Guest Post by:

Harris S. Slone, MD
Assistant Professor
Department of Orthopaedics - Sports Medicine
Medical University of South Carolina

Each year up to 6 million children and adolescents participate in organized youth baseball, and up to 14 million may play some form of recreational or unorganized baseball.1 During this time of year, many of our youngsters here in Charleston will dust off the cleats, pull the glove out of the closet, and hit the baseball diamond.  Youth baseball is a great sport, which helps teach our rising superstars teamwork, discipline, and helps keep them fit and active.  

In general, youth baseball is a very safe sport.   It is estimated that between 2-8% of youth baseball players sustain some sort of injury each year.1  Serious injuries are uncommon however, and generally are acute injuries from direct player-to-player contact, bat-to-player contact, and ball-to-player contact injuries.  Efforts to minimize serious injuries have been employed, including the use of specialized protective equipment, softer and lighter baseballs, rule modifications, elimination of “on-deck” areas, and dugout screening.

In contrast to acute and serious injuries, which are relatively uncommon, overuse injuries of the shoulder and elbow are very common in little leaguers.  Pitchers are most susceptible to overuse injuries of the shoulder an elbow, given the repetitive stress of repeated pitches.  Younger (skeletally immature) patients are at a higher risk of repetitive use injuries, compared to older players.

Experts in orthopaedic surgery have extensively researched youth baseball shoulder and elbow injuries to identify risk factors, and prevent future injuries, and guidelines have been published to minimize risks of injury. Studies have shown that pitch type, pitch count, number of innings pitched, and other positions played may influence a players injury risk. 

Current recommendations include avoiding pitching for two teams during the same season or overlapping seasons, or playing pitcher and catcher in the same game.  Players should avoid overhead throwing for at least 2 months per year, and avoid pitching for at least 4 months per year.  No player should pitch more than 100 innings per year.2 Pitching biomechanics must be established at a young age.  Once players demonstrate good pitching biomechanics, fastballs and change-ups can be introduced.  Curveballs and sliders have been shown to increase the risk of injury in young pitchers.  Most experts agree that curveballs should not be thrown before the age of 14, and sliders should not be thrown before 16. More information and guidelines for pitch counts, and recommended number of rest days between pitching can be found here.  If you or your little leaguer notice any pain in the throwing arm or shoulder, fatigue, or declining pitch velocity, seek professional medical attention from a sports medicine specialist to ensure a long an healthy baseball career.

References:

1.     Matta PA, Myers JB, Sawicki GS. Factors Influencing Ball-Player Impact Probability in Youth Baseball. Sports Health: A Multidisciplinary Approach. 2015;7(2):154–160.

2.     Fleisig GS, Andrews JR. Prevention of elbow injuries in youth baseball pitchers. Sports Health. 2012;4(5):419–424.

3.    http://www.asmi.org/research.php?page=research&section=positionStatement

4.    http://www.asmi.org/research.php?page=research&section=positionStatement

 

Dr. Harris S. Slone is an orthopaedic surgeon specializing in sports-related injuries, such as injuries to the ACL, ankle, knee, and shoulder. He also treats ankle instability, rotator cuff disorders, and shoulder instability. He completed a fellowship in Sports Medicine and Arthroscopy at Emory University following his residency in orthopaedic surgery at the Medical University of South Carolina. During his fellowship, Dr. Slone was a team physician for the Atlanta Falcons and the Georgia Tech Yellow Jackets. He is accepting new patients 10 years of age and older at MUSC Health locations in West Ashley, Mount Pleasant, and North Charleston.