock, PT, DPT, DC
Rotational sports such as baseball, softball, golf, and tennis place tremendous demands on the spine as athletes repeatedly generate powerful forces through the hips, trunk, and upper extremities (Walker et al., Journal of Neurosurgery: Spine, 2019). But when an MRI reveals disc degeneration, facet joint thickening, or even stress fractures in a young athlete, does this indicate injury or normal adaptation?
Adaptation vs. Degeneration: What’s the Difference?
According to Wolff’s Law and the Specific Adaptation to Imposed Demand (SAID) principle, musculoskeletal tissues adapt to progressive mechanical loading. However, not every structural change represents a positive adaptation, and excessive loading can contribute to degeneration or stress injuries. Alyas and colleagues evaluated 33 asymptomatic elite junior tennis players. They found that 85% had abnormal lumbar MRIs, including 70% with facet joint arthropathy, 39% with disc degeneration, and 27% with pars stress injuries, despite reporting no back pain (Alyas et al., British Journal of Sports Medicine, 2007).
Similarly, a study of 308 collegiate athletes and 71 nonathletes found that baseball players had 3.23 times the odds of lumbar disc degeneration compared with nonathletes (Hangai et al., American Journal of Sports Medicine, 2009).
In professional baseball players evaluated for low back pain, disc degeneration was identified in 91% of players in their 30s versus 14% of players in their 20s. (Morimoto et al., Orthopaedic Journal of Sports Medicine, 2022). These findings emphasize an important clinical distinction: MRI abnormalities do not automatically equal pain or disability, but they should not automatically be interpreted as beneficial adaptations (Alyas et al., British Journal of Sports Medicine, 2007).
Spinal Stabilization: Controlling Forces and Building Resilience
The core includes the abdominal muscles, obliques, multifidus, spinal extensors, and surrounding hip musculature, which work together to control spinal movement and transfer forces throughout the kinetic chain.
Spinal stabilization exercises, including bird dogs, side planks, and Pallof presses, and chop variations train the trunk to resist unwanted movement and improve muscular control. For rotational athletes, the goal is not to eliminate rotation but to build enough trunk control while allowing coordinated movement through the hips and thoracic spine.
Rotational Core Training: Increasing Bat Speed, Throwing Velocity, and Golf Power
Rotational training develops the ability to generate, transfer, and decelerate explosive forces during swinging and throwing movements. In a 12-week study of 49 high school baseball players, additional rotational and full-body medicine-ball training produced a 6.4% improvement in bat speed, compared with 3.6% in athletes who performed traditional training and batting practice alone (Szymanski et al., Journal of Strength and Conditioning Research, 2007). The same group also improved dominant-side rotational strength by 17.1%, reinforcing the relationship between rotational strength development and measurable performance gains (Szymanski et al., Journal of Strength and Conditioning Research, 2007).
For golfers, a systematic review reported that combined general and golf-specific resistance training improved clubhead speed by an average of 4.1% and hitting distance by 5.2% (Uthoff et al., Journal of Strength and
Conditioning Research, 2021). A systematic review and meta-analysis of 10 randomized trials also found that core training significantly improved throwing velocity by up to 4 mph. (Lin et al., American Journal of Physical Medicine & Rehabilitation, 2024). These findings support combining foundational strength, trunk stabilization, and explosive rotational exercises to develop sports performance rather than relying exclusively on traditional abdominal exercises.
The Takeaway: Train Smarter, Rotate Stronger
Not all spinal MRI changes indicate injury, but persistent back pain, particularly in young athletes, deserves appropriate evaluation. A comprehensive program combining spinal stabilization, rotational power training, lower-extremity strengthening, mobility, and recovery can improve performance-related physical qualities while helping athletes manage training demands.
Dr. John Mishock holds doctoral degrees in physical therapy and chiropractic. He is the author of Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete and The Rubber Arm: Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury.
We can help!
If pain is limiting you from doing the activities you enjoy, give Mishock Physical Therapy a call: locations in Gilbertsville (610-327-2600), Skippack (610-584-1400), Phoenixville (610-933-3371), Boyertown (610- 845-5000), Limerick (484-948-2800) at www.mishockpt.com or request your appointment by clicking here.
Dr. Mishock is one of only a few clinicians with doctorate-level degrees in both physical therapy and chiropractic in the state of Pennsylvania. He has also authored two books; “Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete”, “The Rubber Arm; Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury” both can be bought on Amazon or train2playsports.com.
