Overuse Injuries Are Rising in Youth Baseball — Docs Warn We Should Do More to Stop It

Youth baseball players are especially vulnerable to overuse injuries due to how rapidly their bodies are growing and changing. Although there are rules in place to help protect these young athletes, some sports medicine physicians say that not enough is being done.

In a new paper published in the Clinical Journal of Sport Medicine, lead author Jason Zaremski, M.D., director of the University of Florida Health Throwing Clinic, says that orthopedic clinics across the United States have been seeing an increase of pitching injuries in kids. 

In particular, cases of ulnar collateral ligament (UCL) tears — a common, yet serious, elbow injury — in pitchers have been climbing, with some larger sports medicine clinics seeing a 20% increase in UCL surgeries, commonly referred to as “Tommy John surgeries,” since 2006.

Over the summer, MLB phenomenon Shohei Ohtani, who plays for the Los Angeles Angels and is one of the league’s best pitchers and hitters, was sidelined when he tore his UCL and had to undergo surgery for the injury.

But these injuries aren’t just happening in professional athletes anymore. Studies reveal they’re a growing issue among athletes in junior high and high school.

This warrants the attention of youth baseball officials, Dr. Zaremski warns.

“As you look at large-scale studies, it is clear the injury rates, particularly at the high school level and younger, are not decreasing,” Dr. Zaremski noted in a release. “So, there’s something we’re missing.”

Due to how much they throw, pitchers are especially susceptible to UCL tears, which typically require surgery and can sideline a player for up to a year. 

As such, there are rules put in place meant to prevent these and other injuries at both the professional and recreational youth level. The rules limit how many pitches a player can throw in a game and require subsequent days of rest that correlate with how many pitches were thrown in a single showing.

Major League Baseball, USA Baseball and Little League Baseball all implement pitch count rules. Despite this, overuse injuries of the elbow have not fallen.

Dr. Zaremski suggests that the increase in injuries could be, in part, due to the emphasis being placed on pitch speed. Pitchers who throw harder put more stress on their arm.

“You can see it on the major league, collegiate and now high school levels,” he said. “You see professional baseball pitchers and some in college who are regularly throwing 100 miles per hour now. You never heard of that before except for maybe a few elite pitchers.”

He says that although the pitch count rules are well-intentioned, it’s time to explore other factors that could contribute to overuse injuries.

He and a team of sports medicine experts from Harvard and Emory universities are recommending changes to the pitch count rules currently in place for junior and high school students. 

Some of those changes include:

Dr. Zaremski acknowledges that the adjustments will not eliminate the problem entirely, but is optimistic that it could help reduce the amount of overuse injuries being seen in youth athletes.