Let's talk about pitching injuries and pitch count guidelines...

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At the high school level, pitching injuries are happening at such an alarming rate that doctors are now performing five times more "Tommy John" elbow surgeries than they were just a decade ago, according to the American Journal of Sports Medicine.
And Dr. James Andrews, one of the most acclaimed orthopedic surgeons in the world for the treatment of pitching arm injuries, has said his clinic has seen a tenfold increase in visits from high school and youth pitchers in the past 10 years.
10 times.
A dramatic rise in baseball pitching injuries
Look, it's no secret that injuries among baseball pitchers at all levels are on the rise, but elbow and shoulder injuries in Little League and throughout other youth baseball organizations are on the verge of becoming an epidemic.

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Thousands of pitchers are seen each year complaining of elbow or shoulder pain. Your son or a youth pitcher you know may be one of them.

Check out this slow-motion video of Clayton Kershaw's arm action as he throws a four-seam fastball. Take a look at his elbow:

Wow. Just plain wow, right?
Now keep in mind that at normal speed, this movement produces enough force to propel a baseball up to 95 MPH—and it's repeated as many as 120 times per game, over 30 games per year.
After seeing that, it's no wonder 25% of active MLB pitchers and 16% of current minor league pitchers have had UCL procedures, which reconstructs a pitcher’s torn ulnar collateral ligament.
Last season was particularly distressing: More pitchers had the surgery in 2014 than in the entirety of the 1990s.

Helping young pitchers stay healthy
The good news is there's a lot we parents and coaches can do to help our kids pitch safe and stay healthy this season.
As a former pro pitcher and now parent and coach of young pitchers, I know firsthand how important it is to help our kids pitch safe and stay healthy on the mound.

