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American Family Children's Hospital

High Pitch Counts Can Lead to Arm Trouble for Young Pitchers

Baseball pitcher throwing off the indoor mound at UW Health Sports RehabilitationMadison, Wisconsin - Some coaches are using innings rather than number of pitches thrown to monitor their pitchers' fatigue. Just like a driver who only monitors the number of months driven between oil changes and ignores the number of miles driven, this sets the pitcher up for an increased risk of injury.


"It's a big problem," says Karl Fry, a UW Health Sports Medicine physical therapist who works extensively with young pitchers in the organization's Thrower's Clinic. "Some kids have a hard time throwing strikes so they can end up throwing around 40 or 50 pitches in an inning. Two or three innings may not seem like many innings, but when you throw that many pitches per inning, that is a very heavy workload and one that many youth athletes may not be able to handle."


Fry says players start pitching around 9 or 10 years old, an age when their growth plates have not yet solidified. Overthrowing at that age can lead to elbow and shoulder pain. And the kids who display the most pitching talent - who throw the hardest - tend to pitch more frequently than their teammates, which can exacerbate the problem.


"The combination of number of pitches and velocity can be a problem for kids who throw hard," Fry says. "When you increase the number of risk factors, you increase the probability for injury."


In his work with Madison-area youth baseball coaches, Fry encourages monitoring pitchers' workloads on a pitch-by-pitch basis. Many coaches do this during their conference or league seasons, but the popularity of multi-team and regional tournaments can increase the challenges associated with accurately monitoring their pitchers.


"The tournament officials don't have the resources to reinforce that coaches are tracking pitch counts for all their pitchers," Fry says, "so they take the easier route and use number of innings."


Fry is adamant about the importance of strict pitch counts, and strongly encourages coaches to seek out resources for assisting with keeping accurate counts. Fry refers coaches and parents to Pitch Smart, a set of safe pitching guidelines established by USA Baseball, as a reliable resource for coaches to follow.


"It breaks down the pitcher's age, the number of pitches they throw and the days of rest they should have between outings, based on the number of pitches they throw in a game," Fry says. "Once the pitch counts are known for a certain age group, coaches need to follow the guidelines. During games, an assistant coach can easily track pitches with a hand held 'pitch count' app or the old-fashioned way, with pen and paper."


For example, how much should an 11-year-old pitcher throw? According to the Pitch Smart guidelines, a pitcher should not throw more than 85 pitches in one day. Further, if he throws those 85 pitches in a tournament start and the coach wants to use him in relief the next day, Pitch Smart indicates he should have four days of rest before pitching again and should not be used the rest of the tournament.


Pitch Smart provides pitch count and rest recommendations for pitchers from 9 to 18 years old and also makes suggestions for between-start and off-season pitcher behavior. For example, the 11-year-old mentioned previously should avoid playing for multiple teams at the same time, resist the urge to throw curve balls and take four months off from throwing each year.


Fry also stresses the importance of proper pitching mechanics, which are best established when players are first learning to pitch. One practice drill he favors when working with young pitchers on the mound at the Throwers Clinic is holding the balance point - the point when the pitcher's knee is at its peak, just before making the transition toward home plate.


"Balance is paramount to unfurling the pitching motion properly and holding that balance point demonstrates effective balance. If they're off-balance, it can affect the whole kinetic chain as they're delivering the baseball," Fry says.


Fry also uses video analysis to study the pitcher's arm path to make sure pitchers achieve a "90-90" position. When their plant foot touches the ground, their arm should be at a 90-degree angle from their bodies with their elbow at shoulder height and bent at close to 90 degrees. Problems can also arise from an erratic target line, which should be a straight line from the center of the pitching rubber to the center of home plate.


"We're finding kids step off the target line and have to adjust their bodies accordingly to get the ball to go straight," he says. "They're throwing across themselves and can't use their legs as much as they should, which increases the stress to the upper body and makes it more difficult to throw strikes."


Rest, of course, is prescribed for tired arms, but Fry advocates for an active rest.


“We'll scale down their throwing and put them in positions where they don't throw as much or as far. They're still being active, but not throwing as much."

Date Published: 05/21/2015

News tag(s):  sports

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