Keeping kids in the game

Elbow and shoulder injury prevention guidelines for youth baseball pitchers

With the summer youth baseball season in full swing, local sports medicine specialists are seeing a spike in elbow and shoulder injuries.

“We are seeing so many young athletes in our office with orthopaedic injuries that I would call it an epidemic,” said Ryan J. Krupp, M.D., orthopaedic surgeon with Norton Orthopaedic Specialists – Brownsboro and director of Norton Sports Health.

One of the main reasons for the injuries is that these young athletes are specializing in one sport at an early age rather than playing a variety of sports. This puts added stress on a single part of the body, which may be still growing and developing. The athletes’ joints are more vulnerable to stress from overuse and repetitive movement.

Noah Frantz, now a pitcher for Thomas More College in northern Kentucky, knows the dangers of overuse. He damaged his shoulder after throwing 150 pitches in a game while in high school.

“When you’re a kid, you just want to play as much as possible,” Frantz said. “You don’t think about the potential damage to your body.”

Dr. Krupp emphasizes the importance of having athletes throw age-appropriate pitches while parents and coaches monitor and enforce pitch counts.

“Adequate rest between games and practices is essential, and it is imperative that these young athletes have a dedicated off-season from their chosen sport,” Dr. Krupp said. “Even professional athletes have an off-season so that their bodies can rest.”

According to the USA Baseball Medical & Safety Advisory Committee, players, parents and coaches should follow the guidelines below to help prevent injury.

Age-appropriate pitches

Fastball 8 (+/-2)
Change-up 10 (+/-3)
Curveball 14 (+/-1)
Knuckleball 15 (+/-3)
Slider 16 (+/-2)
Forkball 16 (+/-2)
Screwball 17 (+/-2)


Recommended maximum pitch counts

Age Pitch count per game
8-10 48-60
11-12 66-72
13-14 78-84
15-16 90-96
17-18 102-108


Days of rest based on pitch count

Age 1 day 2 days 3 days 4 days
8-10 21-35 36-50 51-65 66+
11-12 21-35 36-50 51-65 66+
13-14 21-35 36-50 51-65 66+
15-16 31-45 46-60 61-75 76+
17-18 31-45 46-60 61-75 76+

To make an appointment with one of our sports medicine professionals to evaluate a possible injury, call Norton Orthopedic Specialists – Brownsboro at (502) 394-6341. Additional information can be found online at

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