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Overuse Injuries on the Rise in Youth Baseball: Why?

Posted July 13, 2017

By Elizabeth L. Augustine, MS, LAT, ATC

Baseball is America’s past time. Nothing says summer like spending time at the ball diamond. For some youth involved in the sport, there is an alarming increasing trend of overuse injuries affecting more and more of the participants who enjoy it.

There are many factors that can contribute to overuse injuries in youth baseball. There is an increase in the amount of kids playing year-round and playing on multiple teams. And the young players are not only playing year-round, but they are playing on teams that compete in multiple game tournaments. That creates a potential for too many pitches and throws, with limited rest between games. Kids that play both pitcher and catcher in one game are also at risk for increased overuse injury, as these athletes are throwing even more than other teammates.

Youth baseball players, especially pitchers, face the challenge of the general unnatural motion of pitching and this force upon their bodies. Combine the force of pitching with potential poor throwing mechanics and there is little doubt as to why there is an increase in overuse injuries. Their growing bodies simply cannot keep up with the demand of the repetitive activity. Their bodies cannot repair the damage done with the repetitive micro-trauma. Contributing factors also include throwing advanced pitches, other than fastballs and changeups.

As wide spread as youth baseball is across the nation, there is always potential for less educated and experienced coaches. This can lead to improper instruction on pitching techniques and biomechanics. This lack of instruction can lead to poor form and put undue stress on a youth player’s arm and body.

There remains the old-school mentality of “tough it out” through pain. For younger athletes, pain is a symptom that something is happening in the body and some coaches/parents may encourage their kids to work through their pain. Pain is the body’s signal that trauma is occurring and when kids ignore that signal, injuries can get worse and worse.

So, what is the accumulative effect of these factors? Kids are suffering major injuries to their growing bodies. Youth baseball players who develop overuse injuries may be required to take a long recovery time, once they seek medical care. Some will require surgery. There is an increase in younger athletes needing the notable Tommy John’s surgery to repair their UCL ligaments in their throwing elbows than there ever was before.

Although this trend is concerning for some, there are steps that youth athletes, their parents and coaches can take to minimize the trauma of playing baseball at such a young age. At the heart of the matter is education. Different organizations, such as Little League®, National Federal of High School Sports (NFHS) and individual state organizations provide education on safely playing and rules that mandate pitchers, pitch counts and rest days. Little League® offers PitchSmart, which is a collaboration with Major League Baseball. PitchSmart is a website that provides a series of practical, age-appropriate guidelines to help parents, players and coaches avoid overuse injuries and foster long, healthy careers for youth pitchers. The website offers pitching guidelines, risk factors, Tommy John Surgery FAQ and additional resources.

Pitch count has proven to be the most effective way to keep kids safe while pitching in baseball. Each age group is restricted to a certain number of pitches each athlete can throw and they have specific amounts of rest days following a game where they pitch. This should be monitored by each pitcher and the athlete should never pitch again in the same day.

Athletes should be encouraged to report pain in their arms and elbows while participating in baseball. Coaches should encourage this with all their players. Athletes, parents and coaches should continue to communicate with each other regarding any pain.

In summary, there are many factors that can lead to overuse injuries in youth baseball. But with proper education and interventions, it is possible to decrease the prevalence of these injuries.


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