Here are the guidelines for injury prevention in young throwers. The incidence of shoulder and elbow injuries are increasing at an alarming rate in youth baseball. With the demands on our kids to play in year round programs in order to be competitive, their skeletally immature bodies are exposed to stresses that can lead to significant problems. Parents and coaches are constantly asking about what can be done to limit their kid’s risk of suffering a season or career ending injury. In this article I will discuss some basics of thrower’s injuries and prevention.
First and foremost, preseason preparation is imperative. It is very common to see a young man 2 weeks into the season with a sore shoulder or elbow. When questioned about the injury and pre-season preparation, it is extremely common to hear that there was no prep work. All players should participate in a preseason conditioning program to include upper body and core body strengthening, as well as flexibility. The “Throwers Ten”, developed by the American Sports Medicine Institute, is a series of exercises designed for the thrower (click on link to view) Additionally, some preseason throwing in the form of a “Interval Throwing Program” is very helpful(click on link to view this program). Data proves that preseason prep work goes a long way to prevent injury.
A proper warm up prior to any throwing is essential. Any thrower should start off with some aerobic activity to get the blood flowing to their muscles. Following this, they should stretch shoulders, hips, back and legs. An improper warm up and exposing cold muscles to extreme stress is a key factor leading to injury.
TECHNIQUE and PITCH COUNT
Proper throwing mechanics is essential to prevent injury. Pitchers are much more prone to a shoulder or elbow injury simply because of the volume of throws. Prior to a player moving to the mound to pitch, they should be taught proper technique by a coach who is familiar with throwing mechanics. Proper mechanics will reduce the stress on the shoulder and elbow and make your young player less prone to injury.
Guidelines have been established with recommendations for appropriate pitch counts for age group and the appropriate age at which certain pitch types should be initiated. There are several different organizations with variations of these recommendations which are based on a study from American Sports Medicine Institute. Below are the USA Baseball Medical and Safety Advisory Committee Recommendations.
age Pitches/game Pitches/week Pitches/season Pitches/yr
9-10 50 75 1000 2000
11-12 75 100 1000 3000
13-14 75 125 1000 3000
15-16 90 180
17-18 105 210
Fast-ball – 8 years old
Change-up – 10 yo
Curveball – 14
Knuckleball – 15
Slider, Forkball and splitter – 16
Screwball – 17
LISTEN TO YOUR PLAYER
Coaches and parents should follow the guidelines for Injury prevention in young throwers and listen to their players. Arm soreness after a game may be thought of as a normal part of the game. However, soreness that persists should not be ignored and a player should not be permitted to pitch in the presence of soreness or pain. If a pitcher reports pain or soreness during a game, they should be removed immediately. If the pain does not go away within 4 days, they should be evaluated by an orthopedic physician or sports medicine specialist.
Many players play on more than one team or participate in more than one league in order to get
as much experience and playing time as possible. Players should be carefully watched and should strongly consider pitching for only one team. Further, pitchers should not catch and vice versa as this exposes the player to excessive “throw counts”.
I have presented some basic guidelines for keeping your players safe and healthy. Please stay tuned for discussion on specific injury diagnosis and treatment.
Chris Jones, MD