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Protecting Young Arms

Little League managers and coaches are usually quick to teach their players how to get movement on the ball. Unfortunately, the technique older players use is not appropriate for children 13 years old and younger. The snapping of the arm used to develop this technique will most probably lead to serious injuries to the child as he or she matures.

Arm stress during the acceleration phase of throwing affects both the inside and the outside of the growing elbow. On the inside, the structures are subjected to distraction forces, causing them to pull apart. ON the outside, the forces are compressive in nature with different and potentially more serious consequences. The key structures on the inside (or medial) aspect of the elbow include the tendons of the muscles that allow the wrist to flex and the growth plate of the medial epicondyle ("knobby" bone on the inside of the elbow). The forces generated during throwing can cause this growth plate to pull away (avulse) from the main bone, If the distance between the growth plate and the main bone is great enough, surgery is the only option to fix it. This growth plate does not fully adhere to the main bone until age 15!

Similarly, on the outside (or lateral) aspect of the elbow, compressive forces can damage the two bony surfaces during throwing. This scenario can lead to a condition called avascular necrosis or bone cell death as a result of compromise of the local blood flow to that area. This disorder is permanent and often leads to fragments of bone breaking away (loose bodies), which float in the joint and can cause early arthritis.

This loss of elbow motion and function often precludes further participation. Studies demonstrated that curve balls cause most problems at the inside of the elbow due to sudden counteractive forces of the wrist musculature. Fast balls, on the other hand, place more force at the outside of the elbow. Sidearm delivery, in one study, led to elbow injuries in 74% of pitchers with vertical delivery style.

USA Baseball is in the process of finalizing the results of a study by Dr. Glenn Fleisig at the American Sports Medicine Institute that evaluated pitch counts in skeletally immature athletes as they relate to both elbow and shoulder injuries. The study included 500 athletes, ages 9-14, from the Birmingham. Alabama area. Each child who pitched in a game was called after the game and interviewed over the phone. The investigators were able to conduct over 3000 interviews. Approximately 200 of the 500 pitchers had video of their mechanics.

Preliminary data showed the following:

  1. A significantly higher risk of elbow injury occurred after pitchers reached 50 pitches/outing.
  2. A significantly higher risk of shoulder injury occurred after pitchers reached 75 pitches/outing.
  3. In one season, a total of 450 pitches or more led to cumulative injury to the elbow and the shoulder.
  4. The mechanics, whether good or bad, did not lead to an increased incidence of arm injuries.
  5. The preliminary data suggest that throwing curve balls increased risk of injury to the shoulder more so than the elbow; however, subset analysis is being undertaken to investigate whether or not the older children were the pitchers throwing the curve balls.
  6. The pitchers who limited their pitching repertoire to the fastball and change-up had the lowest rate of injury to their throwing arm.
  7. A slider increased the risk of both elbow and shoulder problems.

Pitching and Catching Limits (Baseball)

The information provided below is based directly on official Little League International rules. Information stated here is meant to summarize and emphasize key thresholds. Any conflict or misrepresentation any statements made within official rules or clarifications provided by Little League International is unintended. Please refer to the Little League International Rulebooks for the most precise information.

For player pitch divisions, each team is required to keep track of players' pitch counts and attempt to keep them at a safe level for the child. Managers and Coaches should look to their players' futures and make an effort to protect their elbows against serious injury.

Once the Little League-mandated pitch count thresholds are reached, the pitcher must be removed from the mound. Should that player be inserted back into the lineup, that player may not play the position of catcher if he/she has pitched 41 or more pitches in that game as the number of throws required by a catcher mirrors that of the pitcher.

Ice is universal First Aid treatment for minor sports injuries. Ice controls the pain and swelling. Pitchers should be taught how to ice their arms at the end of a game. If the Manager of Coach is unsure how to do this, he or she can contact an Irmo Little League Board member for further instructions. Children should not be encouraged to "play through the pain." Pain is a warning sign of injury. Ignoring it can lead to greater injury.

Pitch Counts

Player Age Maximum Pitches in a Game
13-14 95
11-12 85
9 75
8 50

Exceptions

If a pitcher reaches the limit imposed for his/her league age while facing a batter, the pitcher may continue to pitch until any one of the following conditions occurs:

  1. That batter reaches base
  2. That batter is put out
  3. The third out is made to complete the half-inning

Days of Rest

Number of Pitches Thrown Days Rest Required
0-20 0
21-35 1
36-50 2
51-65 3
66+ 4

Limits Concerning Catchers

A player that pitches 41 or more pitches in a game CANNOT play catcher in that same game.

A player can catch a maximum of 3 innings if they intend to also pitch in that game; If a player starts a 4th inning as the catcher (even one warm up pitch) they cannot pitch in that game.

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