Youth Baseball Pitch Counts Vastly Underestimate High-effort Throws Throughout a Season

Wahl, Elizabeth P; Pidgeon, Tyler S.; Richard, Marc J.

doi:10.1097/bpo.0000000000001520

Cited by 8 publications

(10 citation statements)

References 12 publications

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“…13 It is also quite common for pitchers to play on more than 1 team and have many high-effort throws throughout a season outside of game pitches, including warm-up pitches and work with pitching coaches. 16 Considering these factors, our study likely underestimates the actual rate of noncompliance with the PSG and risk for injury. Moreover, data were collected on youth baseball teams from a small geographic region during a single summer season, which may limit the generalizability to all youth baseball athletes around the country.…”

Section: Discussionmentioning

confidence: 84%

Pitching Behaviors in Youth Baseball: Comparison With the Pitch Smart Guidelines

Greiner

Trotter

Walczak

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: The Pitch Smart guidelines aim to limit youth baseball pitching behaviors associated with overuse injuries. Despite many youth baseball leagues being compliant with the guidelines, during tournaments, pitch count restrictions or guidelines are often not followed. Purpose: To perform a quantitative analysis of pitch counts in youth baseball players and evaluate compliance with regard to the Pitch Smart guidelines in the tournament setting. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Included in the analysis were 100 youth baseball teams that competed in the 8-and-under to 14-and-under age divisions during the 2019 tournament season. Pitching data were compared with the Pitch Smart guidelines. Violations were identified as (1) exceeding maximum daily pitch count, (2) inadequate rest between pitching events, and (3) pitching more than 1 event on the same day. Pitcher and game factors were analyzed for possible relationships to guideline violations using mixed-effects negative binomial regression models, with comparisons of violations using rate ratios (RRs). Results: Analysis included 1046 pitchers and 2439 games. There were 1866 total Pitch Smart guideline violations, with 48.6% of pitchers having at least 1 violation. Inadequate rest was the most common reason for violation, with noncompliance occurring in 43.3% of pitchers. The highest rate of any violation (0.32 per appearance) occurred in the 8-and-under age division. High-volume pitchers had increased violation rates in each category compared with low-volume pitchers ( P < .001). Violation rates were increased more than twice the rate when pitchers participated in ≥5 consecutive games without a rest day when compared with a single game (RR, 2.48; P < .001). Conclusion: Noncompliance with Pitch Smart guidelines in tournament settings occurred in more than 90% of teams and almost half of all pitchers. Factors associated with noncompliance included younger pitcher age, high-volume pitching, and pitching in multiple consecutive games. Education of tournament directors, coaches, parents, and athletes regarding pitching guidelines is warranted in order to limit the risk of injury.

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Section: Discussionmentioning

confidence: 84%

Pitching Behaviors in Youth Baseball: Comparison With the Pitch Smart Guidelines

Greiner

Trotter

Walczak

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…Although the daily maximum pitch count limit in our study (70 pitches) was lower than that of Erickson et al 4 (85 pitches), there were no statistically significant differences in reduced extension or positive moving valgus stress test results between the IL and CL groups ( Table 2). Our study did not address some issues, including pitches thrown per season, 23,24 bullpen sessions or warm-up throws, 43 days of rest, and showcases. These factors might have affected the results.…”

