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Preventing Pitching Injuries: Up to Parents To Reduce Injury Risk Where Multiple Teams Involved

May need to track pitch counts

Youth baseball pitcher delivers to plateWhy does the number of youth baseball injuries continue to rise? Youth baseball organizations, especially Little League and USA Baseball, have been looking for answers for years, and, in recent years, have established pitching rules and guidelines in the hope of stemming the epidemic of elbow and shoulder injuries suffered by pitchers in youth baseball.

Young pitchers are very susceptible to shoulder and elbow injuries from throwing too many pitches in a game, in a week, and in a season.  The Little League pitch limit and rest rules enacted in 2007, and revised for 2010, are supposed to reduce the risk of such overuse injuries.  While some advocate limiting or prohibiting the throwing of curveballs and sliders at a young age, recent studies suggest that they actually may put less strain on a pitcher's arm than fastballs. Working together, parents, medical, and sports organizations have made some progress in reducing the risk of arm injuries in youth baseball.

Elephant in the room

So far, though, no one has addressed the "elephant in the room."  While parents, coaches, and organizations are doing a great job looking at parts of the problem to reduce risk of injury, the big question, which remains unanswered, is not "What we are doing?" but more about the youth sports culture: "What have we become?"

Years ago, young athletes would play a variety of sports, go on vacations with the family, and have months for an "off season." Nowadays, it is not unusual to see a 10-year-old playing 100+ baseball games in the summer, cramming in $60 personal training sessions 2 times a week, hitting and pitching lessons 3 times a week, and then squeeze in some strength and conditioning training between practices.

Pitching rules are great, but ignoring the cultural push that "more is better" will only hinder hurt youth baseball in the long run.

So why does baseball allow such a culture to exist? Consider the following:

  • Too many games.  Major League Baseball teams play 162 games a year over a six month season. This number of games is considered appropriate for adults, but for young athletes it is way too much. The youth baseball culture has determined, wrongly in my view, that "if more is good, than even more must be better."
  • Training, training, training.  The idea that players need conditioning for baseball was not a commonly shared belief 20 years ago. Today, youth baseball players are hitting the gym, drinking protein shakes, and participating in workouts more appropriate for a NFL linebacker... and they are 9 years old! The push by our culture towards more and more training is creating a future for our children of broken bodies, and, ultimately, broken dreams. 
  • By the time baseball players reach the point of exhaustion, the damage is done. Baseball is a slow sport punctuated by moments of intense movement that rarely exhaust the athlete. The physicality of football, basketball, soccer, and even hockey will eventually completely exhaust the young athlete, eventually forcing them to take time off to rest.  Baseball players can take hundreds of explosive swings and throws day after day, but the cumulative effect eventually takes its toll on a child's growing body, often to the point of permanent physical injury. 
  • Year-round play.  In years past, when the weather got cold, the baseball season ended. Not so today: indoor facilities, batting cages, and even warehouses allowing for full team practices have made year-round baseball a reality all across the country.  Warm-weather pitchers are at particular risk.  With no time off, no wonder more and more youth baseball players are getting injured. 
  • America's obsession with the "now."  I played baseball from Little league through high school and college. I never remember experiencing the intensity that parents and coaches exhibit today. Dreams of being the best, scholarships, and big league contracts drive many parents, athletes, and coaches to only think in the now, even if it means mortgaging - and in some cases, bankrupting - their children's future. A 6th grade weekend championship game is important, but driving young athletes into the ground to get there is sacrificing the future.

Up to parents

So what is the answer to reducing injuries in baseball? Throwing fewer pitches and playing fewer games are steps in the right direction, but they aren't a panacea. The problem is not one thing, it is a lot of things! Enforcing pitch counts promotes awareness but more steps are necessary for lasting results. They are steps that no governing body can monitor. No one from Little League headquarters can be around to make sure rules about the number of practices and the number of games per week are enforced; no one will follow players around to make sure they aren't benching too much weight.

Ultimately, therefore, it is up to parents to protect their own athletes. Baseball culture will continue its "proliferation" and parents, not organizations or guidelines, will determine the future for their children.

Here are some tips for parents to protect their child from injury while still maximizing baseball fun:

  • Three months off.  Make sure your child takes at least 3 consecutive months off from throwing, as recommended by Dr. James Andrews and the American Sports Medicine Institute, the pre-eminent experts on baseball injuries, and, most recently, in the National Athletic Trainers' Association 2011 position statement on overuse injuries. The time off ensures that your child's arm has enough time to heal before another season of competition.  This rule applies, even if, and perhaps especially, if you live in a warm-weather climate where baseball can be played all-year round.
  • Play other sports: Switching sports on a regular basis not only develops a better athlete but reduces the risk of overuse injuries. Even though playing basketball instead of training for baseball increases the risk of sprained ankles, it significantly reduces the future risk of damage to the rotator cuff.
  • Age- and child-appropriate strength and conditioning training. Talk to your pediatrician and a strength and conditioning expert about what is appropriateyou're your child's growing body.
  • Pay attention to pain. If your child can point a finger to the pain, such as a tendon, ligament, or joint that is very specific, pay attention! Sore muscles happen with every sport but complaints of elbow joint pain on a regular basis needs to be addressed immediately.
  • Raise a well-rounded child. Take your child on vacations, encourage him/her to participate in other extracurricular activities, and have a life outside of sports. Obsession with athletics, particularly one sport, has been shown to increase the likelihood that your child will quit sports before high school. Avoid this "burn out" affect by encouraging a well-rounded child.


Created March 13, 2010; updated January 4, 2012

Keith J. Cronin is a physical therapist in the St. Louis, Missouri area and a MomsTeam expert. 



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