Effect of pitch type, pitch count, and pitching mechanics on risk of elbow and shoulder pain in youth baseball pitchers

Academic Article


  • Background: Joint pain is thought to be an early sign of injury to a pitcher. Objective: To evaluate the association between pitch counts, pitch types, and pitching mechanics and shoulder and elbow pain in young pitchers. Study Design: Prospective cohort study. Methods: Four hundred and seventy-six young (ages 9 to 14 years) baseball pitchers were followed for one season. Data were collected from pre- and postseason questionnaires, injury and performance interviews after each game, pitch count logs, and video analysis of pitching mechanics. Generalized estimating equations and logistic regression analysis were used. Results: Half of the subjects experienced elbow or shoulder pain during the season. The curveball was associated with a 52% increased risk of shoulder pain and the slider was associated with an 86% increased risk of elbow pain. There was a significant association between the number of pitches thrown in a game and during the season and the rate of elbow pain and shoulder pain. Conclusions: Pitchers in this age group should be cautioned about throwing breaking pitches (curveballs and sliders) because of the increased risk of elbow and shoulder pain. Limitations on pitches thrown in a game and in a season can also reduce the risk of pain. Further evaluation of pain and pitching mechanics is necessary. © 2002 American Orthopaedic Society for Sports Medicine.
  • Authors

    Published In

    Digital Object Identifier (doi)

    Author List

  • Lyman S; Fleisig GS; Andrews JR; Osinski ED
  • Start Page

  • 463
  • End Page

  • 468
  • Volume

  • 30
  • Issue

  • 4