Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar 24;5(3):2325967117695085.
doi: 10.1177/2325967117695085. eCollection 2017 Mar.

Exceeding Pitch Count Recommendations in Little League Baseball Increases the Chance of Requiring Tommy John Surgery as a Professional Baseball Pitcher

Brandon J Erickson  1 , Peter N Chalmers  2 , Michael J Axe  3 , Anthony A Romeo  1
Affiliations

Exceeding Pitch Count Recommendations in Little League Baseball Increases the Chance of Requiring Tommy John Surgery as a Professional Baseball Pitcher

Brandon J Erickson et al. Orthop J Sports Med. .

Abstract

Background: Empirical evidence has suggested a connection between youth pitch counts and subsequent elbow injury. For players within the Little League World Series (LLWS), detailed historical player data are available. Some of these players progress to both professional play and require an ulnar collateral ligament reconstruction (UCLR).

Purpose: To determine the percentage of LLWS pitchers who proceed to play professional (major or minor league) baseball, the rate of UCLR in former LLWS pitchers who played professional baseball, and the risk to those who exceeded current pitch count recommendations while playing in the LLWS.

Study design: Cohort study; Level of evidence, 3.

Methods: All LLWS pitchers from 2001 through 2009 from all teams and countries were identified, and all performance data were extracted. A professional (major and minor league) baseball database was then searched to determine whether each former LLWS pitcher played professional baseball. These professional players were then searched for using publicly available databases to determine whether they underwent UCLR.

Results: Overall, 638 adolescents pitched in the LLWS between 2001 and 2009; 62 (10%) progressed to professional play. Of the 56 minor league players, 25 (45%) pitched. Of the 6 Major League Baseball players, 3 (50%) pitched. Three former LLWS pitchers (5%) who played professionally underwent UCLR. In former LLWS pitchers who exceeded pitch counts and played professionally, 50% (2/4) required UCLR, while only 1.7% (1/58) of those who did not exceed pitch count recommendations required UCLR (P = .009). Similarly, among former LLWS pitchers who subsequently played professionally, 23.1% of those who played as a pitcher required UCLR while 0% of those who also played other positions required UCLR (P = .008).

Conclusion: Progression from LLWS pitching to professional baseball is uncommon. Among youth players, both diversification (playing other positions besides pitcher) as well as following current pitch limit regulations may protect against UCLR.

Keywords: Little League World Series; Major League Baseball; Tommy John; baseball; pitch count; ulnar collateral ligament reconstruction.

PubMed Disclaimer

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: M.J.A. is a paid consultant for Smith & Nephew. A.A.R. receives royalties from Arthrex; is a paid consultant for Resea; receives research support from DJO Surgical, Ossur, and Smith & Nephew; and receives publishing royalties from Saunders/Mosby-Elsevier and SLACK Inc.

References

    1. Anz AW, Bushnell BD, Griffin LP, Noonan TJ, Torry MR, Hawkins RJ. Correlation of torque and elbow injury in professional baseball pitchers. Am J Sports Med. 2010;38:1368–1374. - PubMed
    1. Axe MJ, Strube M, Osinski D, Andrews JR, Snyder-Mackler L. A speed distance-based classification system for injury prevention and research in international and domestic youth baseball players. Int J Sports Phys Ther. 2014;9:346–355. - PMC - PubMed
    1. Azar FM, Andrews JR, Wilk KE, Groh D. Operative treatment of ulnar collateral ligament injuries of the elbow in athletes. Am J Sports Med. 2000;28:16–23. - PubMed
    1. Bushnell BD, Anz AW, Noonan TJ, Torry MR, Hawkins RJ. Association of maximum pitch velocity and elbow injury in professional baseball pitchers. Am J Sports Med. 2010;38:728–732. - PubMed
    1. Cain EL, Jr, Andrews JR, Dugas JR, et al. Outcome of ulnar collateral ligament reconstruction of the elbow in 1281 athletes: results in 743 athletes with minimum 2-year follow-up. Am J Sports Med. 2010;38:2426–2434. - PubMed

LinkOut - more resources