Every year, approximately three million children play baseball in the USA . Many of these kids continue to play through their adolescent and high school years. Approximately 25,000 athletes compete each year in National Collegiate Association of America (NCAA) baseball at the collegiate level. A select few of these end up playing minor or major league baseball. This high level of sports participation by the population creates a large role for health care providers in the care of the injured baseball players. It is extremely important for these providers to have a thorough understanding of the sports-specific injuries that affect baseball athletes.
Most of the focus has been correctly placed on awareness and prevention of overuse. Furthermore, although research has been unable to prove an association between youth curveballs and elbow injury, many organizations and leading clinicians believe this is a risk factor and discourage curveballs before skeletal maturity.
- Watch and respond to signs of fatigue (eg, decreased ball velocity, decreased accuracy, upright trunk during pitching, dropped elbow during pitching, or increased time between pitches). If a youth pitcher complains of fatigue or looks fatigued, rest is recommended.5
- No overhead throwing of any kind for at least 2 to 3 months per year (4 months is preferred). No competitive baseball pitching for at least 4 months per year.
- Do not pitch more than 100 innings in games in any calendar year.
- Follow limits for pitch counts and days rest.
- Avoid pitching on multiple teams with overlapping seasons.
- Learn good throwing mechanics as soon as possible. The first steps should be (1) basic throwing, (2) fastball pitching, (3) changeup pitching.
- Avoid using radar guns.
- A pitcher should not also be a catcher for his team. The pitcher-catcher combination results in many throws and may increase the risk of injury.
- If a pitcher complains of pain in his elbow or shoulder, discontinue pitching until evaluated by a sports medicine physician.
- Inspire youth pitchers to have fun playing baseball and other sports. Participation and enjoyment of various physical activities will increase the youth’s athleticism and interest in sports.