Play Ball! (Safely)  

by Dr. Joseph Guettler

The Detroit Tigers are in “full swing” – and all of us Tiger’s fans are hoping for a winning season.  And don’t forget that the USPBL is “knocking it out of the park” out a Jimmy John’s Field in Utica this spring and summer as well.   

This also means that baseball season is here for all of our little leaguers and high school athletes. Personally, I always look forward to baseball season.  It’s a time to enjoy the spring weather, and it’s also a time enjoy “playing ball” at all levels – from T-ball, to the church or city softball league, to the Detroit Tigers. It’s truly “as American as apple pie.”

In the sports medicine world, it also means that baseball injuries will hit their yearly peak.  More that 40 million people across the country will hit the diamond this season, and roughly 500,000 will suffer baseball or softball-related injuries.  While baseball and softball can’t exactly be equated with professional bull riding as one of America’s riskiest sports, there are certainly a variety of injuries that do occur.  These injuries can be divided into throwing injuries, running and sliding injuries, and those injuries that occur when a player is struck with a bat or ball. 

If you want to take a trip around the bases – and not a trip to the doctor’s office or emergency room – you’ll want to read the following recommendations:

Throwing Injuries

Many injuries occur when players overuse their arms.  This time of year, my practice is swamped with little league and high school pitchers who have “overdone it.”  In my practice, I see kids with little leaguers’ elbow and little leaguers’ shoulder every day during the baseball season.  These conditions occur because the throwing motion irritates, and can even fracture, the growth plates of a young thrower’s elbow or shoulder.  What’s troubling is that the number of young throwers flocking to doctors’ offices with sore shoulders and elbows has risen dramatically over the last decade, and what’s even more alarming is that the incidence of shoulder and elbow surgery for problems in young throwers has skyrocketed.  

To combat this, most leagues have put in place some sort of rule that involves pitch counts or limiting the number of innings pitched in a week – that’s because it’s really important.  Your child really doesn’t want a “spent” shoulder or elbow by the time he or she’s in college.  Based upon its expertise and review of existing studies, the USA Baseball Medical & Safety Advisory Committee makes the following recommendations for minimizing a pitcher’s risk of future serious arm injury:  Recommended limits for youth pitchers are as follows:

  • Recommended limits for 9-10 year old pitchers:
    • 50 pitches per game
    • 75 pitches per week
    • 1000 pitches per season
    • 2000 pitches per year
    • Recommended limits for 11-12 year old pitchers:
      • 75 pitches per game
      • 100 pitches per week
      • 1000 pitches per season
      • 3000 pitches per year
    • Recommended limits for 13-14 year old pitchers:
      • 75 pitches per game
      • 125 pitches per week
      • 1000 pitches per season
      • 3000 pitches per year

By using some additional guidelines, that include things like not throwing breaking balls before high-school age, as well as pitching a maximum of 9 months out of the year, many injuries and problems can be avoided.  With that being said, young pitchers are still running into trouble because they are pitching for multiple teams, and they are often pitching too many months of the year by being involved in travel leagues and specialized clinics.  The bottom line is that if a pitcher at any level experiences significant pain with throwing, it’s probably time to get it checked out.

By the way, we did a really cool study that was published in the American Journal of Sports Medicine a few years ago.  We found that if your young pitcher is pitching with a tired or sore arm, the risk of serious injury goes up exponentially.  If your young pitcher is not taking at least a third of the year off from pitching, or engaging in other sports during the year the break up the repetitive stresses that pitching invokes on the growing shoulder and elbow, his risk of injury goes up significantly.  If your young pitcher is not adhering to the commonly accepted guidelines regarding pitch counts and rest as outlined above, then his risk of injury will also skyrocket.

When in Doubt, just remember The Rule of Ones:

  • One Game at a time…don’t pitch in two games in one day
  • One Day at a time…don’t pitch on consecutive days
  • One Hundred Pitches is the absolute upper game limit for even our more developed young pitchers
  • One Position at a time…don’t play pitcher and catcher on the same team
  • One Team at a time…don’t play on teams with overlapping pitching schedules
  • At least One Other Organized Sport or One Season Off
  • One complaint of Arm Pain or Tiredness equals One Week Off

Running and Sliding Injuries

Other injuries occur while players are running around, or sliding into bases.  Proper sliding techniques, coupled with breakaway bases, can significantly reduce the risk of injury (Unfortunately, we can’t do much about the “strawberries” that occur while sliding on our lovely gravel fields here in Southeast Michigan).  In addition, players should always survey the surrounding field for holes, glass, or other debris before play begins.

“Getting Hit” Injuries

Finally, appropriate protective equipment can help prevent the catastrophic injuries that occur when a player is hit by a bat or ball.  This is a “no-brainer,” and appropriate equipment is a “must” when it comes to organized baseball and softball. 

So whether you’re down at Comerica Park this summer or out at Jimmy John’s Field, watching your son or daughter, or playing in your own softball league, have a fun and safe time as you Play Ball!

Dr. Joseph Guettler is an orthopedic surgeon who specializes in sports medicine.  He is a proud member of the MOS Team.  For more information, go to