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Pitching a Shutout: Pay Attention to Your Pitch Counts

​​​​​​​​​​Attention, Little League pitchers (and coaches and parents): Before you hit the mound thi​​s year, here are a few tips about pitch counts and types of pitches to help you “shut out” injuries.

boy throwing ball

A research study published in the July/August 2011 Sports Medicine Update followed 481 youth baseball pitchers during one sports season. The study showed significant associations between the number of pitches thrown and shoulder and elbow pain, and also found associations between the curveball and slider with increased shoulder and elbow pain, respectively.

“I think this has become more important because many young players can play baseball all year,” said Albert Cecchini, D.O., Marshfield Clinic orthopedic surgeon and sports medicine specialist, who sees patients at Wausau and Merrill Centers. “Now they can play at indoor baseball centers, baseball camps in the south, fall baseball leagues and, of course, spring training and the summer baseball season. You’d be surprised how many kids we see, even in the winter months.”

The study showed that the overall risk of a youth pitcher sustaining a serious throwing injury within 10 years was 5 percent. Athletes who:

Pitched more than 100 innings in a year were 3.5 times more likely to be injured, threw more than 80 pitches per game, had almost four times the increased risk of injury, pitched more than eight months per year, were five times more likely to be injured, threw primarily high velocity fastballs or breaking pitches, or who also played catcher in the same game they had already pitched, also were at somewhat higher risk for injury.

Most injuries occur in the shoulders or elbows. Most are not serious, and a large number of them can be prevented by monitoring pitch counts and resting if the athlete feels arm pain or fatigue. In most cases, athletes cannot simply “play through it.” The harm will worsen by continuing to pitch.

“The biggest thing is just resting the kid and not having him throw a ball,” Dr. Cecchini said. He encouraged coaches to familiarize themselves with the most recent guidelines published by Little League Baseball.

Steven Taylor, M.D., a Marshfield Clinic orthopedic surgeon who specializes in arms and hands, said monitoring pitch counts is vital in helping to avoid future problems.

“Younger athletes may not even feel pain, but as they get older, with all the ‘microfracturing’ that’s been going on, if they want to play in high school or college, they’re hurting so much that they can’t use their arms,” said Dr. Taylor, who sees patients at Marshfield and Wausau Centers. “They just throw their arms out. Over time it can really wear them down.”

Surgery is seldom needed for young pitchers, who have not yet developed the strength to cause structural damage. In older youths or young adults using overhand throwing motions, the “Tommy John surgery” to correct a torn medial collateral ligament in the elbow is sometimes needed.

Aside from baseball, Dr. Taylor said a frequent injury for young skateboarders and snowboarders is a fracture to the scaphoid bone on the thumb side of the wrist. This is usually caused by a fall on an outstretched hand, with the weight landing on the palm. It’s less common in adults, who will usually damage something else instead with such a fall.

“Skateboarders and snowboarders can avoid these injuries by wearing splints on their wrists,” he said. “They keep the wrist from hyperextending. A recent report showed a very high benefit to wearing them. They fit right on the wrist, and they do work.”