Youth baseball pitching injuries are on the rise. The world-renowned Dr. James Andrews describes the increase in injury rates as an epidemic (ESPN interview). His research shows 5% of youth pitchers will sustain at least one serious elbow or shoulder injury which will require surgery or end their career. Historically, throwing breaking pitches at a young age was cited as the major risk factor for these types of injuries. However, the latest research shows arm fatigue, not breaking pitches, is the primary reason for the sharp rise in youth pitching injuries.
Should Youth Pitchers Throw Curveballs?
Dr. Andrews and his team at the American Sports Medicine Institute (ASMI) in Birmingham, Alabama tracked 481 youth baseball pitchers (ages 9 to 14) for ten years. Pitchers were interviewed annually to determine the incidence of serious injury and to track pitching volume and pitch type. Serious injury was defined as those requiring surgery or ended an athlete’s career. Pitching more than 100 innings in a year significantly increased the risk of a serious elbow or shoulder injury by 3.5 times. Throwing curveballs before the age of 13 did not significantly increase the risk of injury.
Throwing with Arm Fatigue
Another 2006 study at ASMI identified the following risk factors for shoulder or elbow surgery in youth baseball pitchers:
- Pitching 8 or more months per calendar year (5 times more likely to sustain a serious injury)
- Throwing 80 or more pitches per appearance (3.8 times more likely)
- Throwing velocities greater than 85 mph (2.5 times more likely)
- Regularly pitching with arm fatigue (36 times more likely)
Research from the Journal of Strength and Conditioning Research found throwing accuracy and arm soreness to be closely associated with arm fatigue. Throwing velocity is more closely associated with generalized fatigue. Therefore, youth athletes should be closely monitored by coaches and training staff to gauge arm fatigue and throwing-induced injury risk. Throwing accuracy, and not velocity, is probably the more important variable to monitor in order to reduce injury risk. Also, regularly communicating with athletes about arm soreness is crucual to reduce the risk of youth baseball pitching injuries.
Conclusion: Youth Baseball Pitching Injuries
Parents and coaches should closely monitor youth pitchers for signs of arm fatigue and soreness and discourage throwing year round. A minimum of 2-3 months without throwing is recommended (more from Dr. Andrews). During this active recovery period, athletes should work on other baseball skills along with aspects of strength and conditioning to improve their long-term athletic development. The off-season is the ideal time for an athlete to work with a strength coach to develop strength and power. Contrary to popular belief, throwing breaking pitches is not associated with youth baseball injuries. The Stop Sports Injuries website has posted some other valuable youth baseball pitching injury prevention tips here.
- Fleisig, G. S., Andrews, J. R., Cutter, G. R., Weber, A., Loftice, J., Mcmichael, C., … Lyman, S. (2011). Risk of serious injury for young baseball pitchers: A 10-year prospective study. The American Journal of Sports Medicine, 39(2), 253–257. http://doi.org/10.1177/0363546510384224
- Olsen, S. J., Fleisig, G. S., Dun, S., Loftice, J., & Andrews, J. R. (2006). Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. The American Journal of Sports Medicine, 34(6), 905–12. http://doi.org/10.1177/0363546505284188
- Freeston, J., Adams, R., Ferdinands, R., & Rooney, K. (2014). Indicators of throwing arm fatigue in elite adolescent male baseball players: A randomized crossover trial. Journal of Strength & Conditioning Research, 28(8), 2115–2120.