Professional Documents
Culture Documents
Roughly half of the 476 youth pitchers studied reported elbow or shoulder pain at least
For each additional 25 pitches thrown after reaching the 50 pitch count, the percentage of
The risk of shoulder pain was 2 and a half times greater for pitchers who threw more than
The risk of elbow pain was 3 1/2 times greater for pitchers throwing more than
For pitchers who self-reported pitching while tired, the risk of elbow pain was 6
Youth baseball pitchers who threw curveballs or sliders were at an increased risk of
elbow and shoulder pain [Note: while two recent studies suggest that throwing a
curveball actually puts less stress on the elbow and shoulder than throwing fastballs,
some experts, such as world-reknowned orthopedic surgeon Dr. James Andrews of the
American Sports Medicine Institute (ASMI), still believe throwing curveballs at an early
A 2005 study in the same journal found that overuse was the overriding factor in the
development of arm pain among pitchers in youth baseball. That study found that:
Pitchers who averaged more than 80 pitches per appearance were nearly 4 times more
likely to require arm surgery;
Pitchers who pitched competitively more than 8 months per year were 5 times more likely
to require surgery; and
By age 20, those who pitched on a regular basis with a tired arm were an astounding 36
times more likely to have an elbow or shoulder injury requiring surgery.
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 performed by Dr. James Andrews at ASMI:
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.
Injury prevention tips
1. Watch and respond to signs of fatigue
As a 2009 study by ASMI reported in the journal Sports Health: A Multidisciplinary Approach
notes, like pain (see #8 below), "fatigue is generally difficult to quantify because it is a subjective
measure that varies among persons." The study recommends using pitch counts, ball velocity,
ball location, pitching mechanics, and strength as guides to determining fatigue.
If a youth pitcher complains of being tired or looks tired, let him rest from pitching and
other throwing:
Like most athletes, pitchers are generally reluctant to tell coaches they feel tired, even
when not telling might hurt both the team and the player;
A pitching coach's observational skills and judgment need to be used to detect fatigue:
o a tired pitcher exhibits significantly less maximum shoulder rotation and knee
placing too much stress on the arm and shoulder, which occurs when his arm is
positioned too far behind his body.
o Improper elbow angle: The pitcher's arm needs to be away from his body when
the ball is released; the closer the arm is to the body, the more potential for
injury.
o Arm lagging behind the body. When a pitcher gets tired, his arm tends to lag
minutes to get the blood moving through the muscles and ligaments.
o Static stretching: Then slowly and gently stretching, holding each stretch for 30