Section: Discussionmentioning

confidence: 99%

Limiting the Pitch Count in Youth Baseball Pitchers Decreases Elbow Pain

Matsuura

Takata

Iwame

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Reducing the number of pitches thrown is regarded as the most effective way to prevent throwing injuries in youth baseball pitchers. However, few studies have compared the effectiveness of limiting the pitch count versus the limiting the number of innings pitched in terms of elbow injuries. Hypothesis: We hypothesized that, compared with inning limits, pitch count limits would lead to greater decreases in elbow pain, range of motion deficits, positive moving valgus stress test results, and the risk of capitellar osteochondritis dissecans (OCD). Study Design: Cohort study; Level of evidence, 3. Methods: This study retrospectively reviewed baseball pitchers aged 8 to 12 years in 2017 and 2018. Inning and pitch count limits in games were set to a daily maximum of 7 innings in 2017 and 70 pitches in 2018. Elbow pain, range of motion, and moving valgus stress test results were evaluated. The presence of capitellar OCD was assessed on ultrasonographic and radiographic images. Results: A total of 352 pitchers in 2017 and 367 pitchers in 2018 participated. The mean pitch count per game was lower in the pitch count limit (CL) group (52.5 ± 16.0) than in the inning limit (IL) group (98.2 ± 19.5) ( P < .001). Compared with the IL group, the CL group had significantly lower rates of elbow pain (40.9% vs 31.9%, respectively; P = .01) and reduced flexion (19.0% vs 10.6%, respectively; P = .001). Multivariate analysis revealed a significant association between elbow pain and age in both the IL and the CL groups ( P < .0001 and P = .02, respectively) and between OCD and elbow pain in the CL group ( P = .04). Conclusion: A pitch count limit of ≤70 pitches per day for baseball pitchers ≤12 years could be more protective against elbow pain and reduced flexion than a limit of ≤7 innings per day, but it may not be effective for reducing the risk of capitellar OCD.

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“…4 Limitations of pitch-count rules include not accounting for non-pitching related throwing and not accounting for throwing and pitching outside of league competition (eg, private lessons, club teams). A recent study observed that during a season, 11-to 12-year-old baseball players performed about 10 times more nonpitching throws and about 2 times more high-effort nonpitching throws compared with pitching throws, 19 suggesting that pitch counts alone underestimate the total stresses that a player's throwing arm experiences during youth baseball. While the authors observed no significant difference in the number of current pitchers between our high, moderate, and low specialization groups, the authors did not ask about participants' pitching history during adolescence, which limits our ability to draw conclusions about the relationship between early baseball specialization and upper extremity health relative to pitching.…”

Section: Discussionmentioning

confidence: 99%

Early Sport Specialization Linked to Throwing Arm Function and Upper Extremity Injury History in College Baseball Players

Croci

Nicknair

Goetschius

2021

Sports Health: A Multidisciplinary Approach

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Background: Evidence suggests that shoulder and elbow injuries account for 31% to 37% of all National Collegiate Athletic Association (NCAA) baseball injuries, and up to 69% of NCAA baseball injuries are the result of noncontact and overuse mechanisms. Early sport specialization may contribute to the high rates of upper extremity injuries in college baseball players. Hypothesis: Higher specialization by age 13 years would be associated with worse subjective throwing arm function and a greater history of shoulder and elbow injury. Study Design: Cohort study. Level of Evidence: Level 2. Methods: Survey data were collected from college baseball players (N = 129) during midseason of the spring 2019 baseball season. Participants were stratified in low, moderate, and high specialization groups based on a 3-criteria sports specialization questionnaire. Participants’ throwing arm function was measured using the Functional Arm Scale for Throwers and the Kerlan-Jobe Orthopaedic Clinic shoulder and elbow questionnaires. Participants’ history of a shoulder or elbow injury that resulted in missing ≥2 weeks of baseball activity at any point in their baseball career was also collected. Results: The high specialization group reported worse subjective throwing arm function on the Functional Arm Scale for Throwers questionnaire than the low ( P = 0.03) and moderate ( P = 0.01) specialization groups. The high specialization group was over 5 times more likely to report a history of shoulder injury than the moderate (odds ratio [OR] = 5.42; 95% CI [1.71, 17.2]; P = 0.004) and low (OR = 5.20; 95% CI [1.87, 14.5]; P = 0.002) specialization groups, and over 3 times more likely to report a history of elbow injury than the moderate specialization group (OR = 3.77; 95% CI [1.05, 13.6]; P = 0.04). Conclusion: College baseball players that were highly specialized by age 13 years reported worse subjective throwing arm function and were more likely to have a history of upper extremity injury than players that were moderate or low specialization. Clinical Relevance: Early specialization in baseball may be detrimental to long-term upper extremity health in college baseball players.

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Youth Baseball Pitch Counts Vastly Underestimate High-effort Throws Throughout a Season

Cited by 8 publications

References 12 publications

Pitching Behaviors in Youth Baseball: Comparison With the Pitch Smart Guidelines

Pitching Behaviors in Youth Baseball: Comparison With the Pitch Smart Guidelines

Limiting the Pitch Count in Youth Baseball Pitchers Decreases Elbow Pain

Early Sport Specialization Linked to Throwing Arm Function and Upper Extremity Injury History in College Baseball Players

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