The Youth and Adolescent Thrower: Tips to Avoid Elbow Pain

December 28, 2020
The Youth and Adolescent Thrower: Tips to Avoid Elbow Pain

As the weather will start to become warmer, many youth and adolescent athletes will begin to get back in shape for the upcoming baseball and softball seasons.  I want to help you understand why so many baseball and softball players get medial or inside elbow pain during their seasons or while training for a season. I also want to give some tips on how to avoid these injuries.

More and more youth and adolescent athletes have begun to play their favorite sport and train for it year-round, and this is especially true for baseball and softball.  By technique, the overhead throwing motion is unnatural and places an exorbitant amount of stress across the stabilizing structures of the medial elbow even when performed with perfect technique. Every time a pitch is thrown the stresses that cross the medial elbow structures, structures such as Ulnar collateral ligament, are near the physiologic limit. Needless to say, overusing the throwing arm will cause micro-tears in these medial structures which eventually can lead to failure.  Since the year 2000, medial elbow ligament reconstructive surgery (Tommy John procedure) has increased by six times, largely due to overuse. Baseball players are playing year-round and not taking enough rest, in fact, the turn of the century adolescent pitcher is now an MLB pitcher.  Explains the records for the number of Tommy John surgeries performed during recent MLB seasons.

What are ways to avoid overusing the throwing arm to prevent failure of the medial elbow structures? In 2012 The American Sports Medicine Institute released guidelines to reduce these injuries:

  1. Proper mechanics, good core/abdominal strength, and leg strength
  2. No Competitive Baseball for at least 4 months
  3. Follow Pitch Count and Rest Days (graph below)
  4. Avoid pitching on multiple teams with overlapping seasons
  5. Not playing both pitcher and catcher
  6. Discontinue Pitching if Pain is felt.