Monday Medical: Detecting, preventing youth pitching injuries |

Monday Medical: Detecting, preventing youth pitching injuries

Tamera Manzanares/For the Steamboat Today

Seasoned athletes know that rest is just as important as training. This is particularly true for young athletes, who can be more prone to injuries from overworking certain joints.

Injury is a hot topic in youth baseball and softball, where pitching — too hard, too much and too early — is causing potentially serious elbow and shoulder problems in many children and adolescent players.

This information is especially relevant for Steamboat Springs’ summer visitors attending and participating in Triple Crown World Series baseball, including youth competitions.

“The increasing presence of year-round travel leagues nationwide in youth baseball emphasizes the importance of education and injury prevention,” said Dr. Alex Meininger, a Steamboat Springs orthopaedic sports medicine specialist.

In Northwest Colorado, baseball is not a year-round sport, so these injuries aren’t as prevalent in children here, though orthopaedic doctors do see problems in high school-age pitchers and said it’s important to watch for and treat overuse injuries in all youth sports.

“I think it’s a worthy topic — just like concussions in kids,” said Dr. Andreas Sauerbrey, who specializes in upper body orthopaedic injuries and sports medicine. “You don’t want to try to play through it because that’s what can lead to injury.”

Overuse injuries in young pitchers have prompted youth baseball and sports medicine organizations to issue guidelines for maximum pitch counts, rest periods and age-appropriate pitches. These recommendations as well as other sport-specific youth injury prevention information can be viewed at

The most prominent pitching injuries in children result from excessive strain on the growth plates in the elbow and shoulder joints. The growth plate comprises growing tissue near the ends of the long bones in children and adolescents. This is the weakest part of the bone and absorbs the stress of throwing a baseball.

Throwing too often and/or with extreme force or throwing certain pitches at too young an age can put excessive strain on the growth plates. The most common result of this is “little leaguer’s shoulder or elbow.” Meininger expects to see more of these injuries as youth baseball continues to grow in popularity and competitiveness.

“Children’s growth plates and ligaments simply aren’t ready for that kind of force on the arm,” he said.

The first sign of shoulder and elbow problems is pain. Parents and coaches also can watch for a child rubbing his or her elbow or shoulder, changing form or simply not wanting to play.

“Kids are motivated to stay in the game; they don’t always speak up about pain,” Meininger said.

If detected early, these problems usually can be remedied by rest and, with the help of a doctor or physical therapist, a throwing rehabilitation program.

Delayed treatment may result in growth plate fractures and/or damage to joint cartilage, which can require surgery and significant time away from the sport. Untreated, these problems can affect joint function permanently.

Adolescents and older players who pitch too frequently risk tearing the ulnar collateral ligament in the elbow, damage that often requires surgery. This is among baseball injuries that typically are associated with adult players but can start during adolescence.

Meininger emphasized that it’s important that parents make sure their children take a rest from throwing pitches at home as well at practice/games.

Locally, Meininger and Sauerbrey said high school baseball coaches are keeping pace with pitching guidelines and injury awareness. Sauerbrey noted that volleyball and other coaches also have sought his advice on how to prevent injuries in their young players.

Health care professionals, including pediatricians, physical therapists and chiropractors, seem aware of youth baseball and other overuse injuries. Many parents also are up on this information.

“These are people who are active themselves — they understand injury,” Sauerbrey said.

This article includes information from, a program of the American Orthopaedic Society for Sports Medicine and Sports Medicine at Johns Hopkins,

Tamera Manzanares writes for Yampa Valley Medical Center. She can be reached at

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