Medial Apophysitis (Little Leaguer's Elbow)
This injury occurs when repetitive throwing creates an excessively strong pull on the tendons and ligaments of the elbow. The young player feels pain at the knobby bump on the inside of the elbow.
"Little Leaguer's elbow" can be serious if it becomes aggravated. Repeated pulling can tear ligaments and tendons away from the bone. The tearing may pull tiny bone fragments with it in the same way a plant takes soil with it when it is uprooted. This can disrupt normal bone growth, resulting in deformity.
This injury occurs when repetitive throwing creates an excessively strong pull on the tendons and ligaments of the elbow. The young player feels pain at the knobby bump on the inside of the elbow.
"Little Leaguer's elbow" can be serious if it becomes aggravated. Repeated pulling can tear ligaments and tendons away from the bone. The tearing may pull tiny bone fragments with it in the same way a plant takes soil with it when it is uprooted. This can disrupt normal bone growth, resulting in deformity.Osteochondritis Dissecans
A less common condition called osteochondritis dissecans is also caused by excessive throwing, and may be the source of the pain on the outside of the elbow. Muscles work in pairs. In the elbow, if there is pulling on one side, there is pushing on the other side. As the elbow is compressed, the joint smashes immature bones together. This can loosen or fragment the bone and cartilage. The resulting condition is called osteochondritis dissecans.
Howdy All!
I attended a scheduling meeting for my 8U / 9U youth baseball team a few weeks ago. These meetings are spectacles in their own right...A mix of testosterone ridden blow-harding about this team or that, about who will dominate...usually amusing but not typically fodder for a blog. Unitl this happened.
We are in the middle of an intriguing discussion about how many rainout weekends we will have available for rescheduling and one coach stops the conversation dead in its track:
Coach: "Wait a minute guys, I have a question about the pitching rules"
Coordinator: "OK"
Coach: "If my son pitches three innings in a 9U game and then has a 10U game right after it, can he pitch another 3 innings"
--Insert Awkward Delay--
Me: "Do you really have a boy that can throw 6 innings in a day?"
Coach: (Slightly annoyed) "Yes"
Me: "Really???"
Coach: (More annoyed) "Yes"
Me: "Ok...whatever."
This highlights one of the HUGE problems plaguing "Daddy-ball" in youth baseball. While this man's son may be an excellent pitcher, WHY would you ever want to put one 9 year old on the mound for 3-6 innings in a game?
According to the American Academy of Orthopedic Surgeons, the two most common injury's in youth baseball are Medial Apophysitis and Osteochonsritis Dissecans.
Both of these injuries are chronic in youth baseball. A groundbreaking retrospective study by James Andrews, MD and Glen Fleisig, PhD of the American Sports Medicine Institute, "Prevention of Elbow Injuries in Youth Baseball Pitchers" found:
"The majority of baseball elbow injuries are noncontact injuries to the dominant arm resulting from repetitive pitching. Five percent of youth pitchers suffer a serious elbow or shoulder injury (requiring surgery or retirement from baseball) within 10 years. The risk factor with the strongest correlation to injury is amount of pitching. Specifically, increased pitches per game, innings pitched per season, and months pitched per year are all associated with increased risk of elbow injury. Pitching while fatigued and pitching for concurrent teams are also associated with increased risk. Pitchers who also play catcher have an increased injury risk, perhaps due to the quantity of throws playing catcher adds to the athlete’s arm. Another risk factor is poor pitching biomechanics. Improper biomechanics may increase the torque and force produced about the elbow during each pitch. Although throwing breaking pitches at a young age has been suggested as a risk factor, existing clinical, epidemiologic, and biomechanical data do not support this claim."
The study points out that it was estimated that 5.7 million children play baseball annually annually (kindergarten through 8th grade). The math is a little fuzzy as not every boy pitches, but we are still talking about THOUSANDS of surgeries over a 10 year period.
HOW CAN WE STOP THESE UNNECESSARY INJURIES????
SOLUTION: If we coach to develop players and not to win trophies at early ages then this likely never occurs on your team.
REALITY: Most coaches, teams, clubs, associations, and frankly a lot of parents do not have the bravery to institute common sense pitching regulations that will protect the arms of our youth players and inevitably allow more boys to learn and experience the art and fun of pitching.
Everyone is turning a blind eye to the problem!
WHAT CAN YOU DO?
At the end of this communication, I will post the pitch counts recommended by Dr. Andrews and his colleagues...What you can do is this:
KEEP TALKING ABOUT IT!
If you see a coach working a 8 year old for 40+ pitches in a game, pitching 5 innings in a tournament game, pitching for the 3rd straight day....
GO UP TO THEM AND ASK THEM "WHY?"
GO TO THE PARENTS AND ASK THEM IF THEY ARE COMFORTABLE WITH THEIR 9 YEAR OLD PITCHING THAT MUCH.
ASK YOUR OWN COACH IF HE HAS A PITCHING PLAN IN PLACE.
ASK YOUR ASSOCIATION OR CLUB TO CONSIDER MANDATORY PITCH COUNTS AND DAYS OF REST!
Here are ASMI's Pitch Count Rules:
A less common condition called osteochondritis dissecans is also caused by excessive throwing, and may be the source of the pain on the outside of the elbow. Muscles work in pairs. In the elbow, if there is pulling on one side, there is pushing on the other side. As the elbow is compressed, the joint smashes immature bones together. This can loosen or fragment the bone and cartilage. The resulting condition is called osteochondritis dissecans.
