A Children's Health expert discusses pitch count guidelines and the epidemic of arm injuries in young athletes.
Over 2.4 million children around the world will participate in youth baseball leagues each year, and at some point, many of those participants will pitch. Most leagues have a “pitch count” rule, so that each player is individually monitored. Jeff Baggett, certified athletic trainer and outreach program manager at Children’s Health℠ Andrews Institute for Orthopaedics and Sports Medicine, says that these rules are in place not necessarily to create fair play – but to protect the safety of our young athletes.
“Limiting the number pitches for youth pitchers has been recommended as far back as 1964,” Baggett explains. “However, pitch count limits and rest recommendations were reemphasized in 1996 after a survey showed injuries to baseball pitchers' arms could be caused by the number of pitches thrown.”
Since that time, research has helped revise guidelines to prevent these injuries, and efforts to educate coaches and players have grown. But despite these efforts, injury rates continue to grow. Current research indicates surgical trends are increasing in the youth population by as high as 300%, and the American Journal of Sports Medicine recently published a survey that found that 15-19 year-old athletes made up nearly 60% of all Tommy John surgeries in the U.S.
“Baseball injury rates are increasing at an alarming rate despite current attempts to limit pitcher workloads,” Baggett says. “We must take additional steps to ensure the safety of our young athletes by giving coaches and parents the tools to identify risk factors for injury.”
Risk factors for arm injury
Current pitch counts limit the overall workload of a pitcher, reducing the chance of pitching under fatigue. Of all the injury risk factors involved with pitching, fatigue has the highest correlation with injury: A study found that a pitcher who regularly pitches despite arm fatigue is at 36 times increased risk of injury.
However, pitch counts do not regulate all factors. Baggett says risk factors to be aware of include:
- Pitching while fatigued
- Amount of pitching
- increased pitches per game
- innings pitched per season
- months pitched per year
- Pitching for concurrent teams
- Pitchers who also play catcher
- Poor pitching biomechanics
“Although throwing breaking pitches at a young age has been long suggested as a risk factor, existing data does not support this claim,” Baggett adds. “It is still widely recommended that pitchers wait until their bodies are structurally mature before throwing competitive breaking balls.”
How to detect fatigue in a pitcher
To prevent injury, Baggett encourages parents and coaches to watch for signs of pitcher fatigue in games. Signs can include:
- Loss of velocity (most indicative of fatigue)
- Land with an increasingly bent front knee
- Decrease in hip-to-shoulder separation
- Taking extra time in-between pitches
Interestingly, loss of command and release point are not often found to be indicative of fatigue.
In addition, parents and coaches should be mindful of high-stress situations, as they tax the athlete at a disproportionate rate. “Pay special focus to games with long innings, late game or close game situations, and any situation where there is a discernible increase in the level of competition,” Baggett says. “Scouting situations can also be dangerous as they often require maximum effort outside of traditional game play.”
While pitch counts can help keep young athletes safe, there are other factors in play. Baggett urges families and coaches not to rely solely on the number present on a pitch chart, but on the current condition of the athlete in competition. “If an athlete is fatigued, regardless of the pitch count, please consider the removal of that athlete,” he says. “Let’s keep our athletes on the field of play and out of the operating room.”
For more information on injury prevention strategies and improved performance training, contact Children’s Health Andrews Institute for Orthopaedics and Sports Medicine at 469-303-3000.
Stay current on the health insights that make a difference to your children. Sign up for the Children’s Health newsletter and have more tips sent directly to your inbox.