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ASMI Position Statement for Youth Baseball Pitchers

With the rise in elbow and shoulder injuries in youth 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, a youth 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 youth baseball pitchers are:

  1. Watch and respond to signs of fatigue. If a youth pitcher complains of fatigue or looks fatigued, let him rest from pitching and other throwing.
  2. No overhead throwing of any kind for at least 4 months per year.
  3. Follow limits for pitch counts and days rest. (Example limits are shown in the table below.)
  4. Avoid pitching on multiple teams with overlapping seasons.
  5. 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.
  6. Avoid using radar guns.
  7. 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.
  8. If a pitcher complains of pain in his elbow or shoulder, get an evaluation from a sports medicine physician.
  9. Inspire youth pitchers to have fun playing baseball and other sports. Participation and enjoyment of various physical activities will increase the youth's athleticism and interest in sports.
Example limits for number of pitches thrown in games
Age (yrs) 2006 USA Baseball Guidelines 2008 Little League Baseball Regulations
Daily Limits
17-18 n/a 105/day
15-16 n/a 95/day
13-14 75/game
11-12 75/game 85/day
9-10 50/game 75/day
7-8 n/a 50/day
Weekly Limits
17-18 n/a

26-50 pitches -- 1 day rest;
51-75 pitches -- 2 days rest;
76-105 pitches -- 3 days rest

15-16 n/a

21-40 pitches -- 1 day rest;

41-60 pitches -- 2 days rest;

more than 60 pitches -- 3 days rest

13-14

125/week;
1000 season;
3000/year

11-12 100/week;
1000 season;
3000/year
9-10 75/week;
1000/season;
2000/year
7-8 n/a

References:

  • Dun S, Loftice J, Fleisig GS, Kingsley D, Andrews JR. A biomechanical comparison of youth baseball pitches; is the curveball potentially harmful? Am J Sports Med. 2008; 36(4):686-692
  • Fleisig GS, Andrews JR, Dillman CJ, Escamila RF. Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med. 1995;23:233-239
  • Fleisig GS, Weber A, Hassell N. Andrews JR. Prevention of elbow injuries in youth baseball pitchers. Curr Sports Med Rep 2009; 8:(5):250-254
  • 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. Am J Sports Med. 2002; 30(4):463-468
  • Matsuo T, Fleisig GS, Zheng N, Andrews JR, Influence of shoulder abduction and lateral trunk tilt on peak elbow varus torque for college baseball pitchers during simulated pitching. J Appl Biomech. 2006; 22(2):93-102
  • Nissen CW, Westwell M, Ounpuu S, Patel M, Solomito M, Tate J. A biomechanical comparison of the fastball and curveball in adolescent baseball pitchers. Am J Sports Med, 2009 237(8):1492-1498
  • Olsen SJ, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am J Sports Med. 2006; 34(6):905-912
  • Patty DH, Andrews JR, Fleisig GS, et al. Ulnar collateral ligament reconstruction in high school baseball players; clinical results and injury risk factors. Am J Sports Med 2004; 32:1158-1164

 

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