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Preventing Little League Injuries

By Dr. Dale J. Buchberger

It is that time of year again. Pitchers and catchers have reported to major league baseball spring training camps and the little league baseball season is not far behind. This article will take a hard look at some of the least talked about causes of little league related arm injuries. Parents, players, coaches and league officials to reduce injuries this season should use the information provided. Coaches are volunteers who have the time and not necessarily professional expertise in the field of baseball. Therefore they may not be able to recognize when things are going wrong with a young pitcher. Whether the problem is stage of development, mechanical fault or warning signs most little league level coaches just don’t have the background to catch the problem before the “wheels fall off the bus”. We recommend that coaches take a course in injury prevention specific to the little league athlete.

Players between the ages of 9-14 are at the greatest risk for many reasons. The first is that their developmental stage may not match their chronological age. In other words they may be either physically older or younger than there actual age. More talented and highly developed players for their age are more likely to get injured. Even though their outward appearance is advanced their inner skeleton is not. Little League Baseball has instituted pitch limits as a means to protecting young arms. What coaches and parents need to know is that when a player is advanced for their age those pitch counts should be restricted further. Dr. Michael Axe from the University of Delaware has shown statistically that these more advanced players are at a greater risk of injury and need a higher degree of restriction.

In an attempt to be more competitive coaches and parents encourage young arms to throw alternative pitches such as the curveball or slider. The majority of players lack appropriate physical development and/or proper instruction to throw these pitches correctly. Thus the statistics in the 9-14 year old age group show that players who throw curveballs and sliders are at a 52% and 86% increase risk of shoulder or elbow pain respectively. Instead of gimmicks concentrate on control and changing speeds. Learning a changeup is far better than throwing a “slurve”. Remember this simple phrase, “up, down; in, out; change speeds”. The 13-14 year old age group will have to adapt from a 46’ pitching distance off of a lower pitching mound to a 60’ 6” pitching distance off of an increased slope of pitching mound. The pitcher who excelled at 46’ and a flat mound is now asked to excel at 60’ 6” and an inclined mound 6-8 months later. This rapid change in demand can result in increased arm injuries. It is recommended that pitch limits be restricted by 20% in the first year at the new field structure. This will allow for adaptation time and reduce injury rates.

While we all want to see our children do well sometimes parents become overzealous. Children may be better served if parents were supportive instead of aggressive. Sometimes we want our children to do so well that we fail to recognize that developmental age and ability may be linked. Like it or not some kids are behind their peers developmentally and parents need to be patient. Allow kids to develop and mature. Encourage them to practice but also explain the timeline of maturity. If parents are patient and supportive one day your child will develop better than you thought they could. Continue to encourage involvement in activities and sports they show interest in. Please remember during the spring and summer youth sports season that youthful talent should be cultivated, developed and protected NOT abused!

Figure 1:

Safety Recommendations for Adolescent Baseball Pitchers

1. Avoid pitching with arm fatigue and/or pain.

2. Avoid pitching more than 80 pitches per game. (Little League baseball restrictions are as follows: 13-16; 95 pitches per day, 11-12; 85 pitches per day, 9-10; 75 pitches per day)

3. Pitchers transitioning from 46’ to 60’ 6” should use pitch counts of two age groups before for the transition year.

4. Avoid pitching competitively more than 8 months per year.

5. Avoid pitching more than 2500 pitches in competition per year.

6. Monitor pitchers with the following characteristics closely for injury:

a. Pitchers who regularly use anti-inflammatory drugs to “prevent” an injury

b. Regularly starting pitchers

c. Pitchers who throw with velocity >85 mph

d. Pitchers who are taller and heavier for their age

e. Pitchers who warm up excessively

f. Pitchers who participate in showcases or tournament play

Modified from: Olsen II SJ, et al Am J Sports Med 2006;34:906-912