By Dev Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
- Excessive throws for a young arm can lead to significant injuries to the shoulder and elbow
- The American Sports Medicine Institute recommendations call for a maximum 100 innings thrown per year, age appropriate pitch counts, and at least 3 months complete rest from throwing each year
- The throws can really add up if you are on multiple teams, taking private lessons, throwing at home outside practice, and taking throws from infield positions
It’s that time of year for pitchers: all-star teams and travel teams are in high gear. That means it’s also the time of year when it can become easy to overwork a young pitcher with too many innings or too many pitches. It’s worth having a look at the American Sports Medicine Institute recommendations for youth pitchers. This important set of guidelines was developed through the pioneering work of Dr. James Andrews and his colleagues.
ASMI believes that the proliferation of year round baseball is strongly contributing to the large increase in injuries to the shoulder and elbow seen in young baseball players. For the elbow in particular the accumulated wear and tear likely occurs over many years, often long before the actual problem surfaces.
We often find that the players who are racking up the innings are generally the more advanced players on the team. This means that they will often play an additional defensive position when not pitching. This can add up to a lot of throws for a young shoulder.
It can be easy to lose track of a player, where they might for instance take 50 infield ground balls in practice on the same day they throw a bullpen session. All of these throws will add up in the total wear and tear on that arm. Even though it’s not all throwing from a mound they are throws nevertheless.
Some common additional factors to consider:
- Some players will participate on multiple teams. It’s likely that none of these coaches are communicating pitch counts to the other coaches, leading to the possibility of a very large number of pitches thrown
- The player may be throwing at home outside practice
- There may be private pitching sessions taking place
Most, but not all leagues have rules to prevent players from playing or practicing with another team during that league’s season. These rules are designed to protect the players from over use and are good rules to have.
Unfortunately, it isn’t unusual to have an athlete paying for private lessons and throwing bullpens during the season. As far as I know there are no rules to prevent this from happening.
When a young pitcher comes to my office with shoulder or elbow problems, we’ll work to fix the problem and also use that opportunity to have an honest discussion with the player and parents about the underlying factors that lead to the injury. My hope is that this talk will have a positive effect in reducing that player’s chance for another injury.
It’s unfortunate that the talk I have with the player is often the first time they’ve heard any type of discussion about pitch counts or annual innings. It’s also unfortunate that the talk I have with them is only happening because they’ve already been injured. If you’re the parent of a young pitcher it might fall on you to keep track of your child’s pitching activities. I certainly wouldn’t expect you to be present at every session to log pitch counts but having a general awareness of the throwing activities your child is participating in might allow you to intervene before it’s too late.