In today’s world of youth sports it is a common trend for athletes to be participating in not only multiple sports at once, but to be active on multiple teams for the SAME sport as well.  In baseball, the push for higher velocity throws is the goal.  However, with the ever increasing demand for higher speeds and multi-team participation the trend in overuse injuries, especially for young athletes, has increased dramatically. 

The prevalence of overuse injuries has progressively gotten worse over the decades.  This trend is highly correlated to the excessive training that young athletes are putting themselves through in today’s sports world. Being involved with multiple teams has its benefits but it also has a dramatic effect on the risk for injuries.

Below is an image demonstrating the dramatic increase in Tommy John Surgeries (UCL reconstruction) performed annually over the most recent decades.  This surgery is a procedure for the elbow that is performed commonly on throwers and more specifically pitchers, often times as a result of overuse injuries.

Evidence of Overuse: Tommy John Surgeries Per Year (1)

A research article published by the American Journal of Sports Medicine in 2014 found in a national survey of “754 youth pitchers that 43.4% of participants pitched on consecutive days, 30.7% pitched on multiple teams with overlapping seasons and 19% pitched in multiple games in one during the 12 months prior to beginning the study”.(2)

As supported by the recent research there is an ever increasing demand that pitchers are experiencing.  With this increasing intensity these athletes are at an increased risk for injury,especially young athletes. As a response and attempt to reduce these injuries, USA baseball and MLB have formulated a comprehensive outline for safe pitching practices. 

Pitch Smart Guidelines are “a series of practical, age-appropriate guidelines to help parents, players and coaches avoid overuse injuries and foster long, healthy careers for youth pitchers.(1) These guidelines were developed taking into consideration the maturation of the body at various ages and the appropriate time required for recovery. For each age range a pitch count and required rest recommendation has been established.

Age Daily Max
(Pitches in
0 Day
1 Days
2 Days
3 Days
4 Days
5 Days
7-8 50 1-20 21-35 36-50 N/A N/A N/A
9-10 75 1-20 21-35 36-50 51-65 66+ N/A
85 1-20 21-35 36-50 51-65 66+ N/A
95 1-20 21-35 36-50 51-65 66+ N/A
95 1-30 31-45 46-60 61-75 76+ N/A
105 1-30 31-45 46-60 61-80 81+ N/A
120 1-30 31-45 46-60 61-80 81-105 106+

Youth pitchers and throwing athletes should be aware of the exponential stress being placed on their shoulders / arms and should take the steps to prevent injuries. Utilization of these guidelines is an excellent start in ensuring a healthy season and preserving the arm for a longer baseball career.

For further details on these guidelines go to

  1. “Pitch Smart.”,
  2. Yang G, Barton J, Guettler J, Dugas J, Irrgang J, Fleisig G, Albright J; Risk-Prone Pitching Activities and Injuries in Youth Baseball; American Journal of Sports Medicine; 2014
January 10, 2019 , Posted in Physical Therapy and Sports