I attended a scheduling meeting for my 8U / 9U youth baseball team a few weeks ago. These meetings are spectacles in their own right...A mix of testosterone ridden blow-harding about this team or that, about who will dominate...usually amusing but not typically fodder for a blog. Unitl this happened.
We are in the middle of an intriguing discussion about how many rainout weekends we will have available for rescheduling and one coach stops the conversation dead in its track:
Coach: "Wait a minute guys, I have a question about the pitching rules"
Coordinator: "OK"
Coach: "If my son pitches three innings in a 9U game and then has a 10U game right after it, can he pitch another 3 innings"
--Insert Awkward Delay--
Me: "Do you really have a boy that can throw 6 innings in a day?"
Coach: (Slightly annoyed) "Yes"
Me: "Really???"
Coach: (More annoyed) "Yes"
Me: "Ok...whatever."
This highlights one of the HUGE problems plaguing "Daddy-ball" in youth baseball. While this man's son may be an excellent pitcher, WHY would you ever want to put one 9 year old on the mound for 3-6 innings in a game?
According to the American Academy of Orthopedic Surgeons, the two most common injury's in youth baseball are Medial Apophysitis and Osteochonsritis Dissecans.
Both of these injuries are chronic in youth baseball. A groundbreaking retrospective study by James Andrews, MD and Glen Fleisig, PhD of the American Sports Medicine Institute, "Prevention of Elbow Injuries in Youth Baseball Pitchers" found:
"The majority of baseball elbow injuries are noncontact injuries to the dominant arm resulting from repetitive pitching. Five percent of youth pitchers suffer a serious elbow or shoulder injury (requiring surgery or retirement from baseball) within 10 years. The risk factor with the strongest correlation to injury is amount of pitching. Specifically, increased pitches per game, innings pitched per season, and months pitched per year are all associated with increased risk of elbow injury. Pitching while fatigued and pitching for concurrent teams are also associated with increased risk. Pitchers who also play catcher have an increased injury risk, perhaps due to the quantity of throws playing catcher adds to the athlete’s arm. Another risk factor is poor pitching biomechanics. Improper biomechanics may increase the torque and force produced about the elbow during each pitch. Although throwing breaking pitches at a young age has been suggested as a risk factor, existing clinical, epidemiologic, and biomechanical data do not support this claim."
The study points out that it was estimated that 5.7 million children play baseball annually annually (kindergarten through 8th grade). The math is a little fuzzy as not every boy pitches, but we are still talking about THOUSANDS of surgeries over a 10 year period.
HOW CAN WE STOP THESE UNNECESSARY INJURIES????
SOLUTION: If we coach to develop players and not to win trophies at early ages then this likely never occurs on your team.
REALITY: Most coaches, teams, clubs, associations, and frankly a lot of parents do not have the bravery to institute common sense pitching regulations that will protect the arms of our youth players and inevitably allow more boys to learn and experience the art and fun of pitching.
Everyone is turning a blind eye to the problem!
WHAT CAN YOU DO?
At the end of this communication, I will post the pitch counts recommended by Dr. Andrews and his colleagues...What you can do is this:
KEEP TALKING ABOUT IT!
If you see a coach working a 8 year old for 40+ pitches in a game, pitching 5 innings in a tournament game, pitching for the 3rd straight day....
GO UP TO THEM AND ASK THEM "WHY?"
GO TO THE PARENTS AND ASK THEM IF THEY ARE COMFORTABLE WITH THEIR 9 YEAR OLD PITCHING THAT MUCH.
ASK YOUR OWN COACH IF HE HAS A PITCHING PLAN IN PLACE.
ASK YOUR ASSOCIATION OR CLUB TO CONSIDER MANDATORY PITCH COUNTS AND DAYS OF REST!
Here are ASMI's Pitch Count Rules:
Pitch Counts
Age Max. Pitches
Per Game Max. Games
Per Week 8-10 52 2 11-12 68 2 13-14 76 2 15-16 91 2 17-18 106 2
| Age | Max. Pitches Per Game | Max. Games Per Week |
| 8-10 | 52 | 2 |
| 11-12 | 68 | 2 |
| 13-14 | 76 | 2 |
| 15-16 | 91 | 2 |
| 17-18 | 106 | 2 |
Recovery Times
Age 1 Day Rest 2 Day Rest 3 Day Rest 4 Day Rest 8-10 21 34 43 51 11-12 27 35 55 58 13-14 30 36 56 70 15-16 25 38 62 77 17-18 27 45 62 89
LETS MAKE A DIFFERENCE!
| Age | 1 Day Rest | 2 Day Rest | 3 Day Rest | 4 Day Rest |
| 8-10 | 21 | 34 | 43 | 51 |
| 11-12 | 27 | 35 | 55 | 58 |
| 13-14 | 30 | 36 | 56 | 70 |
| 15-16 | 25 | 38 | 62 | 77 |
| 17-18 | 27 | 45 | 62 | 89 |
LETS MAKE A DIFFERENCE!
Fleisig GS, Andrews JR. Prevention of Elbow Injuries in Youth Baseball Pitchers. Sports Health 2012;4(5):419-424. doi:10.1177/1941738112454828.
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