Sports Injury News: Kids Avoid Baseball Injury with Pitch Counts

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Sports Medicine expert Dr. Kevin Plancher on keeping kids safe on the mound

Let’s face it: Nobody likes a pushy parent, especially when it comes to kids’ sports. But even if you manage to avoid confrontations with your child’s coach (and other parents), and even if your child never complains about your tactics, you might be doing some serious damage.

“Parents often push kids too hard without even realizing it,” says Kevin D. Plancher, M.D., a leading Orthopaedic Surgeon and Sports Medicine Specialist and head of Plancher Orthopaedics & Sports Medicine, PLLC in New York City and Greenwich, CT and founder of the Orthopaedic Foundation for Active Lifestyles ( a non-profit organization dedicated to advancements in research and education for orthopaedics and sports medicine.

A child’s bones and muscles are still growing, so they can’t take as much stress as an adult’s, he explains. While grown-ups and older kids are usually good at pacing themselves, and telling an over-eager coach or other observer, to back off, younger children typically are not. “Kids often don’t know what a particular activity is supposed to feel like, so they might not recognize something as painful,” Dr. Plancher says. “They also might be so eager to please mom or dad that they’ll play right through the pain, and into injury.”

A classic example of this is the child who plays baseball — particularly the child who plays pitcher. Today’s coaches and school administrators — and the Little League Baseball organization — enforce strict pitch counts, which dictate the maximum number of pitches that a child can throw in any game or practice session.

Some parents, especially parents who also happen to be fans of major league baseball, might scoff at the idea of pitch counts, which have been the subject of heated debate (advocates say pitch counts help prevent injuries and “save” a pitcher’s arm, opponents say they only serve to coddle pitchers and discourage fair competetion). “There are players and fans on both sides of the argument,” Dr. Plancher says. “But when you’re talking about kids, it’s a whole different story.”

Why? Because the overhead motion of pitching a baseball — especially when it’s done over and over again — is a common cause of shoulder injury. The shoulder is a ball-and-socket joint, like the hip, Dr. Plancher explains. But instead of being restricted by a tight-fitting enclosure of bone, the shoulder sits loosely in its socket, kind of like a golf ball on a tee, and is held in place by soft tissue, such as muscles and tendons. When it’s used to pitch a baseball, the shoulder is pulled back and away from the pitcher’s body, and then snapped up and back around the front. That impressive range of motion can send a ball flying at great speed but also puts tremendous stress on the tissue that’s stabilizing the joint. Thus, the shoulder is particularly vulnerable to overuse injuries, which are typically caused by excessive repetition of an aggravating motion.

Millions children are injured from playing sports every year, and a large percentage of them suffer overuse injuries, including damage to their shoulders. “Young athletes — particularly kids that are trying to please a demanding parent — are especially vulnerable to these injuries,” Dr. Plancher says.

Pitch counts (and other measures designed to spare young shoulders from injury) are critical, says Dr. Plancher. Research shows that pitch counts work to minimize injuries in younger players. For example, a study conducted by the American Sports Medicine Institute (ASMI) showed a significant relationship between the number of pitches thrown and the risk of shoulder and elbow pain in youth baseball. “And we know that joint pain can be an early sign of potentially serious joint injury,” Dr. Plancher says.

Beyond pitch counts, parents and coaches are also encouraged to limit the number of “curve balls” and “sliders” that a young player throws, both in games and in practice. These types of pitches involve more complicated mechanics and can put even greater strain on the shoulder joint, says Dr. Plancher.

Dr. Plancher offers the following additional tips for parents of young baseball players:

  • Pay attention to your child if he or she complains about arm pain. If it hurts during a game, take the child out immediately. Talk to your doctor if the pain isn’t gone in a few days or if it flares up as soon as the child starts pitching again.
  • Be sure your child learns proper form.
  • Don’t push your child to pitch (or do other stressful overhead activities, like swimming competitively or throwing a javelin or football) more than 9 months a year. Encourage him or her to do a variety of conditioning and strengthening activities throughout the year.

Some parents might feel that injuries are just a part of playing sports (and even qualify as a kind of badge of honor), but many injuries — and virtually all overuse injuries — are avoidable, Dr. Plancher says. “It’s not good for anyone’s body, especially a child’s body, to be pushed so far that it breaks down,” he says. “This is one time when it’s important for the grown-ups to do the thinking.”

About Dr. Plancher: Kevin D. Plancher, M.D., M.S., F.A.C.S., F.A.A.O.S., is one of the nation’s leading orthopaedic surgeons and sports medicine experts, specializing in the treatment of knee, shoulder, elbow and hand injuries. He is Associate Clinical Professor in Orthopaedics at Albert Einstein College of Medicine in New York City and the Head Team physician for the professional lacrosse team, the Long Island Lizards. Dr. Plancher served on the editorial review board of the Journal of the American Academy of Orthopaedic Surgeons from 1994-2010. In 2007, 2008, 2009, and 2010 Castle Connolly Medical Ltd., a New York City research company, named Dr. Plancher America’s Top Doctor in Sports Medicine in the U.S.. Every year from 2001 to 2010 he has been included in Castle Connolly’s list of Top Doctors in the New York Metro area, as published in New York Magazine's yearly "Best Doctors" issue.

Dr. Plancher received his M.D. degree (cum laude) and an M.S. degree in physiology from Georgetown University in Washington, DC. He completed his residency at Harvard University’s orthopaedic program and a fellowship at the Steadman-Hawkins Clinic in Vail, CO., where he studied shoulder and knee reconstruction and served as consultant to the clinic for six years. He has been team physician for more than 15 high school, college and national championship teams.

An attending physician at Beth Israel Hospital in New York City and Stamford Hospital in Stamford, CT, he maintains offices in Manhattan and Greenwich, CT, Dr. Plancher lectures Internationally and here in the U.S. on issues related to orthopaedic procedures and injury management and to halting the process of arthritis. He also has been named to the sports medicine arthroscopy program subcommittee for the American Academy of Orthopaedic Surgeons. Dr. Plancher has been awarded the Order of Merit (magna cum laude) for distinguished philanthropy in the advancement of orthopaedic surgery by the Orthopaedic Research and Education Foundation. In 2001, he founded The Orthopaedic Foundation for Active Lifestyles, a not-for-profit foundation focused on maintaining and enhancing the physical well-being of active individuals through the development and promotion of research and supporting technologies,


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