7. Make sure your child properly warms up and stretches.
Research shows that cold muscles are more injury prone. While a proper warm-up is important for all youth athletes, it is particularly critical during a growth spurt, when your child's muscles and tendons are tight. Experts, including the American Academy of Orthopedic Surgeons , recommend that your child warm up by:
- Dynamic stretching: Do jumping jacks, jogging or walking in place for 3 to 5 minutes to get the blood moving through the muscles and ligaments.
- Static stretching: Then slowly and gently stretching, holding each stretch for 30 seconds. Pitchers should concentrate on stretching their arms, shoulders, neck and wrists, in addition to stretching their legs.
- Soft tossing first. Your child shouldn't start throwing the ball hard right away, especially in cold weather. He should begin by "soft tossing" and then gradually increase the distance and velocity of his throws as his arm gets loose and warm.
8. Never allow your child to play through pain
The stories about youth baseball pitchers pitching in pain to the point of injury abound.
- Any persistent pain is a sign of a chronic (i.e. overuse) or acute (e.g. traumatic) injury that should sideline a child from playing until it subsides.
- Teach your child not to play through pain. If your child gets injured, see your doctor. Follow all the doctor's orders for recovery and get the doctor's (or physical therapist's ) okay before allowing your child to play again.
Pitchers should never try and get through an inning when they feel any soreness or tiredness in their pitching arm.
The key is to be able to distinguish between normal stiffness/soreness from throwing (which needs to be worked out by playing catch the day after) from pain which is the result of overuse, muscle or ligament strain, or serious injury, says youth baseball coach, author and MomsTeam contributor, Dan Clemens."It's tough for kids to know the difference until they've been though it several times (maybe even into high school), " he says. "Coaches have a tough time knowing the difference because it's not their arm and they aren't feeling it. Part of what we need to teach the kids is to know their own bodies," Clemens says.
"As coaches we need to err on the side of caution. But I know that if kids only throw on the days they feel great, they'll only be doing it once or twice a week - and that's a "weekend warrior" strategy that's a surefire recipe for injury," he says.
He recommends that kids throw 4 to 6 times a week (throw, not pitch) in order to build arm strength, which is what prevents a lot of injuries. To do this, they'll have stiffness they have to work through. Just as the only way for runners to work out the pain and stiffness from the previous day's run is to go lace up the shoes, Clemens observes. "I've tried this excuse and it only makes the run later in the week worse!"
9. Avoid use of radar guns
According to a 2006 study,6 pitchers throwing harder than 85 mph are two-and-one-half more times likely to suffer a serious arm injury.
A 2012 study7 by researchers at the Mayo Clinic and the Kerlan-Jobe Orthopedic Clinic in Los Angeles suggests the reason: the harder a pitcher throws, the greater the stress on the elbow and risk of injury, particularly to the ulnar collateral ligament (the ligament repaired in Tommy John surgery).
The researchers called the link "alarming," especially since "increasing velocity is the goal of many pitchers." Since "a high PV is considered a hallmark of talented young pitchers," says the study, it is the best pitchers who may be the "most vulnerable to injury,"
Dr. Andrews, for one, thinks one of the culprits is the radar gun, which he argues, should be outlawed. "Young pitchers, coaches, scouts and parents put so much emphasis now on throwing hard that these kids are hurting their elbows and their shoulders because they are trying to throw 90 mph," he told ESPN.com in February 2012.
Some experts, including Ron Wolforth of Texas Baseball Ranch and Pitching Central,8 recommend continued use of radar guns, not out of an obsession with velocity, but because of their value to measure pitcher fatigue (see #1 above)(in other words, a drop off in velocity is a tell-tale sign that a pitcher is tired, regardless of competitive level, from youth baseball up to Major League Baseball).
The 2012 Mayo Clinic study implies a continued role for radar guns, if only to identify pitchers at greatest risk of elbow injury and in determining the appropriate pitch count.