Injury prevention techniques for youth pitchers
Here are 13 ways to prevent pitching arm injuries to point you and your son in the direction of success:
- Make certain pitchers are properly conditioned before throwing full velocity or pitching competitively.
- Make certain pitchers have and use a proper stretching and warm up program before throwing.
- Develop a year round throwing program to maintain arm strength and stamina, flexibility, and normal range of motion.
I personally recommend 1-2 month rest period at end of a long season, and then begin a limited and modified off season throwing program. - Teach and supervise a proper weight and resistance program.
I recommend the TUFFCUFF Jr pitching guide; coaches or medical personnel should be responsible for implementing this program.
Many pitchers restrict their flexibility and range of motion by improper use of weights. Other pitchers have actually weakened themselves by over stretching the shoulder joint, causing too much laxity. - Have the pitcher throw at reduced velocity and shorter distance when learning new techniques or new pitches.
- Limit the amount of throwing a pitcher does during drills and practices if he plays another position. The positions which would cause the least amount of stress on the arm are first base or outfield.
- Make certain the pitcher dressed properly for warmth during cold temps, or to prevent early heat exhaustion during very hot weather.
Also, be aware of proper intake of fluids to prevent early dehydration and muscle fatigue. - Don't use a radar gun; emphasize the development of proper pitching mechanics, control and accuracy in young pitchers before pitching velocity. Learn the fundamentals now, and the velocity will come later as the pitcher grows and matures.
- Count pitches and adhere to pitch count guidelines.
In 2006, Little League Baseball instituted pitch count regulations with different pitching thresholds for different divisions of play based on age. Specific pitch count regulations for all divisions can be found at www.littleleague.org/playing-rules/pitch-count.
The following are pitch count limits established by MLB's new Pitch Smart initiative: - Make sure the pitcher gets proper rest following pitching appearances in games (and even in practices and/or scrimmages) by adhering to the following rest period guidelines here:
- Concentrate on age-appropriate pitching skills.
Nolan Ryan didn't start pitching until he was in high school.
Madison Bumgarner wasn't allowed to throw a curve ball until he was 16 yrs old, according to an article in Sports Illustrated.
In fact, most Big League pitchers didn't develop secondary pitches or breaking pitches before the age of 13 or 14 years old—they threw nothing but fastballs and change ups. - Make certain a pitcher pitches with proper mechanics.
While each pitcher throws somewhat within his own style, through the critical phase of throwing, most successful injury free pitchers use very similar time-proven techniques.
From what I've observed in working with hundreds of pitchers, is that from the hand break through the deceleration phase of the pitching motion, most successful pitchers use basically the same arm action.
Other common traits of successful pitchers include:
- Proper balance, flexibility and control of the body
- Good body and arm alignment
- Proper weight transfer
- A long smooth arc of deceleration of the pitching arm
When analyzing the pitching motion of a pitcher who is experiencing arm problems, be on the lookout for the following pitching faults, which may potentially be the root cause for the soreness or pain. - Take care of the arm before and after a pitcher throws.
Obviously, having a clean arm action, as previously mentioned, will eliminate a lot of problems, but if you don't prepare and recover you can still potentially run into injuries.
There are also other ways to improve your arm action with arm care activities such as the following examples:
- Resistance tubing or Jobes exercises;
- Scap holds and waiter walks (shoulder stability);
- Wrist weight exercises (forearm stability);
- Rice bucket exercises (finger and forearm strengthening);
- 2-lbs. mini med ball throws (reverse and pivot pick off);
- Some kind of rhythmic stabilization (mini med ball ball throws against rebounder, kneeling stabilizations, or the "shoulder tube"); and
- Foam roll with lacrosse ball (roll the lax ball over arm to find tender spots, increase pressure to release built up knots).
And remember, arm care shouldn't stop only with the arm, either.
Mobility and flexibility of the hips and thoratic extension of the back is just as important. The hip flexors, internal and external rotators, hamstrings and groin all need active and static care.
Recommended pitch count limits
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Age | Pitches/Game |
---|---|
7-8 | 50 |
9-10 | 75 |
11-12 | 85 |
13-16 | 95 |
17-18 | 105 |
A youth pitcher throwing 25 pitches with poor mechanics may be much worse off than a pitcher who throws 50 with good mechanics.
In my view, it's not just about the number of pitches thrown, it's really about the number of mechanically correct pitches thrown.
I found this interesting: A high school baseball team recently had to forfeit a game over a pitch-count violation.
The increasing number of serious arm injuries to baseball pitchers has led to some rules changes at the high school level and below. Some of this is certainly good.
Yet some say the problem with the move toward pitch counts specifically is that there is/was never any logic or research that said that limiting a pitcher to 100 pitches would prevent injuries as opposed to, say, 130 pitches...
- Or as opposed to 130 pitches for young pitchers, and 160 pitches for mature pitchers...
- Or as opposed to taking a pitcher out of the game at the first sign of a problem like poor control...
- Or as opposed to improving his off-season or in season training regimen.
Here are some interesting MLB pitch count stats:
1. Pitchers don't throw as many innings as they once did — none has reached 300 innings in a season since Steve Carlton's 304 for the 1980 Phillies.
2. It takes far more pitches to dispense with today's hitters in a 9 inning game than 50 years ago — 158 pitches today vs 115 pitches from 1930s-1970s. Hitters take more pitches, and strike zones are also smaller.
3. In 2000, managers let their starters throw 120 pitches or more about 12% of the time — there were 454 instances of a pitcher throwing 120-plus pitches.
In 2001, the 120-plus pitch games were cut in half (6% of the time).
In 2006, they were cut in half again (3% of the time).
And last season, there were only 71 total MLB games where a pitcher threw 120-plus pitches.
HOWEVER, as the number of innings and pitch counts have come down, the number of pitcher-related injuries have shot up.
Just something to consider.
Recommended rest periods
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Number of Pitches | Rest Period |
---|---|
61+ | 3 days |
41-60 | 2 days |
21-40 | 1 day |
1-20 | None |
Number of Pitches | Rest Period |
---|---|
76+ | 3 days |
61-75 | 2 days |
26-50 | 1 day |
1-25 | None |
Recommended ages for learning different pitches
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Pitch Type | Age |
---|---|
Fastball | 8 ± 2 |
Change-up | 10 ± 2 |
Curve ball | 14 ± 2 |
Knuckle ball | 15 ± 2 |
Slider | 16 ± 2 |
Fork ball | 16 ± 2 |
Screwball | 17 ± 2 |
→ As for the relationship between certain pitch types and increased stress on the elbow, it has traditionally been believed that the curve ball is a more harmful pitch than the fastball or change up. This led to recommendations by the American Orthopaedic Society for Sports Medicine that youth pitchers refrain from beginning to throw curve balls until the age of 14.
Recommended action steps for sore arms
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Pain | Why it might be happening | What to look for (mechanics) |
---|---|---|
Biceps or Triceps | A result of not having enough functional strength in the arm as the demands of throwing increase, especially early in the season. | Failing to utilize legs, hips and trunk to throw, making the arm carry a majority of the workload. |
Shoulder | A result of poor throwing mechanics and not strengthening the small muscles in the rotator cuff (particularly, the decelerators) and scap with a weekly arm care program. | Releasing the baseball when the elbow is behind the chin and dragging the arm. Postural inefficiencies. |
Elbow | A result of poor throwing mechanics and weak functional strength in the wrist and forearms. | Snapping the wrist when throwing a breaking pitch; releasing the baseball when the elbow is behind the chin; and dragging the arm. |
Protecting youth pitching arms
Finally, even though I recommend light weight, full range-of-motion conditioning and strength work such as the program I put together in my TUFFCUFF Jr pitching guide here, I sincerely believe that the single best method to build throwing arm strength and stamina—and to prevent pitching arm injuries in little league age youth pitchers—is to throw a baseball…
...and throw it mechanically correctly all the time.
It's a constant process; never stop improving, never stop learning, and never stop working hard.
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What do you think?
Now it's time to hear from you:
Are there any injury-free pitching tips that I missed?
Or maybe you have an idea of how I can make this list even better.
Either way, leave a comment and let me know.
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