Young boy playing baseball

Baseball is generally among the safer sports for children, but shoulder and elbow overuse injuries are a major problem, especially in youth baseball pitchers.

Overuse Injuries

  • Little leaguers’ elbow and shoulder are common in youth throwers
  • Greatest risk factor for injury is volume of pitches.  Arm pain, high pitch velocity, traveling baseball and participation in showcases also risk factors
  • Recent surveys to youth baseball players show that a large percentage have some arm pain while throwing.  
  • 5% of youth pitchers sustain a serious shoulder or elbow injury within 10 years


  • Parents and coaches are key to prevention and must act in the child’s best interest
  • If a player has arm pain, avoiding throwing, ice, NSAIDs, and stretching are all important factors in recovery.  Seeing a sports medicine physician is critical in the absence of improvement
  • Players should have a consistent routine for conditioning and core strength exercises when not actively participating in throwing activities

American Sports Medicine Institute Guidelines 

  • If adolescent pitcher shows signs of fatigue, must rest from throwing
  • Avoid any overhead throwing for more than 8 months out of the year
  • Pitch under 100 innings in any calendar year
  • Follow limits for pitch counts and rest days, based on age
  • Focus on proper pitching mechanics early
  • Coaches should avoid using radar guns, which are associated with increased injuries
  • Pitcher should not be the catcher for his team (more throws = higher injury risk)
  • If pitcher complains of shoulder or elbow pain, must discontinue pitching and see a sports medicine physician

Traumatic Injuries and prevention

  • Injuries from collisions, fielding, batting, base-running, etc may be unavoidable at times.
  • Protective equipment, including face guards lower the risk of traumatic injuries, including dental trauma.
  • Stretching, proper technique and avoidance of fatigue are best to minimize risk of injury in youth athletes.

Melugin HP, Leafblad ND, Camp CL, Conte S. Injury Prevention in Baseball: from Youth to the Pros. Curr Rev Musculoskelet Med. 2018;11(1):26-34. doi:10.1007/s12178-018-9456-5

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