Elbow injuries: Getting kids back in the game
Elbow injuries are increasingly common in children and young adults who participate in team sports nearly year-round. This review—and the tables that accompany it—can help you help them safely return to play.
A stepped-up focus on prevention
The increase in UCL injuries in adolescents highlights the need for greater emphasis on prevention.10 Several governing bodies, including USA Baseball and the American Academy of Pediatrics, have developed research-based guidelines for young athletes (TABLE 2).1,10,23-25
One of the easiest to follow is to limit an athlete’s weekly pitch count to 10 times his age. Thus, a 10 year old should pitch no more than 100 pitches in a given 7-day period. Another important measure—in addition to ensuring that young athletes receive instruction in proper pitching mechanics (see https://www.littleleague.org/Little_League_Online.htm)—is to urge coaches and parents to require players to get at least 3 months of rest after each season and to stop throwing if they have pain or fatigue.24
TABLE 2
Keeping young pitchers injury-free1,10,23-25
| Recommendations for coaches and parents |
|---|
| Record the number of pitches thrown at each outing/sports event for all young pitchers |
| Avoid allowing young athletes to pitch competitively >8 months per year |
| Limit the number of pitches to ≤2500 per year and 10 × the pitcher’s age per week, or 90 per outing |
| Ensure that young pitchers are instructed in proper pitching mechanics |
| Restrict throwing breaking ball pitches* prior to puberty |
| Ensure that young pitchers get 3 months of rest per year. |
| *A pitch that changes direction either sideways or downwards as it approaches the batter, eg, a slider or curve ball. |
CORRESPONDENCE
Jennifer A. Southard, MD, MSc, Saint Alphonsus Medical Group, 6533 Emerald Street, Boise, ID 83704; Southarj@sarmc.org
