Is Pitch Count in Baseball Enough?

In the last couple of decades there have been some trends in baseball, some healthy and some arguably not. A healthy trend that spans all levels of baseball from little through major leagues is the awareness of overuse with pitching, and utilizing pitch counts to help protect athletes’ arms. I can tell you from my “n of 1” experience, this was not a tool often employed in the 90s and early 2000s. In my youth, arm care wasn’t popular, and I had a period of having my own shoulder issues.

After years of research, in 2006 Little League began its Pitch Count Program with specific rules determined by age in an attempt to save younger throwers from ailments such as “little leaguers elbow” and “little leaguers shoulder” – injuries common enough in adolescent throwers to earn themselves medical diagnoses.

While managing pitch count is making progress in the right direction, there are other trends in baseball that are also taking off including the boom of youth travel sports. A majority of youth baseball and softball athletes that come into our WellSport clinic are not only playing for their typical little league or high school teams, they are also playing on travel teams. With the pressures of travel sports, we’ve seen sport specialization at very young ages. An interesting in-depth look on this specific topic can be found at the American Orthopedic Society for Sports Medicine. While sport specialization and travel sports have been shown to increase injury risk from overuse with overlapping or extended seasons and a lack of diversity in movement patterns, we must look even harder at individual player management.

Pitch count management has some shortcomings in application. Too often players on multiple teams are managed by a coach for that team alone, regardless of whether an athlete pitched in a travel game over the weekend. This leaves pitch count and/or rest periods at the mercy of those managing them. Athletes are prone to overuse when mismanaged.

With pitch count programs doing their best and the growth of youth travel sports exponential, it begs the question: what else can we do to protect our throwing athletes? As a physical therapist specializing in the biomechanics of throwing, my answer is to focus on correcting the mechanical deficits in the throwing motion that are known to contribute to stress on the ulnar collateral ligament, as well as rotator cuff tendinopathies and labral pathologies in the shoulder. The best way to go about preventing these issues is to get ahead of them with video analysis of the throwing mechanics which allow therapists to look for mechanical deficiencies that correlate to future injury. With analysis, we can prescribe the appropriate interventions for an athlete, putting them in more optimal positions for injury prevention while maximizing mechanical efficiency. With improved throwing mechanics within an acceptable bandwidth of arm positions throughout the throw, we can both reduce risk of injury and improve velocity for the same effort applied.

If you are a coach or parent of a thrower, keep these three things in mind:

1. Ensure pitch count is managed appropriately for your player, especially with respect to playing on multiple teams. It is only effective as an injury prevention tool if used well.
2. Understand that throwing injuries can happen with overuse especially with the growth and prioritization of youth sport specialization. Any player on the field is at risk for injury with a lack of off-seasons and/or diversity in movement patterns.
3. Focus on arm care and optimal throwing mechanics for injury prevention and improved performance for players specializing in throwing sports.

If you’re seeking guidance to best care for your athlete, reach out to us for a sports performance evaluation at (989) 837-9100 or visit our WellSport evaluation services page on the web: Sports Performance Evaluation Services | MyMichigan Health.

Chad Neal, P.T., D.P.T., O.C.S., is a physical therapist and orthopedic clinical specialist with MyMichigan Rehabilitation Services located in Midland.