Longitudinal study of elbow and shoulder pain in youth baseball pitchers

Abstract

Arm complaints are common, with nearly half of the subjects reporting pain. The factors associated with elbow and shoulder pain were different, suggesting differing etiologies. Developmental factors may be important in both. To lower the risk of pain at both locations, young pitchers probably should not throw more than 75 pitches in a game. Other recommendations are to remove pitchers from a game if they demonstrate arm fatigue and limit pitching in nonleague games.

Baseball Injuries

“…Overall, the rates of injury in youth and high school baseball are lower than other sports played by children and adolescents, but they still represent a significant cause of injury and potential long-term disability among the participants [18], particularly among pitchers [19][20][21][22][23][24][25][26][27][28].…”

“…Furthermore, continued overuse is believed to eventually result in serious injury or arm-related disability in some pitchers [18]. Table 2 summarizes the findings of studies of elbow and shoulder injury in pitchers published between 1965 and 2002 [19][20][21][22][23][24][25][26][27][28]. In 1965, Adams conducted the seminal epidemiologic study on this issue [19].…”

“…The frequency of arm pain was highest in pitchers. Subsequent studies of American youth and high school players have demonstrated a prevalence of elbow pain between 18 and 29% [22,24,27,28] and an incidence of elbow pain of 26% among youth players and 58% among high school players [20,21,23,25,26]. Shoulder pain has not been studied as frequently with a prevalence of 29% in single study of 9-18-year-old boys [28] and an incidence of 32-35% in two recent studies by Lyman et al [25,26].…”

“…Two recent studies found incidence rates of self-reported elbow pain in more than 25% of pitchers and self-reported shoulder pain in more than 30% of pitchers [25,26]. These studies used a prospective design with pitcher interviews occurring after each game pitched, improving on previous designs in which pitchers were interviewed only after the tournament or season was completed.…”

“…The incidence of elbow and shoulder injury in youth baseball has been estimated at 26-35 per 100 pitchers per season [25,26]. The definition of injury in these studies has usually been 'pain' in the elbow or shoulder during or after pitching.…”