Your young son might have a pretty hot fastball. But if he throws too many pitches at the youth level, his promising career could be down and away.
A major study of this issue was published in the July/August 2011 Sports Medicine Update. Researchers followed 481 youth baseball pitchers for a season and found significant associations between the number of pitches thrown and shoulder and elbow pain. They also found that throwing fastballs and breaking pitches was even more associated with increased shoulder and elbow pain, respectively.
This has become more important because aspiring young players can play baseball almost all year now, at indoor baseball centers, baseball camps in the south, fall baseball leagues and, of course, spring training and the summer baseball season. Most people would probably be surprised how many parents seek treatment for their sons, even in the winter months.
"Most injuries occur in the shoulders or elbows. Most aren't serious, and a large number of them can be prevented by monitoring pitch counts and resting if the athlete feels arm pain or fatigue," said Wayne Christie, M.D., orthopedic surgeon at Marshfield Clinic Wisconsin Rapids Orthopedics Center.
The study showed that the overall risk of a youth pitcher sustaining a serious throwing injury within 10 years was only 5 percent. However, those 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 are at somewhat higher risk for injury
"In most cases, athletes can't simply 'play through it.' The harm will worsen by continuing to pitch," he said. "The biggest thing is just resting your child and not having him throw a ball. Monitoring pitch counts is vital in helping to avoid future problems.
"Younger athletes may not even feel pain, or might not want to admit it. But as they get older and want to play in high school, college or beyond, they may have "microfracturing" taking place that eventually causes so much pain that they can't use their arms. This is a horrible and unnecessary price to pay for playing a game.
Surgery is seldom needed for young pitchers, who haven't yet developed the strength to cause structural damage. Older youths or young adults using overhand throwing motions may need the so-called "Tommy John surgery" to correct a torn ulnar collateral ligament in the elbow.
It's far better to ease back and monitor pitch counts in the early years of pitching, so such a major injury never occurs.