Elbow and shoulder sports injuries among baseball players are on the rise. A recent focus is on ulnar collateral ligament (UCL) injuries, also known as “Little League Elbow Syndrome.” Baseball pitchers are most at risk, and younger players are being increasingly seen for surgery. With club sports providing more opportunities to play baseball, even year round, preventing pitching overuse injury is worth the attention of coaches, parents and students.
In overhand throwing motions, extreme force and angles are placed on the elbow joint. The UCL provides approximately 50 percent of the force during the throwing motion. When the elbow is repeatedly put through this motion, the forces can cause partial or complete tearing of the UCL. Younger athletes are also at risk of developing bony avulsions or bony deposits near the location where the UCL attaches.
Researchers have determined risk factors for UCL injuries:
- Number of pitches thrown
- Pitching form, how the ball is thrown
- Pitch type such as breaking ball or slider
- Physical condition of the player
Pitch count
Many youth baseball associations have put limits on the number of pitches their players can throw each day or each game. The Wisconsin Interscholastic Athletic Association (WIAA) has implemented a pitching schedule that allows pitchers to be rotated and limits the number of innings each player can pitch per week. It is also important to keep in mind the number of pitches an athlete accumulates during practice as well as during competition.
Pitching form
Coaches and parents should observe their athletes and start early to correct form. Pitch speed and effort should not come from upper body motion alone. Pitching motion starts with the lower body and follows through to the upper body. Form will vary slightly from one pitcher to the next.
Pitch types
Teach the types of pitches appropriate to the athlete’s skill level. Start with the baseball basics of throwing, catching, hitting and running. Master good form for the fastball, then the changeup, before progressing to breaking pitches.
Physical condition
Avoid overuse injuries. Between seasons stay active and continue monitor pitching frequency for signs of overuse. Any reported pain or symptoms should be quickly evaluated by a licensed athletic trainer or other medical professional and treated.
Share comments or questions on this story. E-mail sports.medicine@marshfieldclinic.org.