Knowledge of USA Baseball Pitching Guidelines Is Poor, Says New Study

Knowledge by youth baseball coaches of USA Baseball pitch count recommendations is poor, putting youth pitchers at increased risk for upper extremity pain and injuries, finds a disturbing new study.¹

Depending on the age group with which the coaches worked, coaches of youth baseball players between 9 and 15 years of age in a community league in the Midwest were only able to answer between 35% and 62% of questions about pitching guidelines correctly. Only 73% of coaches reported that they followed the pitching rules, but only half (53%) felt that other coaches generally followed the rules.  Neither percentage differed significantly by age group.

Other significant findings of the first-of-its-kind study:

• 35% of coaches said their pitchers reported shoulder or elbow pain during the season, with the incidence of pain increasing as age group increased;
• 19% of coaches reproted that one or more of their pitchers pitched a game with a sore or fatigued arm during the season;
• No coaches reported any pitching-related injuries among their players requiring surgery.
• Fewer than 10% of coaches reported that their players pitched in multiple leagues or participated in showcases.
• 91% reported that pitchers attended camps or received specific instruction to improve their pitching form.

The percentages of pitchers reporting pain or pitching with pain are "likely underestimates," said lead author, Joseph J. Fazalare, MD, of the United Hospital Center Orthopaedics in Bridgeport, West Virginia, "given that players themselves were not asked about pain."   The study took little solace in the finding that no injuries requiring surgery were reported, noting that such injuries "generally present at a later age than that of the patients in this study."

The low percentages of coaches answering the pitching guideline questions correctly "are concerning, as it is quite difficult for coaches to accurately follow guidelines with which they are not familiar," noted the study.

"In spite of significant efforts to educate coaches regarding youth baseball pitching injuries, knowledge of current recommendations for youth pitchers is poor," said Fazalare. "A better job must be done of educating players, coaches, and parents of the pitching guidelines and their importance."

Is better enforcement the answer?

Unlike Little League Baseball's pitch count limits, which are mandatory, with violations resulting in game forfeits, USA Baseball's recommendations are voluntary.

"Given the strong correlation that several authors have observed between elevated pitch counts, pitching while fatigued, catching in addition to pitching, and pitching in showcases, leagues should potentially take a more active role in enforcement of the [USA Baseball rules]", especially the rules regarding pitch counts and time spent catching and pitching, which are most likely easier to enforce than rules regarding fatigue and arm pain.

"Improved enforcement," said the study, "may also decrease the temptation of coaches to break the rules by improving their perception of the compliance of other coaches."

USA Baseball recommendations

To reduce the risk of arm injuries, USA Baseball recommends:

• Closely monitoring the number of pitches that are thrown in a game and throughout the season (see chart below)
• Avoidance of pitching in showcases, simultaneous leagues, or pitching more than nine months a year
• Not throwing breaking pitches until puberty
• Not catching in the same game as pitching
• Working on proper pitching mechanics.

For a comprehensive article on ways to prevent pitching injuries in youth baseball, click here.

1. Fazalare J, Magnussen R, Pedroza A, Kaeding C.  Knowledge of and Compliance With Pitch Count Recommendations: A Survey of Youth Baseball Coaches.  Sports Health: A Multidisciplinary Approach. published online February 6, 2012. DOI:10.1177/1941738111435632 (accessed February 7, 2012).

Posted February 7, 2012