Take Home Points

  1. Coaches should seek a physical therapist when their young throwing athletes report arm pain. 
  2. A proper personal training program for a pitcher can resolve limitations and risk factors for injuries before they occur.

The main objective of these guidelines is to reduce shoulder and elbow pain and injuries in young pitchers. A noticeable number (35%) of coaches reported that pitchers experienced shoulder or elbow pain during the season. As a matter of fact, 19% reported that players pitched with arm pain. These numbers are likely totally accurate, given that players themselves were not asked about pain. On the bright side, no injuries requiring surgery were reported. When I played youth baseball, there were no recommendations regarding pitch counts and time spent catching and pitching.  There are parents and coaches out there that do not enforce these guidelines and this can be a reason why kids are getting arm injuries at a young age.

The most important finding the study is that with the significant efforts to educate coaches on youth baseball pitching injuries, knowledge of current recommendations for youth pitchers is poorly handled. When looking at the different age groups with which the coaches worked, only 35% to 62% of the pitching guideline questions were answered correctly (Fleisig 2011). These results are a problem as it is very difficult for coaches to accurately follow guidelines with which they are not familiar.
When looking at other research on this topic, no other anonymous surveys exist. There have been strong relationships that several authors have observed between elevated pitch counts, pitching while fatigued, catching in addition to pitching, and pitching in showcases (Fleisig 2011). The leagues that these young kids play should take more of an active role in enforcing of these rules. In the study, 73% of coaches said that they follow the guidelines; 53% felt that the opposition does the same. Improved enforcement may also decrease the temptation of coaches to break the rules by improving their perception of the compliance of other coaches (Fazarale 2012).

Coaches and parents should listen and react responsible to a youth pitcher when they complain about arm pain. A pitcher who is complaining or shows signs of arm pain during a game should be pulled from pitching immediately. Kids who are who are experiencing pain for days should seek medical attention or if there is pain the next time the player pitches. Pitch counts are only limited to pitches thrown in games only. These do not include throws from other positions, pitching lessons and throwing drills, which are important for the development of technique and strength. Pitchers should not be taught or be able to throw breaking pitches in games or practices until their bones have matured. Coaches should focus on good mechanics, a fast fastball, a good change-up, and good control when instructing a young pitcher how to pitch. Young pitchers need to develop proper mechanics as early as possible and include more year-round physical conditioning as their body develops. Baseball can be one of the safest sports for young kids to play. Unfortunately, many of the serious injuries suffered by older pitchers may have started to develop at the youth level.

Individualization is key, as no two athletes, especially pitchers are the same. When working with athletes, performing frequent screen (both verbal and physical) help determine risk factors before they become injuries. Unfortunately, even the most robust injury prevention with personal training can still result in injuries. This makes working with a physical therapist skilled in sports biomechanics key for not only improvement, but prevention of re-injury in the future.

References:
  1. Fleisig GS, Andrews JR, Cutter GR, et al. Risk of serious injury for young baseball pitchers: a 10-year prospective study. Am J Sports Med. 2011;39(2):253-257.
  2. Fazarale JJ, Magnussen RA, Pedroza AD, Kaeding CC, Best TM, Classie J.Knowledge of and compliance with pitch count recommendations: a survey of youth baseball coaches. Sports Health. 2012 May;4(3):202-4
  3. Andrews JR, Fleisig GS. How many pitches should I allow my child to throw? USA Baseball News April, 1996

Written by Coach Chris