Effect of pitch type, pitch count, and pitching mechanics on risk of elbow and shoulder pain in youth baseball pitchers

Am J Sports Med. Jul-Aug 2002;30(4):463-8. doi: 10.1177/03635465020300040201.

Abstract

Background: Joint pain is thought to be an early sign of injury to a pitcher.

Objective: To evaluate the association between pitch counts, pitch types, and pitching mechanics and shoulder and elbow pain in young pitchers.

Study design: Prospective cohort study.

Methods: Four hundred and seventy-six young (ages 9 to 14 years) baseball pitchers were followed for one season. Data were collected from pre- and postseason questionnaires, injury and performance interviews after each game, pitch count logs, and video analysis of pitching mechanics. Generalized estimating equations and logistic regression analysis were used.

Results: Half of the subjects experienced elbow or shoulder pain during the season. The curveball was associated with a 52% increased risk of shoulder pain and the slider was associated with an 86% increased risk of elbow pain. There was a significant association between the number of pitches thrown in a game and during the season and the rate of elbow pain and shoulder pain.

Conclusions: Pitchers in this age group should be cautioned about throwing breaking pitches (curveballs and sliders) because of the increased risk of elbow and shoulder pain. Limitations on pitches thrown in a game and in a season can also reduce the risk of pain. Further evaluation of pain and pitching mechanics is necessary.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Baseball / injuries*
  • Baseball / physiology*
  • Biomechanical Phenomena
  • Child
  • Elbow / injuries*
  • Humans
  • Logistic Models
  • Male
  • Prospective Studies
  • Shoulder Injuries*
  • Shoulder Pain