10. Avoid showcases
Showcases (multiday, high-level events in which athletes may play in multiple games in a short period of time) provide young players the opportunity to show off their skills to scouts at higher levels of baseball.
As USA Baseball notes,2 "Unfortunately, showcases often occur near the end of the player's season, when players are often fatigued and require rest and recovery. In other instances, players participate in a showcase after a prolonged period since the league ended and without adequate preparation for throwing hard again. It is without a doubt that young throwers will try to overthrow at these events in an effort to impress the scouts, which further increases the risk of serious arm injury."
The 2011 Little League pitching injury study3 reported that pitching in showcase events was associated with an increased risk of elbow and shoulder injury for those who also pitched in Little League Baseball and in high school pitchers.
That showcases are not safe is a view shared by Dr. Andrews: "A lot of the times they go to these events not in shape or tired because they may have pitched the night before. They throw them off the mound as hard as they can and damage their arm by doing so," he told ESPN.com.
11. Don't let pitchers be catchers too
The pitcher-catcher combination results in too many throws and may increase the risk of injury. Little League Baseball instituted a new rule for 2010 banning any pitcher who delivers 41 or more pitches in a game from going behind the plate to play catcher for the remainder of the day.
The results of a 2010 ASMI study9 appear to support such a ban. While it found that playing catcher appeared to double or triple a pitcher's risk of injury, the small number of injured players in the study prevented a finding that the risk was statistically significant. Neverthless, the authors concluded that playing both pitcher and catcher in the same game or on the same day be "discouraged."
For its part, the National Athletic Trainers' Association 2011 position statement on overuse injuries4 advises "caution when combining pitching with other demanding throwing positions (e.g. pitch 1 day and catch the next day) to ensure adequate time for recovery."
12. Consider delayed throwing of the curveball
The relationship between pitch types (particularly curve-balls) and injuries in youth baseball pitchers is controversial, and the evidence, and the views of experts, go both ways. For a detailed discussion of the curve ball debate, click here.
1. Kaplan KM, Jobe FW, Morrey BF, Kaufman KR, Hurd WJ. Comparison of Shoulder Range of Motion, Strength, and Playing Time in Uninjured High School Baseball Pitchers Who Reside in Warm- and Cold-Weather Climates. Am. J Sports Med. 2011; 39(2): 320-328.
2. ASMI Position Statement for Youth Baseball Pitchers, August 2009.
3. The Learning Curve: Little League Seeks to Address Concerns, Answer Questions about Curveballs and Overuse (Little League International 2011).
4. Valovich McLeod TC, Decoster LC, Loud KJ, Micheli LJ, Parker JT, SandreyMA, White C. National Athletic Trainers' Association Position Statement: Prevention of Pediatric Overuse Injuries. J Ath. Tr. 2011;46(2):206-220.
5. American Academy of Pediatrics Council on Sports Medicine and Fitness, Baseball and Softball Policy Statement (doi 10.1542/peds 2011-3593)(www.pediatrics.org/cgi/doi/10.1542/peds2011-3593 (accessed February 27, 2012).
6. Olsen SJ 2nd, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk factors forshoulder and elbow injuries in adolescent baseball pitchers. Am. J Sports Med. 2006;34(6):905-912.
7. Hurd W, Jazayeri R, Mohr K, Limpisvasti O, ElAttrache N, Kaufman K. Pitch Velocity Is A Predictor of Medial Elbow Distraction Forces in the Uninjured High-School Aged Baseball Pitcher. Sports Health: A Multidisciplinary Approach. 2012; DOI:10.1177/1941738112439695 (accessed March 22, 2012)(published online ahead of print).
8. Wolforth, Ron, Observational Fatigue & New Guidelines (accessed May 27, 2010)
9. Fleisig G, Andrews J, Cutter G, Weber A, Loftice J, McMichael C, Hassel N, Lyman S. Risk of Serious Injury for Young Baseball Pitchers: A 10-Year Prospective Study. Am. J. Sports Med. 2010;20(10): 1-5.
Most recently revised May 2, 2013
