Preventing pitching overuse injuries

Arm injuries in youth sports continue to increase at an alarming rate. In particular, baseball and softball players are at significant risk of overuse injuries during their playing careers.

In fact, it is estimated that up to 35 percent of baseball players will experience elbow or shoulder pain each year. Although throwing injuries occur in position players, pitchers are especially at risk for injury.

It’s important that parents, coaches, doctors and the athletes understand the risk factors and preventative measures, and work together to decrease pitching overuse injuries.

Overuse injury is often the result of specializing in one sport and is the main factor in the rise of arm injuries in throwing sports. Overuse leads to muscle fatigue and weakness, which can alter throwing mechanics and cause injury.

In addition, muscles protect the bones and ligaments of the shoulder and elbow during the throwing motion by absorbing the energy of the throw. When the arm is fatigued, the risk of ligament rupture or fracture increases. As the season progresses, the risk of fatigue and injury increases.

The total number of throws, not the type of pitch thrown, is the most important risk. Many baseball associations recommend daily, weekly and yearly pitch limits, as well as mandatory rest periods.

Throwing too many pitches with insufficient rest is more likely at weekend or showcase tournaments. For example, a 12-year-old who throws 50 pitches on the first day of a tournament should not pitch again until day four.

Referenced from “The Bare Minimum: Baseball” (Essential Training for the Baseball Athlete Youth through College)

Everyone involved is responsible for preventing pitching overuse injuries. The American Sports Medicine Institute has common sense suggestions to limit overuse:

  • Follow pitch limit guidelines during the season.
  • Pitch on only one team per season.
  • Don’t allow pitchers to play catcher during the same season since these two positions throw the most during a game.
  • Refrain from overhead throwing for three months and competitive pitching for four months each year.

It can be hard to take the necessary rest periods when a lot of kids now play year-round baseball. I suggest the months of November through January as ideal time in our area of the country for this essential rest.

Players should realize that a good conditioning program for their legs, core, and rotator cuff muscles is crucial to protect the shoulder and elbow from excessive force during the throwing motion. In addition to strengthening, a shoulder stretching program focused on the posterior shoulder capsule is also helpful in preventing arm injuries.

Armed with this information, coaches, parents, and players can work together to limit overuse and enjoy a full, injury-free season.

Cyrus LashgariCyrus Lashgari, MD, is an orthopedic surgeon with AAMC Orthopedics. To reach his practice, call 410-268-8862.

Originally published March 19, 2018. Last updated March 28, 2019.

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