Top 5 Causes of Overuse Injuries in Youth Baseball

Pitch Types

Studies have found that youth baseball pitchers who develop "sliders" and "curveballs" as pitches have an increased risk of elbow and shoulder pain. It is recommended that young players avoid throwing these pitches to reduce the risk of injury, and development of these pitches should only occur under close supervision.

Pitch Counts

Professional and collegiate coaches have routinely utilized pitch count to minimize injury to players, and now high schools and youth leagues are beginning to monitor activity. Research has indicated that a significant relationship exists between the number of pitches thrown and the risk of shoulder and elbow pain in youth baseball players. Monitoring and limiting the number of pitches thrown is crucial in minimizing the risk of overuse injuries.

Physical Conditioning and Mechanics

Young pitchers should work to develop proper throwing mechanics as early as possible, as proper mechanics may serve to reduce the strain on the body and thus reduce injury. Conditioning should include low weight/high repetition exercises that strengthen the shoulder girdle. Likewise, core strengthening should be emphasized.

Multiple Leagues

Because of their enthusiasm for the game, many young players want to play in multiple leagues. Since the coaches in the different leagues may not have a complete understanding of what the player is doing in the other league, it is much more likely that players will experience overuse injuries-even if issues like pitch count are addressed. Rest is essential for healthy musculoskeletal development, so caution must be used when playing in multiple leagues.

Showcases

While showcases are necessary to show scouts what a player can do, there is undoubtedly an increased likelihood of injury as players try to impress scouts. As players attempt to push themselves beyond their limits to display their talent, the risk of serious injury increases. Proper training, rest and warm-up may serve to minimize the potential risk of injury, but close supervision of players is essential at showcase events.

Common Elbow Injuries in Youth Baseball

Medial Apophysitis (Little Leaguer’s Elbow)

This injury occurs when repetitive throwing creates an excessively strong pull on the tendons and ligaments of the elbow. The young player feels pain at the knobby bump on the inside of the elbow.

"Little Leaguer's elbow" can be serious if it becomes aggravated. Repeated pulling can tear ligaments and tendons away from the bone. The tearing may pull tiny bone fragments with it in the same way a plant takes soil with it when it is uprooted. This can disrupt normal bone growth, resulting in deformity.

Osteochondritis Dissecans

A less common condition called osteochondritis dissecans is also caused by excessive throwing, and may be the source of the pain on the outside of the elbow. Muscles work in pairs. In the elbow, if there is pulling on one side, there is pushing on the other side. As the elbow is compressed, the joint smashes immature bones together. This can loosen or fragment the bone and cartilage. The resulting condition is called osteochondritis dissecans.

Symptoms

"Little Leaguer's elbow" may cause pain on the inside of the elbow. A child should stop throwing if any of the following symptoms appear:

-          Elbow pain
-          Restricted range of motion
-          Locking of the elbow joint

Treatment

Left untreated, throwing injuries in the elbow can become complicated conditions.

Nonsurgical Treatment

Younger children tend to respond better to nonsurgical treatments.

-          Rest. Continuing to throw may lead to major complications and jeopardize a child's ability to remain active in a sport that requires throwing.
-          Apply ice packs to bring down any swelling.
-          If pain persists after a few days of complete rest of the affected area, or if pain recurs when throwing is resumed, stop the activity again until the child gets treatment.
-          Refine throwing technique.

Surgical Treatment

Surgery is occasionally necessary, especially in girls older than 12 years and boys older than 14 years. Depending upon a child's injury, surgery may involve removing loose bone fragments, bone grafting, or reattaching a ligament back to the bone.

Prevention

The general guideline for how many pitches a child can safely throw each week is 75 for 8-10 year olds, 100 for 11-12 year olds, and 125 for 13-14 year olds. This includes both practice and competitive play. To prevent throwing injuries, young pitchers should only play three to four innings each game.

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