Q. My son is a pitcher for a little league baseball team. How often can he pitch, and how many pitches should he be allowed to throw, so he doesn’t hurt his arm?
A. While the strength and skill required to become a successful pitcher are developed through repetition, excessive pitching is a potential source of serious joint injury. A significant relationship is seen between the number of pitches thrown and the risk of shoulder and elbow pain in youth baseball.
Guidelines have been established to minimize the risk of overuse. Pitch counts, and the types of pitches thrown, vary by age. The USA Baseball Medical & Safety Advisory Committee guidelines recommend a limit of 75 pitches per game, 100 pitches per week, 1,000 pitches per season, and 3,000 pitches per year in the 11- to 12-year-old age group. This does not include throws from other positions, instructional pitching or throwing drills.
Youth pitchers should avoid throwing breaking balls due to an increased risk of shoulder and elbow pain. Additionally, pitchers should be prohibited from returning to the mound once they have been removed for the game. Finally, the athlete should be monitored closely for signs or symptoms of pain. Any pitcher who complains or shows signs of arm pain during a game should be removed from pitching. Medical evaluation is advised if the pain persists beyond four days or if pain recurs immediately the next time he/she pitches.