Factors That Contribute to Throwing Injuries in Youth Athletes


Odds are if you’re a baseball fan, you likely have a favorite pitcher. Watching a pitcher wind up, check the bases, and hurtle a ball toward home plate can be captivating. And if you’re the one pitching, it can feel even more exhilarating.

What happens when a pitching arm starts to hurt? Of the approximately 15 million children and adults playing baseball, 26 percent of youth pitchers and 58 percent of high school pitchers experience elbow pain.

The “thrower’s paradox” happens because the pitching motion is one of the most mechanically violent movements in all of sports. It’s no surprise that baseball injuries are on the rise. The majority of these injuries to throwing athletes are due to overuse. The repeated stress on a pitcher’s shoulders and elbows can lead to injuries that—if not treated—can become permanent or may require surgery.

Risk factors that contribute to throwing injuries

The good news is throwing injuries can be prevented and treated. But it’s first important to know whether a youth athlete is at risk for a throwing injury. These are just a few of the factors that may put a youth throwing athlete at risk:

  1. Pitching while fatigued — Teen pitchers who have had elbow or shoulder surgery are 36 times more likely to have routinely pitched while their arms were fatigued.
  1. Throwing too many innings over the course of a year — Youth pitchers are 3.5 times more likely to be injured if they have pitched more than 100 innings in at least one year.
  1. Not taking enough time off from baseball each year — Competitive pitching for more than 8 months increases the chance of surgery by 5 times.
  1. Throwing too many pitches and not getting enough rest — Pitch count programs have been shown to reduce risk of shoulder injury by 50 percent.
  1. Pitching on consecutive days — Youth pitchers are 2.5 times more likely to develop arm pain, regardless of pitch count, if they pitch on consecutive days.
  1. Excess throwing when not pitching — A pitcher should not be a catcher for their team. This increases the risk of major arm injury by 2.7 times.
  1. Playing for multiple teams at the same time — It is more difficult to monitor pitch limits and get enough rest when pitchers play for multiple teams.
  1. Pitching with injuries to other body regions — Any small injury can affect a player’s biomechanics. This can change the way they throw and place more stress on the arm.
  1. Not following proper strength and conditioning routines — The lower body, core, upper back, and shoulder should all be in good condition. One muscle group affects the other.
  1. Not following safe practices while at showcases — Pitchers should practice safe throwing while at offseason and avoid overthrowing.
  1. Throwing curveballs and sliders at a young age — The change-up is the safest pitch to throw. Youth pitchers are at 86% increased risk of elbow pain when throwing sliders.
  1. Radar gun use — The faster velocity that radar guns encourage can make pitchers overthrow beyond their comfort level.

With proper technique, rest, and listening to your body when it is fatigued or sore, throwing injuries can be prevented. Talk to an orthopedic specialist if a throwing athlete is starting to experience signs of an overuse injury.

Most throwing injuries are treatable without surgery if they are diagnosed early.