Throwing Injuries in young athletes

Throwing injuries can harm children's bones, muscles, tendons, and ligaments. These injuries most often occur in the shoulders and elbows.

Video: Preventing and rehabilitating throwing injuries in young athletes

Be on the lookout for these symptoms

Signs of a throwing injury may include one or more of the following:

  • Severe and/or constant pain
  • Swelling
  • Decreased arm function
  • Worsened performance, such as decreased accuracy or throwing speed

Evaluation and treatment

Specialists usually will request X-rays of the shoulder or elbow and examine the injured area before recommending treatment. Advanced imaging, such as an MRI, may sometimes be necessary.

Most throwing injuries do not require surgery and will improve on their own if your young athlete takes a break from throwing and other physical activity. Children with severe injuries may need surgery, though. Full recovery may take several weeks or months. Young athletes shouldn’t return to playing sports until their doctor has cleared them for participation.

Preventing throwing injuries

Fortunately, many throwing injuries are preventable. Tell your child to take these precautions:

  • Learn and use proper throwing techniques. Learn fastball and change-up pitching styles first.
  • Before playing, do a full-body warm-up, followed by stretching and slow and steady throwing.
  • Focus on control and accuracy instead of speed.
  • If possible, rotate to other positions on the team — but never directly between pitcher and catcher.
  • Don’t pitch on more than one team with overlapping seasons.
  • Never use a radar gun to measure your pitching speed.
  • Don’t pitch if your arm or shoulder hurts or if your arm is tired.
  • Take a break from throwing for at least a few months a year. Consider limiting sports that involve similar movements, like volleyball, tennis and swimming. These also can stress the shoulders and arms.

Following these pitch-count, pitch-type, and rest guidelines also can help prevent throwing injuries:

Maximum number of pitches per game

Age of athlete  Pitches 
7-8 50 
9-10  75 
11-12  85 
13-16  95 
17-18  105 

Source: Little League Baseball

Pitching styles based on age

Age of athlete*  Pitching style 
8 plus or minus 2 years  Fastball 
10 plus or minus 2 years  Change-up 
14 plus or minus 2 years  Curveball
15 plus or minus 2 years  Knuckleball 
16 plus or minus 2 years  Forkball 
16 plus or minus 2 years  Slider 
17 plus or minus 2 years  Screwball 

  Source: American Sports Institute

* Recommended ages vary based on athletes’ skeletal maturity. Each child’s bones mature at a different rate, so it’s difficult to set an exact age to begin using certain pitching styles. Discuss these guidelines with your child’s doctor.

Required days of rest based on number of pitches per game

Required days of rest  Age 14 and younger  Ages 15 to 18 
More than 66 pitches  76 or more pitches 
3 51-65 pitches  61-75 pitches 
36-50 pitches  46-60 pitches 
21-35 pitches  31-45 pitches 
No rest needed  1-20 pitches  1-30 pitches 

Source: Little League Baseball

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