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Preventing Baseball Injuries
Injuries in young athletes are on the rise, but elbow and shoulder injuries in children are on the verge of becoming an epidemic. Thousands of children are seen each year complaining of elbow or shoulder pain. Damage or tear to the ulnar collateral ligament (UCL) is the most common injury suffered and is often caused by pitchers throwing too much. This ligament is the main stabilizer of the elbow for the motions of pitching. When it becomes damaged, it can be difficult to repair and rehabilitate.
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HOW IS AN ELBOW OR SHOULDER INJURY DIAGNOSED?
If a young athlete is throwing too hard, too much, too early, and without rest, a serious elbow or shoulder injury may be on the horizon. If the athlete complains of elbow or shoulder pain the day after throwing, or movement of the joint is painful or restricted compared to the opposite side, see a physician familiar with youth sports injuries immediately.
HOW CAN OVERUSE BASEBALL INJURIES BE PREVENTED?
— especially those related to the UCL and shoulder—are preventable. Some tips to keep you in the game throughout your life include:
Warm up properly by stretching, running, and easy, gradual throwing
Rotate playing other positions besides pitcher
Concentrate on age-appropriate pitching
Adhere to pitch count guidelines, such as those established by Little League Baseball (See tables)
Avoid pitching on multiple teams with overlapping seasons
Don't pitch with elbow or shoulder pain, if the pain persists, see a doctor
Don't pitch on consecutive days
Don't play year-round
Never use a radar gun
Communicate regularly about how your arm is feeling and if there is pain
Develop skills that are age appropriate
Emphasize control, accuracy, and good mechanics
Master the fastball first and the change-up second, before considering breaking pitches
Speak with a sports medicine professional or athletic trainer if you have any concerns about baseball injuries or baseball injury prevention strategies
Maximum Pitch Counts
Source: Little League Baseball
Rest Periods Required
Ages 14 and under
Required # of
4 calendar days
3 calendar days
2 calendar days
1 calendar day
Source: Little League Baseball
Age Recommended for Various Pitches
Source: From work by James R. Andrews, MD, and Glenn S. Fleisig, PhD
HOW IS AN OVERUSE ELBOW OR SHOULDER INJURY TREATED?
The most obvious treatment for overuse is rest, especially from the activity that created the injury. Ice is also used to reduce soreness and inflammation. Ibuprofen can be taken to help with any pain. If symptoms persist, it is critical that a physician be contacted, especially if there is a lack of full-joint motion. An examination and radiographs should be done. An MRI scan may also be helpful.
Usually a simple "rest cure" approach will not be enough, because even though it allows symptoms to subside, it also creates loss of muscle bulk, tone, flexibility, and endurance. Once pain is gone and full motion is present, a throwing rehabilitation program can start.
Under some circumstances, surgery may be necessary to correct a problem. Overuse and stress related problems can affect growing parts of bone, not just the soft tissue (muscles, tendons, and ligaments). If the condition is not treated, it could cause deformity of the limb and permanent disability. The athlete should return to play only when clearance is granted by a health care professional.
REFERENCES AND ADDITIONAL RESOURCES
Prevention and Emergency Management of Youth Baseball and Softball Injuries
. American Orthopaedic Society for Sports Medicine. 2005.
Little League Baseball.
American Sports Medicine Institute.
Professional Baseball Athletic Trainers Society.
The following expert consultants contributed to the tip sheet:
Mary Lloyd Ireland, MD
James R. Andrews, MD
Glenn S. Fleisig, PhD
Sports Tips provide general information only and are not a substitute for your own good judgement or consultation with a physician.