While most Little League pitchers dream of pitching in the “Big League”, the sad truth is that none will. Almost all Major League Baseball (MLB) pitchers, if they even played in Little League, played a different position in their youth. Do I have your attention yet? As surprising as these statements may seem, according to studies by several MLB team physicians, they are true.

Injuries are the number one preventable reason youth (9-12 years old) pitchers seldom continue pitching past high school. The risk of injury is especially high in this age group due to immature skeletons, poor coordination, improper technique, and coaching. At all levels, the biggest risk factor is “overuse”. While injury risk factors can be mitigated, injuries are inherent to pitching. For example, despite access to the best coaches, trainers, and doctors, virtually every MLB pitcher sustains a serious injury at some point in their career.

What can be done to reduce the risk of pitching injuries, especially in young pitchers? The three most important contributors to a pitcher’s ability to perform well and stay healthy are pitching mechanics, pitch volume, and pitch type. Pitching mechanics, “proper form”, is the same at all levels of competition. That is why it is so important to teach proper pitching and throwing mechanics early. As the level of competition increases, pitchers throw harder-increasing the torque and forces on the throwing arm. Good mechanics will spread the forces more evenly along the kinetic chain (foot to hand). Flaws in the pitching form will put more stress on the joints (shoulder and elbow primarily), causing an injury sooner, rather than later. Because Little Leaguers don’t throw very hard (relatively speaking), injuries may not be visible for years. Yet the effects add up and will cause problems eventually. Some studies have reported that 15% of male college students feel their ability to throw in college is hindered or hampered by pain, tenderness, or limitation of movement as a result of their youth baseball pitching. So teaching proper pitching mechanics is first step in reducing throwing injuries.

The next most important contributor is pitching volume-the number of pitches thrown. All youth leagues have regulations limiting innings pitched. Yet the important component, number of pitches thrown, isn’t (usually). Although there is no study that defines the exact number of pitches that can be thrown safely, MLB pitchers are generally limited to 100. College and high school pitchers often greatly exceed that number. What is a “safe”amount for Little Leaguers? I recommend no more than 70 pitches a game. The third important risk factor is the type of pitch thrown. Most people assume that throwing a curveball is more stressful to the arm than a fastball. Biomechanical studies of adult pitchers indicate though, that there are minimal differences in elbow and shoulder forces when throwing a fastball or curveball, and significantly less force throwing a change-up. But, an improperly thrown curveball is much more stressful than an improperly thrown fastball. Worse yet is the split-fingered fastball (should be banned at the amateur level). The least stressful pitch? Knuckleball. A fastball is the easiest to learn and the most natural to throw, and along with a change-up, should be the only pitches thrown before the age of 14. There are a lot of factors contributing to pitching injuries, most of which can be minimized by emphasizing pitching mechanics and limiting the number and type of pitches thrown. Proper conditioning is also important, and we will talk more about that in future columns.

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