Elbow Injuries in Athletes

Preventing Elbow Injuries in Young Pitchers

By Kenny Cabe, ATC
St. Francis Sports Medicine

 
One of the biggest problems that young baseball and softball pitchers face is injuries to the elbow. When I worked in college athletics, we would see many baseball players who had pre-existing elbow problems that either ended or changed their careers. Many of them had chronic tendonitis or ulnar collateral ligament instability.

To understand these conditions, it helps to understand the anatomy of the arm. The forearm has both tendons and ligaments. The tendons of the forearm attach to the inside and the outer side of the elbow, and the two primary ligaments (ulnar collateral and radial collateral) attach to the inner and outer sides of the elbow, respectively.

With repetitive stress, tendons in the elbow area can become inflamed, causing pain on either side of the elbow when throwing. Repetitive stress and improper mechanics also can cause ligaments to develop micro tears, or even tears to the point that they rupture.

There are several things that can be done to prevent these problems, including proper body mechanics, strengthening exercises, and avoiding risky pitches and high pitch counts.

 

For younger adolescent children, it is imperative that fundamentals and proper mechanics be taught. Coaches at this level should ensure that young athletes are learning how to throw in a way that will not cause injuries later in life.

 

Strengthening and Conditioning

As the athlete gets older, strengthening of the elbow and forearm is important. While the windmill pitching mechanics of fast pitch softball is much more shoulder friendly than overhand pitching, the violent wrist snap that is required to throw some pitches can place stress on the wrist flexors and elbow. So young ladies also should incorporate a good wrist and elbow strengthening program and pay close attention to their mechanics.

Avoiding Breaking Pitches

The male adolescent elbow does not completely develop until the athlete is 16 or 17 years old. Pitchers should not be allowed to begin throwing breaking pitches until after this age. In fact, many major league pitchers have commented that they would not allow their sons to throw anything other than two seam and four seam fastballs and change ups until late high school. In addition, some orthopedists have recommended that adolescents do not throw breaking pitches until their growth plates have closed.

Limiting Pitch Counts