OrthoVirginia Blog

Overuse Injuries in Baseball

Overuse injuries in Baseball


Spring is officially here and so is baseball season.  As with any sport, overuse injuries become a concern with practice and training. The shoulder and elbow are the most frequently injured joints in baseball.


Medial elbow pain and shoulder pain/loss of mobility are the most common complaints in throwing athletes.  Several researchers have found a significant link between these disorders and improper training.  According to work referenced by the American Sports Medicine Institute, “too much emphasis on ball velocity versus quality of mechanics, speed variation, and control” have led to an increase in shoulder and elbow pathologies in young overhead athletes.  In work referenced by Dr. James Andrews, “young pitchers who pitched past the point of fatigue were 36 times more likely to end up on the surgery table”.


There are several organizations that provide recommendations and guidelines to prevent overuse injuries.  The website for Sports Trauma and Overuse Prevention (STOP) is a valuable resource.  It has links and information for parents, athletes, and coaches.  This site includes tips for a wide variety of sports, from baseball to lacrosse, and from golf to rowing. www.stopsportsinjuries.org


The American Sports Medicine Institute has published their official position statement for youth baseball pitchers as updated in 2013.  It outlines pitch counts and recommended days of rests based upon pitch type and count.  The following is an excerpt from their website to help prevent overuse throwing injuries: www.asmi.org



            1.  Watch and respond to signs of fatigue (such as 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, let him rest from pitching and other throwing.

            2.  No overhead throwing of any kind for at least 2-3 months per year (4 months is preferred). No competitive baseball pitching for at least 4 months per year.

            3.  Do not pitch more than 100 innings in games in any calendar year.

            4.  Follow limits for pitch counts and days rest.

            5.  Avoid pitching on multiple teams with overlapping seasons.

            6.  Learn good throwing mechanics as soon as possible. The first steps should be to learn, in order: 1) basic throwing, 2) fastball pitching, 3) change-up pitching.

            7.  Avoid using radar guns.

            8.  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.

            9.  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.