Preventing Throwing Arm Injuries
As reported on The Baseball Resource Website

The goal of is to prevent injuries for the 10 million American youth currently playing baseball. Epidemic of serious arm injuries, developing at young age (difficult to diagnose). Arm injuries, traditionally occurring in college & professional baseball, are now commonplace in high school. 50-60% of youth baseball injuries are due to overuse. Children are growing and growth cartilage still present at growth plates, which are vulnerable to overuse. Injuries result from increased pitch counts & increased use of breaking pitches by youth pitchers.

Repetitive nature of throwing motion predisposes all players to similar injury-patterns. Young players are more susceptible to arm injuries due to weak growth plates, loose ligaments, & lack of stability. Baseball players, parents, and coaches should focus efforts on injury-prevention

Professional Baseball Medical-Opinions

“There is growing epidemic of injuries to the throwing arm and the number one risk factor is year round baseball. Pitch count guidelines will serve as the cornerstone of injury-prevention in youth baseball. The goal is to educate parents and coaches”. Dr.
James R. Andrews, M.D

“The passion for success has resulted in an excessive number of pitches thrown by young players. This is associated with additional risks of poor mechanics and inadequate conditioning. The current environment of excess needs moderation to prevent continued injury increases.” Dr. Frank Jobe, Los Angeles Dodgers

“The emphasis must be on prevention rather than treatment for overuse injuries in youth baseball. Coaches & parents must be willing to sacrifice short-term success for long-term health. Youth baseball organizations must take leading roles in the education,
by enforcing regulations that ensure the long-term health of these athletes.” Dr. Joseph
B. Chandler, M.D., Atlanta Braves

Professional Baseball Pitcher-Opinions
  • High pitch counts (more than 75 per-game) & arm injuries were uncommon during youth careers.
  • Year-round baseball was uncommon & all played multiple sports.
  • Average age started throwing curveball was 14 years old.
  • Average age started throwing slider was 18 years old.
  • Would not allow son to throw curveball until 15 years old & slider until 17.

Elbow & Forearm Injuries
  • Elbow is most frequent site of youth arm-injury. 60% of youth pitchers experience elbow pain during season.
  • Elbow pain typically results from overuse, not ligament failure.
  • Throwing mechanics of adult & youth baseball players are similar. However, youth throwers have inadequate forearm strength & stability at elbow joint, which increases force on connective tissue.

Rotator-Cuff Injuries

Throwing a baseball creates significant force across shoulder joint, which is complex & susceptible to injury. Dr. James Andrews calls a rotator-cuff injury the “granddaddy of all baseball injuries”. At time of pitch release, shoulder rotation velocity reaches 7500 deg. per-second (same as tire rotation on car going 90 mph). If velocity maintained f or 1 second, shoulder would make 20 full rotations. Shoulder injuries caused by overuse, poor throwing mechanics, & inadequate strength in rotator cuff muscles. Baseball players of all ages must maintain shoulder function to avoid injuries that cause pain & limit performance

Arm-Injury Risk Factors
  • Increased baseball specialization at early age.
  • Repetitive stress of throwing combined with insufficient rest & recovery.
  • Specific throwing muscles are weak.
  • De-conditioned athlete with weak & tight muscles.
  • Overweight & short athlete increases risk for elbow pain.
  • Improper exercise & training programs.
  • Throwing breaking balls at early age
  • Throwing too many pitches per-game
  • Throwing too many innings per-week.
  • Participating in multiple youth leagues simultaneously.
  • Participation in year round baseball.
  • Poor pitching mechanics.
  • High velocity ability leads to overuse by youth coaches.

Breaking Pitches & Arm Injuries
  • Emphasis on wining youth games encourages pitchers to throw breaking pitches before ages 14-16, which increases risk of arm injury.
  • Avoid throwing breaking pitches until ages 14-16 or until athlete begins shaving. Young pitchers that haven't reached puberty should only throw fastballs & change-ups, NOT breaking pitches.
  • Fastball generates more arm speed than breaking pitches, but breaking pitches create more stress, due to hand, wrist, & forearm position.
  • Curveball produces greater force than fastball.
  • Slider produces greater force than curveball.
  • Change-up creates least force of pitch variations, resulting in fewer injuries.
  • Young pitchers throw breaking pitches incorrectly, increasing force at elbow.
  • Pitchers throwing sliders are 75% more likely to experience elbow pain.
  • Pitchers throwing curveballs are 50% more likely to experience shoulder pain
  • Pitchers throwing change-ups are 10% less likely to experience elbow pain & 30% less for shoulder pain
  • As pitch counts increase from 75-99, shoulder pain increases 50% & elbow pain by 35%.

Common Mistakes Throwing Breaking Pitches:
  • Small hand & finger size forces hand under baseball.
  • Overthrowing or overexerting maximal effort.
  • Inability to repeat delivery.
  • Improper arm slot across body during deceleration.
  • Arm & trunk out of sequence.
  • Overuse of breaking pitches.

Arm Injury-Prevention Goals
  • Minimize overuse injuries to throwing arm & injury potential by strengthening injury prone muscle groups.
  • Decrease muscle imbalances.
  • Optimize balance, joint function, mobility & stability.
  • Improve baseball performance.