Baseball Injuries on the Rise—What You Need to Know As a Parent

It’s a beautiful Saturday morning. The sun is out, and there’s not the slightest chance of a typical afternoon thunderstorm. You and your family are at the ball fields, watching your son pitch a great game. He only gives up two hits, and his team wins the game. 

Then, the next day, your son is back out on the mound, pitching another great game. This trend continues for the next several months—until one day, he tears a ligament in his elbow during a game. 

In recent years, this scenario has become all too common. Serious injuries among youth baseball and softball pitchers are on the rise, and many of them are caused by overuse. When young athletes throw too much, too hard or without proper rest in between games, they are very much at risk for a serious elbow or shoulder injury that can put them out of the game for weeks, months or even longer.

Unfortunately, this problem is only fueled by a lack of knowledge about injury risk, as well as increased competition among youth leagues and coaches. With so much pressure to win and consistently perform well, youth pitchers are often asked to do too much too soon. While it may seem like smart game strategy to have pitchers play as often as possible, it is not a smart move from a health and safety perspective. 

But here’s the good news—these overuse injuries can often be prevented. All it takes is the athlete’s support system coming together to stop it. When parents, coaches and mentors work together to learn about overuse injuries and take the necessary steps to prevent them, pitching injuries can decline significantly. 

As a team physician and orthopedic consultant for USA Baseball and the Atlanta Braves, I frequently work with pitchers and coaches to help reduce the risk for overuse injuries. Here are some common factors that contribute to pitching injuries and practical tips for preventing them: 

Pitch Counts

In professional, collegiate and high school leagues, pitch counts are strictly monitored. Oddly enough, however, pitch counts are often not kept for youth pitchers—whose bodies are still in the process of growing and developing.

According to a study published in 2002, there is a link between the number of pitches thrown and the likelihood of shoulder and elbow pain among youth pitchers. This is why I strongly recommend to parents and coaches that they keep a pitch count in youth leagues. If you’re unsure of how many pitches your son or daughter should be throwing per game, here is a breakdown of recommended pitch counts by age, as determined by STOP Sports Injuries: 

• Age 7–8: 50 pitches
• Age 9–10: 75 pitches
• Age 11–12: 85 pitches
• Age 13–16: 95 pitches
• Age 17–18: 105 pitches 

But here’s the catch—they can’t pitch that amount too much. If your son or daughter pitches more than 50 times in one game, he or she needs to rest for at least three to four days before pitching again. 

Multiple Appearances in a Game

In many leagues, a youth pitcher will play another position after pitching and then return to the mound later in the game. Yes, this may seem like a good game strategy, but in reality, all it does is increase the risk of an elbow or shoulder injury. Athletes have to let their muscles, tendons and ligaments rest after physical activity—just like they have to warm them up beforehand. 

Multiple Leagues

All too often, I see injuries occur because youth pitchers play in multiple leagues at the same time. Young athletes will do this to develop their skills, but it could put your child at risk for injury. While the individual leagues may keep pitch counts, the pitcher may exceed those counts by playing in more than one league. It’s fine to let your child get additional practice, but it must be done in moderation. Pitchers need time to let their bodies rest and recover so that an injury doesn’t force them out of the game. 

Year-Round Leagues

Here in Florida, it is extremely common to see year-round baseball and softball leagues. However, participating in year-round baseball means that your child never gets a break, which—you guessed it—increases the risk for injury. 

Youth pitchers need a period of active rest for at least three months each year. During this active rest period, your child can participate in physical activity, but it should not include any type of throwing drills or overhead arm motions, such as javelin throwing, competitive swimming or playing quarterback for a football team. 

Preventing Overuse Injuries in Baseball

Here are some additional tips to help prevent your child from suffering an elbow or shoulder injury: 

• Warm up thoroughly by stretching, running and gradually throwing
• Play other positions besides pitcher
• Do not play pitcher and catcher in the same game
• Follow pitch count guidelines
• Do not pitch on consecutive days
• Never use a radar gun
• Develop control, accuracy and proper mechanics as early as possible and incorporate year-round physical conditioning
• Pitchers should vary pitch type speeds. Youth pitchers should first learn to throw an effective fastball and change-up before proceeding with any breaking pitches, including curveballs and sliders.
• Monitor the player for signs of fatigue
• Do not pitch with elbow or shoulder pain
• Take your child to see a doctor if the elbow or shoulder pain persists 

For more tips and information on baseball overuse injuries, visit the STOP Sports Injuries website or the American Sports Medicine Institute website.