Prevention of overuse injuries in young baseball pitchers

Abstract

With millions of athletes participating in baseball in the United States annually, overuse injuries are common occurrences. Epidemiological studies, including surveys of orthopaedic surgeons, coaches, and athletes, indicate that injuries such as those to the ulnar collateral ligament are increasing in incidence. Many risk factors for throwing injuries have been proposed-including the immature skeleton, throwing mechanics, glenohumeral internal rotation deficit, pitch type, velocity, and counts-but little evidence is available to support the majority of these factors. Recent studies have shown that pitch volume and overuse are central factors that lead to shoulder and elbow injuries in the young throwing athlete. Pitching while fatigued and in spite of arm pain has also been implicated.

Keywords: apophysitis; overuse; pitch counts; youth pitchers’ injuries.

Figure 1.

Pictorial series of normal pitching mechanics. Photos © American Sports Medicine Institute. Reprinted with permission. Wind-up: from first movement to peak lead knee height. Stride: from lead knee height to stride foot contact. Arm cocking: from stride foot contact to maximum shoulder external rotation. Arm acceleration: from maximum shoulder external rotation to ball release. Arm deceleration and follow-through: from ball release to the end of the throwing motion.