Youth baseball is a very popular sport in Iowa. Many parents are concerned about potential injuries, some that could even affect children into their adult lives.

We should be mindful of the differences between the adolescent shoulder and adult shoulder. Our Physical Medicine & Rehabilitation physicians treat various musculoskeletal injuries in patients of all ages, and strongly recommend protecting our young players from injury.

The throwing motion of the young athlete is similar to the adult; however, arm angular velocities, or lever arm length, and joint forces depend on strength and physical maturity. These are relatively lower in the young athlete yet still can produce considerable force.

Youth pitchers are at a higher risk of injury than their adult/professional counterparts. They have shorter strides that do not dissipate forces in addition to underdeveloped musculature, poor balance, and inadequate flexibility. EMG analysis has shown that these factors lead to increased activity of the rotator cuff and less activity of the surrounding shoulder girdle muscles, causing less efficient transfer of energy to the ball.

Common injuries in youth pitchers are:

  • Little Leaguer’s shoulder
  • Rotator cuff injury
  • Shoulder joint instability (glenohumeral joint)

Recommendations for Adolescent Pitchers

To protect the young athletes shoulder, USA Baseball Medical and Safety Advisory Committee recommends focus should be placed on mechanics, proper conditioning, and pitch counts.

  • Avoid pitching with pain or fatigue
  • Avoid pitching too much
  • Avoid pitching more than 80 pitches a game
  • Avoid pitching more than 8 months a year
  • Avoid pitching more than 2500 pitches in competition a year

Monitor pitchers for injury who:

Require regular use of OTC pain meds or ice to “prevent” an injury

  • Are starting pitchers
  • Throw with velocity >85 mph
  • Are taller and heavier than average
  • Warm up excessively
  • Participate in showcases

Adapted from Olsen, SJ et. al: Risk factors for shoulder and elbow injuries in adolescent pitchers. Am J Sports med 34(6):905-912, 2006