If your child is a pitcher, he/she has about a fifty-fifty chance of experiencing pain in his/her elbow or shoulder during his/her baseball career. Not surprisingly, baseball has been the most widely studied youth sport in the United States.
Here's what the studies have identified as risk factors for overuse injuries:
A 2001 study in the journal Medicine, Science, Sports & Exercise1 found that athletes who pitched with a tired arm were 6 times more likely to suffer from elbow pain and 4 more times more likely to have shoulder pain than those who did not have a tired arm.
A 2002 study in the American Journal of Sports Medicine2 found that roughly half of the 476 youth pitchers studied (47%) reported elbow or shoulder pain at least once over the course of two seasons, although most of the pain was considered mild (i.e. without loss of time in games or practices).
The study identified the following risk factors for injury:
Elbow pain was related to:
Shoulder pain was associated with:
A 2006 study in the American Journal of Sports Medicine4 found that overuse was the overriding factor in the development of arm pain among pitchers in youth baseball. That study found that:
A 2010 study by researchers at ASMI reported in the American Journal of Sports Medicine5 found that:
A 2011 study6 [5] reported in the American Journal of Sports Medicine suggests that pitchers in warm-weather climates are increased risk for injury because of the excessive time they dedicate to pitching in a calendar year.
Other studies have found that:
The epidemic of arm injuries suffered by youth baseball pitchers is reflected in the dramatic increase in the number of shoulder and so-called Tommy John elbow (ulnar) ligament-transplant operations [6] performed by Dr. James Andrews at ASMI:
Research by the ASMI and others points to three principal risk factors for injury to youth baseball pitchers: overuse (number of pitches during a game, season, and a year), poor pitching mechanics, and poor physical fitness/physical conditioning.
Of the three, experts seem to agree that the number of pitches thrown coupled with the lack of appropriate rest periods are the greatest contributor to the increasing incidence of pitcher arm injuries. The 2010 ASMI study [9]5 suggests that it is the number of innings (greater than 100 in a calendar year) that puts pitchers at greatest risk of serious injury. Likewise, the 2011 study6 [5] reported in the American Journal of Sports Medicine suggests that pitchers in warm-weather climates are increased risk for injury because of the excessive time they dedicate to pitching in a calendar year.
Because both arm fatigue and decreased self-perceived performance are risk factors for both elbow and shoulder pain, the bottom line message for parents and athletes: pain should not be ignored, because it is often the first indicator of an overuse problem.2
1. Lyman S, Fleisig GS, Waterbor JW, et al. Longitudinal study of elbow and shoulder pain in youth baseball pitchers. Med Sci Sports Exerc. 2001;33(11):1803-1810.
2. Lyman S, Fleisig GS, Andrews JR, Osinski ED. Effect of pitch type, pitch count, and pitching mechanics on risk of elbow and shoulder pain in youth baseball pitchers. Am J. Sports Med 2002;30(4):463-468.
3. Valovich McLeod TC, Decoster LC, Loud KJ, Micheli LJ, Parker JT, Sandrey MA, White C. National Athletic Trainers' Association Position Statement: Prevention of Pediatric Overuse Injuries. J Ath. Tr. 2011;46(2):206-220.
4. Olsen SJ 2nd, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am. J Sports Med. 2006;34(6):905-912.
5. Fleisig G, Andrews J, Cutter G, Weber A, Loftice J, McMichael C, Hassel N, Lyman S. Risk of Serious Injury for Young Baseball Pitchers: A 10-Year Prospective Study. Am. J. Sports Med. 2010;20(10): 1-5.
6.Kaplan KM, Jobe FW, Morrey BF, Kaufman KR, Hurd WJ. Comparison of Shoulder Range of Motion, Strength, and Playing Time in Uninjured High School Baseball Pitchers Who Reside in Warm- and Cold-Weather Climates.Am. J Sports Med.2011; 39(2): 320-328.
Posted March 15, 2011
Links:
[1] https://www.momsteam.com/node/3348
[2] https://www.momsteam.com/node/3343
[3] https://www.momsteam.com/node/2941
[4] https://www.momsteam.com/node/3030
[5] https://www.momsteam.com/node/3306
[6] https://www.momsteam.com/node/3305
[7] https://www.momsteam.com/node/2938
[8] https://www.momsteam.com/node/2988
[9] https://www.momsteam.com/node/3239
[10] https://www.momsteam.com/sports/baseball/safety/preventing-pitching-injuries-in-youth-baseball
[11] https://www.momsteam.com/sports/preventing-pitching-injuries-up-to-parents-where-playing-on-multiple-teams
[12] https://www.momsteam.com/sports/baseball-players-in-warm-weather-climates-more-prone-injuries-pitching-shoulder
[13] https://www.momsteam.com/breaking-pitches/preventing-pitching-injuries-curve-ball-debate-continues
[14] https://www.momsteam.com/health-safety/inadequate-warm-up-relief-pitchers-often-overlooked-injury-risk-in-youth-baseball
[15] https://www.momsteam.com/sports/preventing-pitching-injuries-spotting-signs-fatigue