Baseball, amongst most other “seasonal” sports, is seldom seasonal in today’s youth population. I find more and more young athletes are becoming injured because they are involved in a single sport for multiple seasons at a time.  These injuries that occur in a players high school or collegiate career are believed to have stemmed from overuse at the youth level (Kerut, E, 2008).

Awareness to this growing problem is important and thus the purpose of this article.  Baseball is considered one of the safest sports available for the youth population; let’s help our younger generation by keeping it that way!

Let us start with some research, boring… maybe, but astonishing none the less.  It has been reported that 28% of all injuries sustained to baseball pitchers occurred at the shoulder (glenohumeral) joint.  At the collegiate level, 75% of injuries occur to the upper extremities, with pitchers being the most commonly injured players at 68% of the time.


The most common injuries noted were to the shoulder rotator cuff, a series of four muscles (supraspinatus, infraspinatus, teres minor and subscapularis).  The rotator cuff’s main function is to stabilize the head of the humerus (upper arm bone) into the glenohumeral fossa (fancy term for socket) of the scapula. Pitchers in baseball put their shoulders through the same repetitive motion for multiple innings at a time with the goal of generating torque to throw as fast as possible.  Think that this doesn’t apply to youth baseball players?

In 2002 a study published in The American Journal of Sports Medicine found a significant correlation between number of pitches thrown and risk for shoulder and elbow pain in youth baseball players.  So, here is a great place to start in regards to baseball injury prevention.

baseball injury prevention

Injury prevention begins with an assessment of shoulder joint mobility, range of motion, strength and stability.  It is important to understand that all of these components are important in striving to prevent baseball injury; however, maybe just as important is the concept of overuse.  Overuse injuries may be avoided especially in the younger population by following some simple guidelines:

– Begin with a proper dynamic upper and lower body warm up.
– Incorporate upper extremity plyometric activities into warm-up.
– Abide by pitch count and rest guidelines as per little league guidelines
– Focus on control and proper throwing mechanics during little league ball.
– Breaking pitches (sliders and curveballs) should be avoided until puberty.
– Pitchers should not be placed to pitch on more than one team per season.
– Pitchers should not participate in throwing activities or play baseball for at least three months a year to allow for rest.
– Most importantly, pitchers must have an open line of communication with their coaches.  Every athlete is different!

Here are the guidelines as described by the USA Baseball Medical & Safety Advisory Committee.

9-10 year old pitchers:

– 50 pitches per game
– 75 pitches per week
– 1000 pitches per season
– 2000 pitches per year

11-12 year old pitchers:

– 75 pitches per game
– 100 pitches per week
– 1000 pitches per season
– 3000 pitches per year

13-14 year old pitchers:

– 75 pitches per game
– 125 pitches per week
– 1000 pitches per season
– 3000 pitches per year

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. The American Journal of Sports Medicine 30(4):463-468, 2002

Kerut, E, et al. Prevention of arm injury in youth baseball pitchers.  J La State Med Soc VOL 160 March/April 2008.

Conte S, Requa RK, Garrick JG.  Disability days in major league baseball.  Am J Sports Med.  2001; 29(4): 431-436.

McFarland EG, Wasik M.  Epidemiology of collegiate baseball injuries.  Clin J Sports Med.  1998; 8(1):10-13.

Andrews JR, Fleisig GS. How many pitches should I allow my child to throw? USA Baseball News April, 1996

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