With the rise in elbow and shoulder injuries in youth baseball pitchers, the adult community needs to take steps to prevent these injuries. Research points to overuse and fatigue as the principle risk factors. Studies have shown that throwing when the arm and/or body are fatigued, leads to injury and even surgery. Poor pitching mechanics also contribute to injury risk. Another suggested risk factor is poor physical fitness.

Throwing curveballs has been suggested as a risk factor, but the existing research does not support this concern. However, a youth pitcher may not have enough physical development, neuromuscular control, and proper coaching instruction to throw a curveball with good mechanics. Throwing curveballs too early may be counter-productive, leading to arm fatigue as well as limiting the youth’s ability to master fastball mechanics.

Many times when young pitchers start throwing breaking balls, ie, curveballs or sliders, and are not being taught correct mechanics, their arm slot tends to drop down, therefore having increased risk/potential for elbow and shoulder injuries. So when can a young pitcher start working and throwing breaking ball? There are many orthopedic specialists that recommend not throwing breaking balls until the young man starts shaving, ie puberty. That’s when he is supposed to be skeletally mature, and should be able to withstand the stress that breaking balls have on the whole arm.

Thus, the recommendations for preventing injuries in youth baseball pitchers are: Watch and respond to signs of fatigue. If a youth pitcher complains of fatigue or looks fatigued, let him rest from pitching and other throwing. No overhead throwing of any kind for at least 2-3 months per year (4 months is preferred). No competitive baseball pitching for at least 4 months per year. Do not pitch more than 100 innings in games in any calendar year. Follow limits for pitch counts and days rest.

Avoid pitching on multiple teams with overlapping seasons. Learn good throwing mechanics as soon as possible. The first steps should be to learn, in order: 1) basic throwing, 2) fastball pitching, 3) change-up pitching. Avoid using radar guns.

A pitcher should not also be a catcher for his team. The pitcher-catcher combination results in many throws and may increase the risk of injury. If a pitcher complains of pain in his elbow or shoulder, get an evaluation from a sports medicine professional, ie a sports physician, throwing specialist/physical

Stodden Physical Therapy loves to see those young athletes if injured. We will do a comprehensive exam for the elbow, shoulder, flexibility and core strength. There will also be throwing evaluations done on site with our outdoor throwing facility. Our goal is to get the athlete back to competition quickly and safely. We will work with parents and coaches for a safe return to baseball.

Daily Limits

17-18 yrs/old: 105 pitches /day
15-16 yrs/old: 95 pitches/day
13-14 yrs/old: 75 pitches /game
11-12 yrs/old: 75 pitches /game, 85 pitches /day
9-10 yrs/old: 50 pitches /game, 75 pitches /day
7-8 yrs/old: 50 pitches /day

Weekly Limits

13-14 yrs/old: 125 pitches /wk; 1000/season; 3000/yr
11-12 yrs/old: 100 pitches /wk; 1000 /season; 3000/yr
9-10 yrs/old: 75 pitches /wk; 1000/season; 2000/yr

Daily limits and Rest

21-35 pitches — > 1 day rest
36-50 pitches — > 2 days rest
51-65 pitches — > 3 days rest
66- pitches — > 4 days rest

Conditioning ideas for the thrower:

A great warm up is always recommended before any athletic event. Things that will help build up the young throwers without any special equipment. Body weight type exercises for young kids usually work the best. For example: push-ups, walking pushups moving hands side-side and front-back, sit-ups, sit-ups with rotation very important, dips off of bench or chair, pull-ups, squats, lunges, lunge jumps.

After warm up exercises and stretching, then can begin throwing. It is recommended to the thrower, that even during easy toss, try and be as accurate as possible. That makes the thrower more accurate when throwing longer and harder. It is a matter of focusing and training arm to do same thing every time. The Crow-Hop method, (a hop, and then a skip, followed by the throw) is a great way to get the whole body into the throw and take pressure off of the arm.

For any age, icing the shoulder and/or elbow for 15 min after pitching in a game is very important to reduce inflammation caused by the pitching motion. We, as parents and coaches need to protect these young arms from getting fatigued and getting injured. The baseball starts at an early age, and if we can keep the young thrower healthy, they will enjoy playing baseball much more. Hopefully this information is helpful for all who read it.

ASMI (American Sports Medicine Institute) Position Statement for
Youth Baseball Pitchers: Website: asmi.org
Updated March 2011