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Getting an Arm around Guidelines for Youth Baseball Pitchers

Parents and coaches involved in youth baseball in the United States have asked for help. Arm problems in pitchers are all too common. The athlete's elbow and shoulder are structurally the same as the nonathlete's. The difference is the stress of training and the demands of regular and intense competition. Using the same arm over and over can cause damage to the ligaments, tendons, nerves, and muscles.

Repeated requests for information about elbow and shoulder injuries in young pitchers have been received. How many pitches per game are safe? What causes elbow or shoulder pain or injury in pitchers? Does it matter what kind of pitches are thrown?

Answers to many of these are still unknown. Information is limited, as only a few studies have been done. Risk factors for pitching injuries are unknown. For these reasons, researchers spent two baseball seasons interviewing 298 pitchers after each game. Here's what they found.

Nearly half of the pitchers reported pain after a game. Elbow pain occurred one-fourth of the time, and shoulder pain was present one-third of the time. The causes of elbow and shoulder pain were different, so preventive steps are often different. This is what coaches can do to help prevent problems for their pitchers:

• Certain types of pitches such as the curveball and slider are stressful and should be saved for older ages. These pitches can be used when the arm is more developed.


• Throwing the change-up pitch is safe and has less risk of injury.


• Young pitchers should not throw more than 75 pitches in a game.


• Pitchers should throw at least 300 pitches but not more than 600 pitches during the season.


• Remove pitchers from a game if they show arm fatigue.


• Limit pitching in nonleague games. Limit recreational baseball outside of league activities.


• Any changes made to prevent pain in the elbow should not increase pain in the shoulder. Likewise, any measures to decrease pain in the shoulder should not increase pain in the elbow.

Parents and coaches can work together to help young pitchers prevent arm injuries. A pitch-count book is vital for recording how often pitchers practice, the number and type of pitches they make, and any complaints they have of elbow or shoulder pain during or after pitching. By tracking this information and by following the guidelines listed, risks of arm injury can be reduced.

References: Stephen Lyman, Ph.D., et al. Longitudinal Study of Elbow and Shoulder Pain in Youth Baseball Pitchers. In Medicine & Science in Sports & Exercise. November 2001. Vol. 33. No. 11. Pp. 1803-1810.

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