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Keeping Our Pitchers Safe

January 01, 2019

By Amberle Phillips, MA, ATC, SCAT

Early sport specialization is becoming a new normal for many young athletes today. Children are expected to choose their “forever sport” and stick with it year-round to develop their skills and become proficient earlier in their careers. This not only increases chances for burnout, it also increases the risk of injury.

Baseball is the sport where we see the majority of these early adopters. Specifically, baseball pitchers have the highest incidence of early specialization. Dangerous pitches like the curveball and the slider have been shown to increase risk for little leaguer elbow, and little leaguer shoulder. Many of these conditions seen in adolescent pitchers are caused by skeletal immaturity. The child’s bones have not finished growing and the growth plate has not closed, hence, increasing the risk for injury to these areas. The mechanics of throwing play a crucial role for injury rates in baseball athletes aged 9-14, according to a 2008 study. The increased forces placed on these weak soft spots in bones that have not finished developing cause many of the injuries we see in adolescent pitchers. Proper throwing mechanics and waiting to introduce riskier pitches until the athlete is skeletally mature are ways to help minimize injury risks.

Pitch counts are an important factor to take into account with baseball pitchers. USA Baseball and Little League Baseball are governing bodies that have different sets of suggested pitch counts based on age. These pitch counts are a way to track the number of pitches thrown as well as the required number of days of rest to help prevent injury. These pitch counts need to be monitored closely by coaches and parents. If a child is playing for more than one team, say a travel ball team and their school team, these pitch counts need to be updated and followed between the different organizations so that adequate rest is achieved. Coaches and parents need to be vigilant with the player and keep track of pitch counts to keep our athletes safe.

USA Baseball in conjunction with Major League Baseball has developed the Pitch Smart Program which outlines recommendations for pitch counts and days of rest for pitchers ages 7 to 22 year-old:

Pitch Count Limits and Required Rest Recommendations

It is important for each league to set workload limits for their pitchers to limit the likelihood of pitching with fatigue. Research has shown that pitch counts are the most accurate and effective means of doing so. See required rest recommendations below.

Age Daily Max (Pitches in game 0 Days Rest 1 Days Rest 2 Days Rest 3 Days Rest 4 Days Rest 5 Days Rest
7-8 50 1-20 21-35   36-50 N/A N/A N/A
9-10 75 1-20
21-35  36-50 51-65 66+ N/A
11-12 85 1-20 21-35  36-50 51-65 66+ N/A
13-14 95 1-20 21-35  36-50 51-65 66+ N/A
15-16 95 1-30 31-45  46-60 61-75 76+ N/A
17-18 105 1-30 31-45  46-60 61-80 81+ N/A
19-22 120 1-30  31-45   46-60 61-80 81-105 106+

For more information on the Pitch Smart Program and specific details per age group go to:

As an Athletic Trainer I think we need to help be a voice for our athletes and to talk about the importance of rest. Overuse injuries can be a long road to come back from mid-season when a day or two off may help to calm down the inflammation and irritation from the game the night before.


Leonard, J., & Hutchinson, M. (2010). Shoulder Injuries in Skeletally Immature Throwers: Review and Current Thoughts. British journal of Sports Medicine, 44(5), 306-310. doi: 10.1136/bjsm.2009.062588

Marsh, D. (2010). Little League Elbow: Risk Factors and Prevention Strategies. Strength & Conditioning Journal (Lippincott Williams & Wilkins), 32(6), 22-37.