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Overuse Injuries Are Real: It’s Important to Know the Risk Factors

By Dr. James Andrews

Spring is almost here and that means “baseball.” For parents and coaches it is a time to understand all of the risk factors and how to make sure your young players are healthy.

Many of you will be starting up youth baseball in very cold climates. Even in the deep South there have been record-breaking low temperatures.

You must remember that most injuries in baseball occur in the early part of the season when conditioning is lacking. Extra cold weather makes it even more likely for early-season injuries to occur. Practice indoors as necessary.

Remember conditioning is a process and prevention steps are essential, especially early in the season.

There is no youth sports organization more involved with promoting injury prevention and keeping our kids safe and healthy than Little League International. I strongly encourage everyone, from coaches, to local league officials, to parents, to please strive for a safe and injury-free Little League season.


If the risk factors for injury are understood then often common sense will dictate prevention! The most common risk factors for youth baseball are:

  1. Specialization: Playing one sport year-round
    I believe all youth athletes should have at least two months off per year. It’s my recommendation that youth baseball players have 3-to 4 months where no overhead throwing is done, regardless of the sport.

  2. Professionalism: Overtraining
    Avoid training a child as if he/she was a professional athlete. In this scenario “overuse abounds.”

  3. Too Much is Too Much: Participation on multiple teams increases likelihood of injury
    When a child is playing in several leagues at one time, there are no rules in play for injury prevention. Each league or event is only interested with the performance of a player at that time.

  4. Fatigue: A “tired” arm leads to an injured arm
    Avoid arm fatigue, especially early in the season. If your child throws with fatigue, our research at the American Sports Medicine Institute (ASMI) indicates that there is a 36-to-1 times increased risk for injury to the throwing shoulder and/or elbow.

  5. Radar Gun: Learning to pitch safely is not about speed
    Avoid overuse of the radar gun. Throwing for speed promotes over-throwing and leads to arm and shoulder injuries. Location, location, location! A youth player needs to learn how to throw strikes and place the baseball! Pitch velocity will develop natural with good pitching mechanics.

  6. Showcases and Travel Ball: Respect the physical limits of the child
    Be careful with showcases and travel ball tournaments where a child is expected to throw multiple innings, and pitch with limited rest periods. These types of events are where young throwers have a tendency to go beyond their normal capabilities.

  7. Poor Mechanics: Always work on good mechanics to avoid injury
    There are many resources and training materials available to parents, players and coaches than assist in the prevention of throwing-related, over-use injuries. Major League Baseball has recently started a new national initiative to educate and help to prevent injuries in youth throwers. The MLB Pitch Smart Program was built from the concepts that ASMI and Little League devised nearly 10 years ago. The core components are similar to Little League's Pitch Count Regulations. You can also visit ASMI.org for additional preventive information.

Note - Doctor James Andrews is internationally known and recognized for his skills as an orthopaedic surgeon as well as his scientific and clinic research contributions in knee, shoulder, and elbow injury prevention and treatment. Doctor Andrews is a founding member of Andrews Sports Medicine and Orthopaedic Center and is also co-founder of the American Sports Medicine Institute (ASMI), a non-profit institute dedicated to injury prevention, education and research in orthopaedic and sports medicine. Doctor Andrews is Senior Consultant for the Washington Redskins Professional Football team and Orthopaedic Medical Director for the Tampa Bay Rays Professional Baseball team. Doctor Andrews serves on the Medical and Safety Advisory Committee of USA Baseball and on the Board of Little League Baseball, Inc.

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Little Leaguer® | March 2015 | Archive