Overuse Injuries in Adolescent Baseball Pitchers

The elbow is the most frequent location for overuse injuries in children who play baseball. Even though girls who play high school softball have a higher injury rate than boys who play high school baseball, little league elbows associated with repetitive pitching and improper technique is highest in boys.

Side arm pitching by little leaguers is three times more likely to cause elbow symptoms than overhead pitching. Curve balls produce more forces on the inside of the elbow than overhead throwing. Young children should avoid throwing side arm and curve balls until 14 years of age. Even then, it requires adequate training, coaching and exercises to throw curve balls safely.

By age 18, throwing a curve ball with regularity is not associated with an increased injury rate. The usual rule is to limit the number of pitches thrown at home and in practice to 200 or fewer pitches per week. The way a little leaguer pitches is extremely important. It is not just a matter of throwing the ball. Proper pitching and body mechanics will result in fewer injuries to the little league pitcher or child who throws a baseball. This requires not only strength training to increase power on the pitching arm, but also strength training for the legs.

In most cases the following rules apply:

Years of age Pitches/Game
8-10* 55
11-12* 70-75
13-14* 85
15-16* 100
17-18 110

*No More Than Two Games Per Week