Fry K, et al. - A comprehensive review of the literature was done to achieve a full understanding of all recently available biomechanical and clinical evidence surrounding the windmill softball pitch and associated softball injuries. Modified pitching biomechanics, high pitch velocity, elevated pitch counts, reduced rest between outings, and raised pitcher fatigue may enhance tissue stress on the upper extremity of a softball pitcher. Persuasive evidence that each of these variables has a compounding influence on injury risk for a softball pitcher was found. Hence, coaches and clinicians require more research to promote upper extremity health in the softball pitcher at all levels of competition such as pitch volume guidelines and injury prevention approaches.