Monday, April 1, 2013

Youth Baseball and Injuries - Keep them on the Field and Off the DL!

There is nothing that reminds us more of spring than 70 degree temperatures, the smell of peanuts and a good baseball game.  February and March is traditionally the month that most major league baseball pitchers and catchers start reporting for duty and a time that we are often carting our kids off to their first practice.  March 2010 is also the time that the American Orthopedic Society for Sports Medicine (AOSSM) has chosen to launch a national campaign entitled STOP (Sports Trauma and Overuse Prevention).  STOP is initiative designed to educate parents, coaches, athletes and all those working with athletes on how to prevent injuries in youth athletics (

Why would the AOSSM launch this national campaign?  Did you know:

·       High school athletes account for 2 million injuries, 500,000 MD visits and >30,000 hospital visits.

·       >3.5 million kids under 14 receive medical treatment for sports related injuries

·       Over use injuries are responsible for ~50% of all sports injuries in middle and high school students.

·       Youth baseball injuries have had a 2 fold increase in the last 5 years

·       There has been a >2 fold increase in middle and high school pitchers ulnar collateral ligament injuries resulting in Tommy John procedures (for ruptured ulnar collateral ligament in the elbow), a surgical procedure usually reserved for the collegiate or pro athlete.

Youth Baseball and Injuries

So why is there this increase in youth baseball injuries?  This is really multi-factorial but can be associated with:

·       Pitch Types - In 2002 a study by the ASMI (American Sports Medicine Institute) also showed that youth baseball pitchers who throw curveballs or sliders have an increased risk of elbow and shoulder pain. Take Home: Pitchers should not throw break pitches till the age of 13 and parents/coaches should monitor pitch counts.

·       Pitching Mechanics and Physical Conditioning – A study by ASMI published in 1999 showed that pitching mechanics greatly impacts the forces at the elbow.  Therefore bad mechanics and poor preconditioning predispose to elbow and shoulder injuries.  Take Home: Young pitchers should focus on perfecting mechanics and year round physical conditioning.

·       Multiple Appearances - Youth pitchers usually stays in the game at another position after pitching & eligible to return to the mound later in the game.  This increases potential for injuries.  Take Home: Returning to the mound in a game once removed should be strongly discouraged.

·       Showcases - are established to give young players the opportunity to display their skills to scouts. These typically occur at the end of a season & players are encouraged to give a 110% effort during.  This is a time at which players are more susceptible to injury.  Take Home: Pitchers should be discouraged from participating in and should be allowed appropriate time to prepare for.

·       Multiple Leagues - many young players today play in multiple leagues. This limits rest time and recuperation which can lead to increased potential for injury.  Take Home: Pitchers should be discouraged from pitching for more than one team.

·       Year-Round Baseball – it is becoming more and more common place for youth baseball players to play year round in various clubs and team sports.  With that, the body is not allowed to fully recover which increases the potential for injury. Take Home: Youth baseball players should not compete in more than nine months in any given year.

Keeping off the DL (Disabled List)

So how do you keep your player off the DL?  Following the above simple suggestions and the recommendations below will aid in keeping your player in the game and healthy.

·       Know your pitch counts.  The current recommendations by USA Baseball:

9-10 year old pitchers:
50 pitches per game
75 pitches per week
1000 pitches per season
2000 pitches per year

11-12 year old pitchers:
75 pitches per game
100 pitches per week
1000 pitches per season
3000 pitches per year

13-14 year old pitchers:
75 pitches per game
125 pitches per week
1000 pitches per season
3000 pitches per year

·       Preseason conditioning – should include a well rounded program.  A baseball specific program should include cardiovascular exercise, sprint training, leg and hip strengthening, core strength and endurance, shoulder and scapular work.  Focus on proper hydration and nutritional component should not be ignored.

·       Throwers 10 – training in the throwers 10 will aid in providing proper strengthening to the shoulder girdle and rotator cuff musculature.  For a copy of this go to

·       Sleeper stretch – along with the scapular weakness that can result from throwing, there is also a posterior capsular tightness and loss of internal rotation in the shoulder.  As a result there is an increased potential for rotator cuff and labral tears.  Performing the sleeper stretch will aid in restoration of normal range of motion and aid in reducing risk for injury.  For a copy of this go to:

Hopefully by following the suggestions above, you to can enjoy a great baseball season without injury.  For more information related to this article or for a free injury assessment, contact Champion Sports Medicine.

Andrews JR, Chmielewski T, Escamilla RF, Fleisig GS, Wilk KE. Conditioning program for professional baseball pitchers. ASMI, Birmingham, AL, 1997.

Andrews JR, Fleisig GS. How many pitches should I allow my child to throw? USA Baseball News April, 1996

Fleisig GS, Barrentine SW, Zheng N, Escamilla RF, Andrews JR. Kinematic and kinetic comparison of baseball pitching among various levels of development. Journal of Biomechanics 32(12):1371-1375, 1999.

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 Sport Med. 30(4):463-468, 2002.

Powell, JW, KD Barber-Foss.  1999.  Injury patterns in selected high school sports: a review of the 1995-1997 seasons. J Athl Train 34:277-84.

Safe Kids USA Campaign Web site, 2009.

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