OrthoVirginia Blog

Avoiding Elbow Problems in Youth Baseball

By: Julious P. "Jody" Smith, III, MD


Springtime means Little League Baseball, which means hot dogs, dirt stains and elbow pain.  Well, maybe it’s not quite that dramatic.  Unfortunately, however, our youth baseball players are experiencing elbow pain at a much higher rate than previous generations, and the problem seems to be getting worse.  The biggest issue seems to be volume.  Today’s young players are throwing faster and more frequently.  This is mainly the result of two changes in the game over the last 20 years:  Travel baseball and the extension of the season to (basically) year-round.  

Nowadays, most youth players play for at least two teams and often three.  The season starts in January and ends in December.  Gone are the days of an April to July season.  The fall season has melded into the summer, and now the late fall is the “showcase” season.  This means that after playing for ten consecutive months, our children go out on multiple weekends to throw as hard as they can to impress scouts from colleges and professional teams.  This has become the new standard, and it is taking its toll.  The rate of ligament reconstruction, or “Tommy John Surgery”, has increased by 10% in the youth and high school population over the last five years; and there does not appear to be any change coming along to alter this trajectory.  So, what can be done to protect the arms of our children?

Little league baseball offers suggestions regarding the type and number of pitches that should be thrown by certain ages.  Those are available on the Little League Website:
http://www.littleleague.org/Assets/old_assets/media/Pitch_Count_Publication_2008.pdf.

The idea is good, as the intent is to limit arm stress by controlling the number and type of pitches thrown based on the age of the thrower.  These suggestions alone are, unfortunately, not enough.  Pitch counts are difficult to follow when players pitch for more than one team.  One coach does not always know how many pitches his player made for his “other” team.  Thus, the onus falls on the parents and the players to control their pitch counts.

Interestingly, a recent study has shown that three main factors seem to put youth pitchers at risk of more elbow injuries:  Pitching for more than one team, velocity of pitches, and pitcher height.  Obviously, we cannot control how tall our children are; but we certainly can be more attentive to the number and speed of the pitches they throw.  That is not to say that we should tell our kids to throw the ball fast.  It is more about the cumulative damage that occurs in the process.  If your child plays, take an active role in the protection of their arm.

For more information on the topic, you may visit these web sites:

About the Author:

Dr. Jody Smith has been practicing Orthopedic Medicine for over 14 years and is currently seeing patients at our St. Mary's and Farmville locations. In that 14+ years of practice, he has received the Elite Award of “Top Doc” from Richmond Magazine from 2008-2017.
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