In the United States, it is estimated that about 5 million children and adolescents participate in organized baseball each year.


Recently, emphasis has been made on prevention of arm injuries. However, there are still a significant amount of shoulder and elbow injuries caused by participation. In a report, nearly half of the pitchers aged 9 to 14 reported shoulder or elbow pain during pitching activities. One of the biggest risk factors related to arm injuries among young players is participation while fatigued or in pain. As the sport is modernizing, more youth athletes find themselves participating in the same sport for a longer time frame throughout the year. Youth baseball players should be given ample time to recover after each pitching opportunity and should be on a certain pitch count.
Sometimes the tournament venue has strict guidelines that will be enforced. Other times it’s up to the parents and coaches to ensure that the pitcher isn’t being overworked. Proper conditioning that includes a warm-up and cool down should be considered to protect the arms of these young players. Other factors that may increase the chance of elbow pain include: decreased stature, increased body mass index, arm fatigue, concurrent participation in other physical activities or sport. Shoulder pain may be correlated with: an increase in pitch count, pitching while sore or fatigued, or decreased perception of performance. To reduce pitching related injuries, it is suggested that youth pitchers may begin throwing a fastball at 8 years old, a change-up at 10 years old, and a curveball at 14 years old. Breaking-ball pitches have been studied and throwing a curve ball too early may increase risk of injury by 52% while a slider may increase the risk by 86% (Popchak et. Al., 2015).There should be a focus on protecting young baseball players to reduce the risk of early Tommy John or shoulder surgery. It is important to make sure that coaches and parents communicate effectively to identify any warning signs the players may be displaying or verbally communicating.
Source: Popchak, A., Burnett, T., Weber, N., & Boninger, M. (2015). Factors Related to Injury in Youth and Adolescent Baseball Pitching, with an Eye Toward Prevention. American Journal of Physical Medicine & Rehabilitation, 94(5), 395-409.