This is part one of three part series on throwing injuries.
Risk is part of sports. Some injuries can happen in sports no matter what precautions are taken; however, most throwing injuries to the elbow are preventable. As a sports medicine physician, I hate seeing these injuries because in many cases they can be avoided by following well established guidelines.
Throwing injuries in athletes have been on the rise and are particularly common in baseball players. They are strongly associated with overuse; therefore, the way to avoid an injury from throwing is to not “overuse” the shoulder and elbow. The two biggest contributors to this type of injury are 1) single sport specialization and 2) year round playing of one sport (baseball) combined with travel teams and multiple leagues.
For years, Little League has recognized the importance of limiting the number of pitches that pitchers throw each week and has put pitch counts in place. Major league baseball also recognizes this and closely follows pitch counts. However, we have not had pitch counts at the high school or college level in the state of Michigan.
In the Lakeshore area we put together a group of experts that include area baseball coaches, athletic trainers, athletic directors and physicians to try to address these injuries. Our first focus was to try to get pitch counts implemented across the state at the high school level. We have had success with that and these changes will be happening. It is up to each athlete and parents of young athletes to be an advocate for themselves or their child. Pitch counts are one way to try to protect the throwing arm.
Maximum Pitch Count by Age*
| Age | Daily Maximum |
| 7-8 | 50 |
| 9-10 | 75 |
| 11-12 | 85 |
| 13-16 | 95 |
| 17-18 | 105 |
Required Rest by Age and # of Pitches*
| 14 & under | 15-18 | # of Rest Days Required |
| 66 + | 76 + | 4 calendar days |
| 51–65 | 61–75 | 3 calendar days |
| 36–50 | 46–60 | 2 calendar days |
| 21–35 | 31–45 | 1 calendar day |
| 1-20 | 1–30 | None |
Watch for “Throwing Injuries – Part 2” where I will discuss multiple sport athletes and feature documented opinions of well-known college coaches and professional athletes on that topic. Then in Part 3, I’ll talk about ways of preventing injury, what to do for specific throwing injuries and the importance of expert treatment and follow up care.
Keeping you in the game,
Bruce Stewart, MD