A 2006 study performed by Olsen, et al.(1) looked at 95 adolescent baseball pitchers who had either undergone shoulder or elbow surgery and 45 adolescent baseball pitchers (control group) who had never had a pitching related injury.
What the investigators found was that the injured group pitched significantly more months per year, games per year, innings per game, pitches per game, pitches per year, and warm up pitches prior to a game. Additionally the injured pitchers tended to utilize ice and anti-inflammatory drugs more often than their uninjured counterparts.
The investigators found that incidence of injury increased by five times when young athletes pitch more than 8 months a year, by four times when throwing more than 80 pitches per game, and that athletes were 2.5 times more likely to injure themselves when pitching fastballs greater than 85 miles per hour.
This information is useful in that it really gives some credibility to the implementation of pitch counts for young pitchers and for the need for rest. Unfortunately there are too many young pitchers who just want to play baseball and too many coaches out there that just want to win. Unfortunately these kids sometimes play on 2 and 3 different teams at the same time and are expected to pitch in back to back days when moving from school team to club team and so on.
An example from my own office is that we recently had a 13 year old left handed pitcher come in with reports of left elbow pain. He was on 3 baseball teams at the same time and in one week had thrown in 4 different games. When I asked about his pitch count, the family looked at me surprised and they had no idea how many pitches this pitcher had actually thrown. Faulty mechanics were an issue, however I believe that the excessive pitching expedited the process and advanced the faulty mechanics to the point where the child experienced pain. Fortunately we were able to work with this player and his pain was only a warning sign. But not everyone is so lucky.
Parents please be sure to implement a "pitch count" for your adolescent pitchers and make sure they have ample rest between pitching and in the "off season." Not everyone is Bryce Harper, he is a baseball prodigy.
1) Olsen et al. Risk Factors for Shoulder and Elbow Injuries in Adolescent Baseball Players. Am J Sports Med 34(6): 905-912.
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