Throwing Guidelines: Time to “Play Ball” :: Nationwide Children's Hospital

Sports Medicine

Throwing Guidelines: Time to “Play Ball”

Coaches and parents of young baseball players, or any athlete in a throwing sport, often have questions about throwing injuries and how to prevent them. These are legitimate concerns due to the increasing rate of shoulder injuries seen in this population. Dr. Richard Rodenberg MD, Sports Medicine Physician at Nationwide Children's Hospital states “There is currently an alarming trend in youth baseball injuries. Shoulder and elbow growth plate injuries have become common as young athletes are playing in leagues with high game volumes in a given season. These players often don’t have enough recovery time prior to the next outing and subsequently may play through pain”. Pain is often perceived as part of the game. “Adolescent growth plates are vulnerable to stress up through the later teen years” Dr. Rodenberg continues. “Injuries to these areas are often season ending due to the amount of healing that needs to take place.” We will outline some of the major topics associated with throwing injuries in 9 individual sections or “innings.” Each inning provides insight into unique challenges faced by young throwers, so let’s play ball!

1st Inning: Preparation for the season.

To reduce the risk of injury – conditioning drills should be initiated prior to the start of the first practice session. Kids that are in shape at the beginning of the season have a better chance of performing at a higher level and staying injury free. Concentrate on flexibility, upper body and core strengthening and always include running drills. This combination will help ensure that the body is ready to accept the demands of the season.

2nd Inning: Time to stretch!

Just like any other sport it is very important to warm up and stretch before a player throws. Dynamic warm-ups help prepare the body for this. Light conditioning at the beginning of practice warms muscles making it easier to stretch them. Stretching should include the upper and lower body as well as the hips and back. Inflexibility can actually decrease force production and speed and can limit the power of the throw.

3rd Inning: Mechanics, mechanics, mechanics.

Kids should learn proper throwing mechanics and master them completely before ever starting to pitch. Always avoid using a radar gun. Young pitchers are often more concerned with how hard or fast they can throw, instead of how efficiently they throw. Throwing hard combined with poor or inefficient form almost always predisposes injury. Proper mechanics → decreases stress on arm → less arm fatigue → increased overall control and speed.

4th Inning: Put me in coach, I’m ready to play!

Young players often think (incorrectly) that arm soreness is part of the game- as if it is a badge of honor. Soreness can alter mechanics as players try to avoid painful arm positions. Shoulder and elbow pain should always be concerning to coaches and parents. Early intervention and activity modification can expedite return to play and reduce the risk of a more serious injury that may be season ending.

5th Inning: So what is a Pitch Count?

It is the actual number of pitches thrown during a game. Limits are used in order to reduce the amount of stress placed on a pitcher’s arm. Various pitch count guidelines have been developed by different baseball organizations and we feel the version available here at Nationwide Children’s Sports Medicine is most appropriate for young pitchers. It takes into account the age of the thrower and includes limits on the number of pitches that should be made during each game as well as the maximum number of pitches that should be thrown in a week, during the entire season and even throughout the year. Adhering to pitch count guidelines is critical for the longevity of a pitcher’s arm..

6th Inning: What pitches are appropriate for young throwers?

A fastball should be the first pitch to be learned and after this has been mastered a change-up can be added. Physicians at Nationwide Children’s Sports Medicine prefer to see young pitchers begin to throw curveballs and other breaking pitches once they are close to skeletal maturity and have adequate arm strength and control. Breaking pitches should be taught by someone with knowledge of proper pitching mechanics, otherwise there may be undue stress placed upon a young pitcher’s arm predisposing him to elbow and shoulder injury.

7th Inning: Player substitutions, making the right change.

It is common for a coach to “take out” a pitcher once he has reached his allotted pitch count or if the game situation calls for a change. If the pitcher continues to play in that game, he should not be placed at shortstop or 3rd base where long hard throws are required on an already fatigued arm. Pitchers should never be catchers on the same team. This combination results in too many throws and increases their risk of injury. The safest place is moving to 2nd or 1st base where the throws are shorter and less stress is placed on the arm..

8th Inning: nowing when to rest.

It is also important to know how long to rest young pitchers after they throw in order to allow time for their arms to recover between outings. This rest period is again based on age and is included in our pitch count guidelines. Pitchers should also ice their shoulders and elbows for 20 minutes after they throw to reduce the inflammation associated with activity and speed recovery.

9th Inning: My child plays in multiple leagues.

Sometimes players may join more than one team at a time to get as much experience as possible. Situations like this warrant close attention to proper rest to avoid “breakdown” from overuse and decreased recovery time. Overall body/arm fatigue CAN alter mechanics and lead to injury!! If you must play on more than 1 team at once, consider pitching on one team and playing a fielding position on the other (not catcher!) Also, there should be no competitive pitching for at least 3 consecutive months every year to ensure optimal recovery and allow for normal growth processes.

MAXIMUM PITCHING LIMITS

AGE

PER DAY

PER WEEK

PER SEASON

PER YEAR

10 & Under

50

75

1000

2000

11-12

75

100

1000

3000

13-14

75

125

1000

3000

15-16

95

*

*

*

17-18

105

*

*

*

*There is no evidence to support pitching limits for these specific categories and age groups.Remember to stop throwing if fatigue, pain, or injury.

DAYS OF REST REQUIRED FOR PITCHES THROWN IN A DAY

AGE

0 DAY REST

1 DAY REST

2 DAYS REST

3 DAYS REST

4 DAYS REST

14 & Under

1-20

21-35

36-50

51-65

66+

15-18

1-30

31-45

46-60

61-75

76+

Information and Guidelines adapted from the following:

  1. Medical Safety Advisory Committee Special Report, USA Baseball®, 2006
  2. Little League® Baseball & Softball, 2010
  3. Position Statement for Youth Baseball Pitchers, American Sports Medicine Institute, 2009

Consult your primary care physician for more serious injuries that do not respond to basic first aid. As an added resource, the staff at Nationwide Children’s Hospital Sports Medicine is available to diagnose and treat sports-related injuries for youth or adolescent athletes. Services are now available in five locations. To make an appointment, call (614) 355-6000 or request an appointment online.

Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000