The Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball Pitchers

The Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball Pitchers

(Lyman et al.; The American Journal of Sports Medicine; 2002)

  • The 476 pitchers (from youth leagues in Alabama) made 3789 pitching appearances during the season. Nearly 7% of all pitching appearances (254 of 3789) resulted in elbow pain, with 28% of all subjects (134 of 476) reporting elbow pain at least once during the season (Table 1). More than 9% of all pitching appearances (353 of 3789) resulted in shoulder pain, with 35% of all subjects (165 of 476) reporting shoulder pain at least once during the season. Overall, almost 15% of all pitching appearances resulted in elbow or shoulder pain, with half (50%) of all subjects reporting elbow or shoulder pain during the season.
  • Only the slider was found to have a statistically significant relationship to elbow pain, with an 86% increase risk of elbow pain among slider users. Meanwhile, use of the curveball accounted for a 52% increase risk of shoulder pain.
  • Use of the change-up was associated with a 12% reduction in the risk of elbow pain and a 29% reduction in the risk of shoulder pain.
  • There was a statistically significant relationship between pitches thrown in season up through a given appearance and risk of elbow pain from that appearance (and a similar trend for shoulder pain).
  • They recommended 75 pitches in a game and 600 pitches in a season for ages 9-14.