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Preventing Pitching Injuries: Take 3 to 4 Months Off Every Year From Pitching and Overhand Throwing Sports

Experts recommend period of "active rest" every year


To reduce the risk of arm injuries from overuse, youth baseball pitchers need a period of "active rest" after the baseball season ends and before the next season begins during which they should stay physically active to maintain conditioning but refrain from overhand throwing of any kind

Research shows that youth baseball pitchers who pitch competitively more than 8 months a year are 5 times more likely to suffer shoulder and elbow injuries than those pitch less.1High school pitcher winding up

Pitchers in warm-weather climates, who tend to play more months of the year than those in cold-weather climates, are at particular risk. 

A 2011 study2 found relative weakness of the rotator cuff of shoulders of warm-weather pitchers and an inverse and negative relationship between months spent pitching and internal rotation range of motion and external rotation strength, identifying the group as a "previously unrecognized, vulnerable population in terms of their injury risk."

Time off every year 

The amount of rest recommended by experts varies. Most experts recommend:

  • "Active rest" and no overhead throwing of any kind for at least 2-3 months per year (4 months is better). In other words, not only should a baseball player not participate in throwing drills, but should not participate in other activities that put stress on the shoulder (javelin throwing, football quarterback, softball, competitive swimming etc.); and
  • No competitive baseball pitching for at least 4 months per year.

In its 2011 position statement on overuse injuries3, the National Athletic Trainers' Association recommends that:

  • youth athletes play only 1 overhead throwing sport at a time and avoid playing that sport year round.
  • take time off between sport seasons and 2 to 3 nonconsecutive months away from a specific sport if they participate in that sport year round; and
  • follow the recommended guidelines with respect to the cumulative number of pitches over the course of the year if they play on two teams at the same time (e.g high school and club team) or in consecutive seasons (USA Baseball's recommended yearly limit is 3,000 pitches; NATA's is 2,000 to 3,000 per year for pitchers age 9 to 14). 
The American Academy of Pediatrics' 2012 Policy Statement on Baseball and Softball4 recommends that youth pitchers should pitch competitively no more than 8 months in any 12-month period with 3 consecutive months of complete rest from pitching each year.
One leading expert thinks that year-round baseball should be abolished altogether.  "Young pitchers now are throwing hard all year and that is not a good thing," said Dr. James Andrews in a February 2012 interview with ESPN.com. "There is no rest period.  Baseball is a development sport and the ligaments in the elbow need time to develop."  

 

1. Olsen SJ 2nd, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am. J Sports Med. 2006;34(6):905-912.

 

2. Kaplan KM, Jobe FW, Morrey BF, Kaufman KR, Hurd WJ. Comparison of Shoulder Range of Motion, Strength, and Playing Time in Uninjured High School Baseball Pitchers Who Reside in Warm- and Cold-Weather Climates. Am. J Sports Med. 2011;39(2): 320-328.

3. Valovich McLeod TC, Decoster LC, Loud KJ, Micheli LJ, Parker JT, Sandrey MA, White C.  National Athletic Trainers' Association Position Statement: Prevention of Pediatric Overuse Injuries.  J Ath. Tr. 2011;46(2):206-220.

4. American Academy of Pediatrics, Council on Sports Medicine and Fitness,  Policy Statement: Baseball and Softball. Pediatrics. 2012;129(3):842-856. (doi: 10.1542/peds.2011-3593)(accessed February 26, 2012)

Most recently updated March 23, 2012