 Pitch Counts
 Shoulder/Elbow Anatomy
 Risks for Injury
 Medical Care
 Injury Prevention
 Rehabilitation
 Return to Sport
 Training
 9 Months
 3 months of NO throwing
REST, Conditioning, Rehab, Preparation
 Two Major Studies
 1996 USA Baseball Medical & Advisory
Committee
 Expert Survey
 2002 American Journal of Sports Medicine
Study
 Epidemiological Study
 2002 Study; American
Journal of Sports Medicine
 476 baseball pitchers ages 914 followed x1 season
 Pre-season and Post-season
Questionaires
 Types of pitches
 Stiffness and pain in elbow
and shoulder
 Injury and Performance
interviews following each
game
 Pitch count logs
 Video analysis of pitching
mechanics
 50% reports elbow or shoulder pain
at least once during the season
 Pitchers who threw sliders were
86% more likely to experience
elbow pain during the season
 Pitchers who threw curve balls were
56% more likely to experience
shoulder pain during season
 Pitchers who threw change-ups
were 12% less likely to experience
elbow pain and 29% less likely to
experience shoulder pain during
season
 As pitch counts increased, the
number of shoulder and elbow
pain cases increased
 The incidence of elbow and
shoulder pain increased with
the number of pitches thrown in
a season
 LISTEN and REACT to complaints of arm
pain
 A pitcher who complains or shows arm pain
during a game should be removed
immediately
 Medical Attention:
 Pain not relieved in 4 days
 Recurs immediately upon return to throwing




GAME: 50
WEEK: 75
SEASON: 1000
YEAR: 2000




GAME: 75
WEEK: 100
SEASON: 1000
YEAR: 3000




GAME: 75
WEEK: 125
SEASON: 1000
YEAR: 3000
 GAME Pitch Count
 Warm up pitches
 No breaking pitches until bones mature
 13 years old
 FOCUS: Good Mechanics and Control
 NO MORE than 9 Months of Competition
 Pitch Count, Pitch Count, PITCH COUNT




OVERUSE
Showcases
Playing year round
Improper Activity to Rest Ratio
 Poor Shoulder ROM/Flexibility
 Poor Elbow ROM/Flexibility
Kids who required surgery TWICE as many
pitches as those who did not….
After ONE game pitchers loose some shoulder
and elbow range of motion
 Number of pitches
 History of previous injury to area
 Games
 In-season
 Painful
 Off Season
 Warm Up: Full Body and Shoulder
 NOT all throwing
 Pitch Counts
 COUNT full speed, warm up pitches/throws
 Limit between inning warm up throws
 Post Game Stretching: Elbow and Shoulder
 Flexibility post throwing (ALL Positions)
 Light shoulder exercises
 Mix Up Demands, Practice, and Training
Consequences: Devastating
 “Elbow Pain”
 Torn UCL = Tommy John Surgery
 Shoulder Pain, “Little Leaguers Shoulder”
 Fracture of Humerus
 Pain greater 3-4 days
 Pain immediately returns
 Unable to walk (weight bear) >3-4 steps
 Pain is getting significantly worse
 Not improved with rest
REFER THEM
OUT
 Less often, less weight in season
 Make a part of practice at least in pre-season
 NOT TO FATIGUE
 3 sets of 8-12
 Slow, good control, EXCELLENT form
http://www.mikereinold.com/2010/05/little-league-injury-prevention-program.html
 Lower Body Strength, Power, Control &
Balance
 Single Leg Balance
 Lunge
 Squats
 Core Strength & Control
 Lower Body Flexibility
 Higher Level Shoulder Exercises
 RELATIVE REST > NO THROWING
 Strengthen small stabilizers of shoulder and
shoulder blade
 Total Body conditioning including strength
and resistance
Baseball Players CAN and SHOULD lift
weights
http://www.mikereinold.com/2009/04/littleleague-pitching-injuries.html
Curveballs:
http://www.mikereinold.com/2009/08/isthrowing-curveball-dangerous-to-our.html
Youth
Injuries:http://www.mikereinold.com/2012/02/
the-real-reason-why-there-are-so-manyyouth-pitching-injuries.html
 http://www.ericcressey.com/baseball-content
 http://www.asmi.org/asmiweb/usabaseball.ht
m
 Effect of pitch type, pitch count, and
pitching mechanics on risk of elbow and
shoulder pain in youth baseball pitchers.
Am J Sports Med. 2002 Jul-Aug;30(4):463-8.
Lyman S, Fleisig GS, Andrews JR, Osinski
ED.