Safety-Preventing Arm Injuries

Misconceptions abound among  baseball parents, coaches and players about the reasons for and benefits of Tommy John surgery and the relationship between pitch counts and injury risk.

Youth baseball pitchers throwing more than 100 innings in a calendar year are 3.5 times more likely to be so seriously injured as to require elbow or shoulder surgery or retirement due to injury, says a new study from the American Sports Medicine Institute. The study suggests that playing catcher may double or triple a pitcher's risk of injury, but the small number of injured players studied prevented a finding that the risk was significantly significant. 

Youth baseball programs - Little League in particular -  have put new limits in place in recent years to reduce the number of pitches thrown per game, week, and for what team, prompting, indeed requiring, parents and coaches to get out "the clicker" to count pitches. With pitch limits in place, the attention seems to have turned to another important element in the pitching injury equation: the type of pitches being thrown.

Inadequate warm-up is one often overlooked risk factor for youth baseball pitchers .  Research by the American Sports Medicine Institute shows that a pitcher needs to throw twenty-five fastballs before he achieves command and is fully warmed up. The problem is that a pitcher who comes to the mound from playing another position as a reliever only gets seven tosses before facing live batters.

Little League and USA Baseball have focused in recent years on total pitch counts and rest periods between pitching outings as ways to reduce the number of pitching injuries.  Some baseball experts believe, however, that removing pitchers from games based on the number of pitchers they throw per inning and/or when they  exhibit certain signs of fatigue will do more to protect the arms of young pitchers than total pitch count limits.

Tips from the American Academy of Orthopaedic Surgeons on ways to reduce overuse injuries in youth baseball.

Stretching exercises maintains good shoulder flexibility and reduce the risk of rotator cuff and other injuries to baseball pitchers and other throwing athletes (football quarterbacks, javelin throwers).  Without a stretching program, athletes tend to develop muscle imbalances over the course of a season, exposing the athlete to increased risk of injury.

With baseball season kicking into full gear, it is important to ensure that young arms are ready for the field. While a  great deal of emphasis is placed on "throwing more to get a stronger arm"  there are several other factors to consider. Physical therapist Keith Cronin provides a simple list of assessment tools and exercises to assess strength deficits in a throwing shoulder that increase that increase the risk of injury and decrease overall performance.

When athletes pitch for multiple teams during the same season or on unregulated travel ball team, parents should keep track of pitch counts to protect them from injury.