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We are an out-of-network practice focused on delivering individualized, concierge-level orthopedic care.
Injuries in young athletes are on the rise, but elbow and shoulder injuries in children are on the verge of becoming an epidemic. Thousands of children are seen each year complaining of elbow or shoulder pain. Damage or tear to the ulnar collateral ligament (UCL) is the most common injury suffered and is often caused by pitchers throwing too much. This ligament is the main stabilizer of the elbow for the motions of pitching. When it becomes damaged, it can be difficult to repair and rehabilitate.
Overuse injuries — especially those related to the UCL and shoulder — are preventable. Some tips to keep you in the game throughout your life include:
| Age | Pitches / Game |
|---|---|
| 7–8 | 50 |
| 9–10 | 75 |
| 11–12 | 85 |
| 13–16 | 95 |
| 17–18 | 105 |
| Ages 14 & Under | Ages 15–18 | Required Rest |
|---|---|---|
| 66+ | 76+ | 4 calendar days |
| 51–65 | 61–75 | 3 calendar days |
| 36–50 | 46–60 | 2 calendar days |
| 21–35 | 31–45 | 1 calendar day |
| 1–20 | 1–30 | None |
| Pitch Type | Recommended Age |
|---|---|
| Fastball | 8 ± 2 |
| Change-up | 10 ± 3 |
| Curveball | 14 ± 2 |
| Knuckleball | 15 ± 3 |
| Forkball | 16 ± 2 |
| Slider | 16 ± 2 |
| Screwball | 17 ± 2 |
The most obvious treatment for overuse is rest, especially from the activity that created the injury. Ice is also used to reduce soreness and inflammation. Ibuprofen can be taken to help with any pain. If symptoms persist, it is critical that a physician be contacted, especially if there is a lack of full-joint motion. An examination and radiographs should be done. An MRI scan may also be helpful.
Usually a simple “rest cure” approach will not be enough, because even though it allows symptoms to subside, it also creates loss of muscle bulk, tone, flexibility, and endurance. Once pain is gone and full motion is present, a throwing rehabilitation program can start.
Under some circumstances, surgery may be necessary to correct a problem. Overuse and stress related problems can affect growing parts of bone, not just the soft tissue
(muscles, tendons, and ligaments). If the condition is not treated, it could cause deformity of the limb and permanent disability. The athlete should return to play only when clearance is granted by a health care professional.
Mary Lloyd Ireland, MD
James R. Andrews, MD
Glenn S. Fleisig, PhD
Prevention and Emergency Management of Youth Baseball and Softball Injuries. American Orthopaedic Society for Sports Medicine. 2005.
Little League Baseball. www.littleleague.org/ Assets/old_assets/media/pitchcount_faq_08.pdf
American Sports Medicine Institute. www.asmi.org
