Pitching injuries in children

by Dr. Matt Swiesz              Image by  Keith Johnston

This is the time of year that we start to see children coming into our office with shoulder and elbow problems from pitching.  It can be from either baseball or softball.  We are right at the point in the season when kids have been pitching for a few weeks and problems start.  Currently my 11 year old son is pitching and he loves it, but he is also aware of what can happen if you over do it.  The repetitive strain of pitching can lead to a variety of different shoulder and elbow issues, some more serious than others.

Elbow Injuries:

The Elbow is put under stress when a child is pitching.  Although the muscles and ligaments may be strong enough to handle it, it’s the developing bone that might be the first to get injured.  This is because developing bones have weak areas called growth plates.  Growth plates are weaker than mature bone since this is the area where growth is occurring.  Therefore this can be the area of the problem.

The  most common growth plate injuries are Little Leaguer’s Elbow ( pain on the inside of the elbow) & Osteochondritis Dissecans (pain on the outside).  Both problems occur from the stress of the pitch damages the growth plate.  Most cases of both types of injuries do not require surgery, but they do require rest.  Do Not Throw In Pain!!

Shoulder Injuries:

The shoulder can undergo the same stress on the joint and growth plate as the elbow.  Little leaguer’s shoulder is when the growth plate at the humerus is affected.  It can become swollen and inflamed. Again, throwing in pain is not advised.  Rest is required for it to heal.

Signs and symptoms

If your child has the following symptoms, he/she should see a doctor:

•    Shoulder pain while throwing
•    Soreness that lasts a few days
•    Slower and less controlled throws than normal
•    Swelling or tenderness near the shoulder

Throwing guidelines

USA Baseball has put together guidelines for how much throwing an athlete should do on a regular basis:

9- to 10-year-old pitchers:	11- to 12-year-old pitchers:	13- to 14-year-old pitchers:
•   50 pitches per game •   75 pitches per week •   1,000 pitches per season •   2,000 pitches per year	•   75 pitches per game •   100 pitches per week •   1,000 pitches per season •   3,000 pitches per year	•   75 pitches per game •   125 pitches per week •   1,000 pitches per season •   3,000 pitches per year

More guidelines have been established in order to ensure proper rest time between pitching as well:

For pitchers age 7 to 16:	For pitchers age 17 to 18:
Pitches in a day               Rest time 61 or more                        4 days 41-60                               3 days 21-40                               2 days 1-20                                 1 day	Pitches in a day             Rest time 76 or more                       4 days 51-75                               3 days 26-50                               2 days 1-25                                 1 day

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history