Basic guidelines to help young baseball pitchers stay healthy

Baseball season has arrived, but no matter how eager young players are to get on the diamond they have to keep from overdoing it - especially if they're pitchers.

Overhand pitching creates great forces, stresses and strains at both the elbow and shoulder. In most children up to age 16, bones, muscles and connective tissues are not fully developed, so it should come as no surprise that the pitching motion can lead to injury if it is performed too frequently.

"Parents may find it difficult to put limits on any activity that a child is good at and enjoys performing," said Michael T. Freehill, M.D., assistant professor of orthopaedics at Wake Forest Baptist Medical Center. "But when it comes to pitching, the surest way to ruin a young athlete's chances of success is to allow him or her to overdo it."

Fortunately, overuse injuries are preventable. Following some basic guidelines can help young baseball pitchers stay healthy.
● Young pitchers should always warm up properly by stretching and running before throwing. Throwing should begin with easy tosses, with gradual increases in distance, then intensity.
● Youngsters should concentrate on age-appropriate pitching skills. The emphasis should be on control, accuracy and good mechanics, not curveballs and velocity.
● Tracking the number of pitches thrown is important. Staying within age-specific pitch-count limits, such as those established by Little League Baseball, is recommended.
● Proper rest periods between pitching sessions should be observed. Youngsters can still play during these rest periods, but only at positions other than pitcher and catcher.
● Children should not pitch for multiple teams with overlapping schedules or play baseball year-round.
● Children should never pitch when it hurts. They must understand that telling a parent or coach is the right thing to do if they experience discomfort while throwing.

"Following these guidelines may force a young pitcher to sit out a few innings or miss a few pitching opportunities during the season," said Freehill, who pitched in the minor leagues before attending medical school, reaching the AAA level with two different organizations and making it onto the 40-man roster of the Anaheim (now Los Angeles) Angels. "However, that's a small price to pay for keeping our kids healthy and giving them their best shot at success over the long run."