Youth baseball safety guidelines: prevent arm injury

We are all seeing more and more injuries among adolescent baseball players. There is widespread agreement among orthopaedic surgeons that this is caused by kids playing too much baseball without enough rest. Here is a summary of guidelines that have been put forth by baseball medicine experts. Parents and coaches of youth players should familiarize themselves with these issues to help keep our baseball players healthy.

1.     Don’t play baseball year-round. Young players, especially pitchers, should have a period of rest of at least two months each year. During this time they should not be throwing, and instead should focus on other sports and building strength.  For more information onthis topic.

2.     Don’t play through pain. Players should be not throwing if they are having pain. If it hurts to throw, stop playing and rest for a few days and then resume throwing. If it still hurts to throw after a few days of rest seek medical evaluation.  Throwing in spite of pain places athletes at high risk for severe injury.

3.    Know the Pitch Count Guidelines. It is recommended that youth pitchers adhere to a “pitch count”, meaning they should not throw more than a certain number of pitches during a game. There are several good resources from USA baseball,  American Sports Medicine Institute,   Major League Baseball. Coaches and parents should know the pitch count for their athletes and the “days off” recommended between pitching appearances.

4.     Beware of playing on multiple teams during a single season. Many adolescents are playing on multiple teams during a single season. This may include a local recreational league, a travel team, and showcase tournaments. It can become dangerous if a child is pitching on more than one team, because there is often no communication between coaches about how may pitches the child has thrown, and how many days rest he has had. Parents need to be especially cautious in this situation, and help communicate between coaches.

5.     Catchers are at risk also.  After pitchers, catchers have the highest number of youth baseball arm injuries. This actually makes sense, think of how many throws a catcher makes each game. An athlete should probably not play both positions during the same season. If a pitcher is catching during his “days off” from pitching he is not allowing the arm to rest!

6.     Don’t go home and practice after the game. Parents may want to practice with their child after they pitched a game. This should be avoided. Wait until another day and let the arm rest.

7.     Teach proper pitching techniques. Research studies have shown that proper throwing mechanics decrease the risk of arm injury and also improve pitching performance. Here is an article I’ve written on proper throwing mechanics.  

8.     No curveballs until you can shave. This is a statement that Dr. Jim Andrews has put forward. He suggests that we should not teach or allow youth players to throw breaking pitches until after puberty when their bones have matured. Research has shown that a properly thrown curve ball does not place increased stress on the elbow, however many kids do not know how to throw these pitches correctly and can injure themselves with incorrect technique. Furthermore, if our goal is to develop pitchers then coaches should focus on pitch command, emphasizing the fastball and change up. There is no need to have adolescents throwing breaking pitches.

I hope these help ,

Brad Carofino MD.