Strike Out Throwing Injuries
Keep Tabs on Pitches
Even the big guns in Major League Baseball are often limited to 100 pitches per game in order to preserve their health. Young players need to be even more cautious. The following guidelines from the USA Baseball Medical and Safety Advisory Committee can help young players avoid throwing injuries.

9 to 10 years old
Limit to 50 pitches per game, 75 pitches per week

11 to 12 years old
Limit to 75 pitches per game, 100 pitches per week

13 to 14 years old
Limit to 75 pitches per game, 125 pitches per week

14 years old
Can begin throwing curveballs

17 years old
Can begin throwing sliders
Strike Out Throwing Injuries
Timothy S. Sitter, M.D., Orthopedic Surgeon Specializing in Sports Medicine

Throwing a baseball subjects the elbow and shoulder joints to intense speed and force, placing players at great risk of injury. While many sports’ rules and standards are designed to protect the health of athletes, one study involving several Major League Baseball pitchers reveals that one of baseball’s regulations – pitching mound height – may actually threaten players’ safety.

The study analyzed the pitching motion at mound heights of 10 inches (the standard height of a pitching mound in professional, college and high school baseball), eight inches, six inches and on flat ground. When compared to pitching from flat ground, pitching from a 10-inch mound placed more stress on the shoulder joint and surrounding structures, which could increase the risk for serious injury and hamper the player’s ability to deliver a consistent pitch.

Elbow and Shoulder Problems
The study serves to highlight the substantial risks of repetitive throwing. “Some of the most common throwing injuries to the shoulder result from trauma or wear and tear of the labrum – the cartilage that surrounds and supports the shoulder socket – and the rotator cuff – the tendons and muscles that stabilize the shoulder during motion,” explains Timothy S. Sitter, M.D., board-certified orthopedic surgeon specializing in sports medicine.

Two common injuries to the elbow are Little Leaguers elbow and medial collateral ligament (MCL) tear. “Better known as the Tommy John injury, an MCL tear affects the main stabilizing ligament on the inner side of the elbow,” Dr. Sitter says. “Little Leaguers elbow occurs when frequent throwing pulls the tendons and ligaments of the elbow away from the bone. It can sometimes bring bone fragments with it, which may disrupt bone growth.”

The following tips may help avoid throwing injuries:

  • Warm up and stretch. Try jumping jacks or running the bases, then gently stretch the back, hamstring and shoulder muscles.
  • Develop proper mechanics. Make sure you use healthy pitching and throwing techniques. A year-round conditioning routine can also help boost strength and flexibility.
  • Limit number and types of pitches. The USA Baseball Medical and Safety Advisory Committee suggests monitoring pitch counts (see accompanying article) and prohibiting breaking pitches until physical maturity.

Perhaps the most important step in avoiding throwing injuries is heeding your body’s warnings. If you feel pain – or if a young player complains of pain – stop play immediately. “Conservative treatment, including rest, ice, rehabilitation exercises and pain medication, are often all that’s needed to repair an injury that’s discovered early,” Dr. Sitter says.

When more serious throwing injuries develop, the physicians at the Methodist Orthopaedic Specialists of Texas (MOST) offer a variety of treatments to help players return to the game safely. To schedule a consultation with Dr. Sitter or another orthopedic specialist at MOST, call 866-567-4130.