Overuse and Fatigue: Risk Factors for Pitching Injuries

In response to an increased number of pitching-related injuries, the authors of this study surveyed two groups of baseball pitchers. The goal was to find risk factors for shoulder and elbow injuries. Ideas for prevention were a natural outcome of the results.

Two groups of male adolescent pitchers ages 14 to 20 years were included. The first group (95) had shoulder or elbow surgery at least once. The second group (45) never had a significant pitching-related injury. Each pitcher was given a survey of questions to answer about pitching, playing, and injury.

They found big differences between these two groups. First of all, the injured players were more likely to be taller and heavier. Pitching practices were also very different. The injured players pitched more all the way around.

They pitched more innings per game, games per year, and months per year. They also pitched more often with arm pain or while taking anti-inflammatory drugs. The velocity of their pitches was higher than in the uninjured group.

Based on the results of this study, the author made some safety recommendations for this age group:

  • Watch taller, heavier pitchers closely for signs of injury.
  • Coaches should give more importance to a pitcher’s long-term success over winning.
  • Discomfort during warm up pitches should not lead to a longer warm-up period to “loosen up;” it may be better to sit out the practice or game.
  • Don’t pitch through pain or discomfort; if ice and/or anti-inflammatories are needed, then the pitcher shouldn’t pitch that game or practice.
  • Don’t allow adolescents to pitch year round; at least three months’ of rest is needed.

    The authors also offer specific pitching limits based on number of pitches per game and number of pitches per year. They advise against throwing breaking pitches until the pitcher is at least 13 years old. Parents, coaches, and pitchers can work together to avoid injuries and protect the long-term health of the pitcher.