7 Ways to Prevent Throwing Injuries in Youth Baseball Players

The most common arm injuries found in youth baseball players include, arm pain, Muscle tears(strains), ligament tears(sprains/avulsions), hip pain, tendinosis, and nerve injuries.

Baseball is considered a minimal contact sport, some contact can occur sliding into a base, running into another player or wall, and getting hit by the equipment such as the baseball bat or baseball itself.  

While serious injuries are rare, they include little league elbow, medial ulnar collateral ligament (MUCL) injury, rotator cuff tears, commotio cordis and more. These serious injuries are the result of high rotational forces exerted on the athlete’s bodies and due to the dangers of the ball and equipment flying at high speeds. These serious injuries can result in many weeks and months of lost playing time. On average, an MUCL injury can result in 17.1 months of lost playing time. (Melugin, 2018)

One of the main predictors of baseball injuries can be pain. The aforementioned authors reported that most “youth baseball players (8-18) report some degree of arm pain while throwing.” (74%). This is a staggering number and one that should make coaches, parents and clinicians take a pause when their baseball athletes report arm pain when throwing, especially before full skeletal maturity which usually starts is completed during high school or college. It was reported in 2012 that 5 percent of the youth pitchers in the study experienced a serious elbow or shoulder injury. (Melugin, 2018)

There is no clear answer as to why these numbers are so high, but scientists and authors theorize that the amount of youth involvement has increased over the past 5-10 years and the increased push for athletes to play one sport and specialize early have been contributing factors. (Melugin, 2018) Another factor to consider is that training techniques and strength regimens are being introduced into the youth athlete’s life earlier and earlier. This has brought increased throwing velocity and in turn increased arm torque on young athletes’ developing anatomy.

The question everyone should be asking is this: “Should the athlete stop throwing if there is arm pain?” and the answer is “it depends.” To find out if that arm pain is causing serious harm, a licensed movement specialist should be seen, such as a sports chiropractor or sports physical therapist.

What does Seeing a Sports Chiropractor or Physical Therapist look Like?

• A sports chiropractor or a sports physical therapist, are both a good starting point, because they are movement specialists. The reason you should start with a chiropractor or physical therapist, is because they focus on self-healing first, through movement. Movement and time, in combination, can be a great healing tool and will serve as an experimental measure to see if you need surgery or medication or anything more specific. You could see an orthopedist or a physical medicine doctor, but these options are usually reserved for more serious injuries.

• A good sports chiropractor or physical therapist will start by asking for you to fill out a history intake form. Once that is done, they will perform an initial examination that looks at function, severity of injury and takes into consideration your goals. Next, they will talk to you about treatment and provide a realistic treatment plan to address the injuries that brought you in.

• Most injuries in the sports realm will resolve themselves in 1-6 weeks depending on the severity, type, history of previous injuries and many other factors. This should be the typical length to a treatment plan as well with treatment visits 1-2 times per week depending on the above factors.

• At Vector Sport and Spine: Chiro and Rehab we work extensively with athletes and would love to help you get back on the field playing, competing in a weekend tournament or high school game. If you are interested in scheduling an appointment, visit vectorsportsportandspine.com and click “schedule an appointment” at the top of the page.

The next question that usually comes up at this point is, “how can I prevent this from happening? Well, the literature shows us a few things that have been correlated in youth baseball throwing injuries. The following list is by no means the end all be all in regard to prevention and things each individual player needs to work on, but is a good starting point.

1. No competitive pitching 2-4 months of the year. Makes sure your youth is taking at least 2 months off pitching. Your arm needs time to rest and develop. This does not mean you need to stop all throwing, just make sure they aren’t throwing at competitive speed or >60% of that.

2. Follow pitch limit counts and complete all days of rest. 100+ innings, >2500 pitches per year and 80+ per game should be avoided in pre-high school aged kids. (Wilk et al. 2021)

3. Avoid pitching for multiple teams at the same time. This does not mean you can’t have multiple teams through the baseball season, just make sure they are not at the same time or blend into each other.

4. Don’t play catcher and pitcher in the same game or weekend. This increases the risk of injury due to the number of throws added per game. It is best to play that athlete in the field or rest him.

5. Play different sports and don’t specialize until High School or later. Specialization early can lead to broken or inept motor patterns and poor functional movement. It is best for youth to learn as many different movement patterns as possible before specializing. According to Tim Gabbett PhD, has been shown to lower the risk of injury.

6. Don’t pitch through pain or fatigue. This one is so important,in Wilk et al. 2021 they stated that there can be a 3600% increase in injury risk while pitching with a fatigued arm. If a youth’s arm is feeling fatigue or has pain when pitching/throwing consult a medical provider.

7. Training hours should be less than the age of the athlete per week. This is a simple way of measuring the amount of activity that is appropriate for youth (8-18). For example, if you have a 12-year-old he should do 11 hours of training or less per week. It is a simple tool to determine the safety for an athlete and prevent injury.

At this time, it is important to mention that you can never truly prevent injuries, there are just too many factors involved to be able to predict everything, rather this list presents injury resistance and ways to bolster you chance to avoid injury.

References:

Melugin HP, Leafblad ND, Camp CL, Conte S. Injury Prevention in Baseball: from Youth to the Pros. Curr Rev Musculoskelet Med. 2018 Mar;11(1):26-34. doi: 10.1007/s12178-018-9456-5. PMID: 29353376; PMCID: PMC5825337.

Wilk, K. E., Lupowitz, L. G., & Arrigo, C. A. (2021). The Youth Throwers Ten Exercise Program: A variation of an exercise series for enhanced dynamic shoulder control in the youth overhead throwing athlete. International journal of sports physical therapy, 16(6), 1387–1395. https://doi.org/10.26603/001c.29923

Disclaimer: this post is used for educational purposes only and does not constitute medical or training advice. If you would like medical advice, please schedule an appointment with us or your local licensed movement specialist.  

Dr. Dan is a Sports Chiropractor located in Burnsville, MN. He graduated from Northwestern Health Sciences University with his Doctor of Chiropractic and University of Concordia St Paul with his Masters in Exercise Science. He specializes in rotational and throwing Sports and serves the Southern Twin Cities suburbs. He currently is coaching for MN MASH Baseball and enjoys spending time drinking tea with his wife Erica and playing with his Great Dane George.