Updated April 2013
With the rise in elbow and shoulder injuries in adolescent baseball pitchers, the adult community needs to take steps to prevent these injuries. Research points to overuse as the principle risk factor. 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, an adolescent 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.
Thus, the recommendations for preventing injuries in adolescent baseball pitchers are:
- Watch and respond to signs of fatigue (such as decreased ball velocity, decreased accuracy, upright trunk during pitching, dropped elbow during pitching, or increased time between pitches). If an adolescent 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, discontinue pitching until evaluated by a sports medicine physician. Inspire adolescent pitchers to have fun playing baseball and other sports. Participation and enjoyment of various physical activities will increase the player’s athleticism and interest in sports.