USA Baseball Medical & Safety Advisory Committee
Position Statement on Youth Baseball Injuries
July 2003

Baseball is one of the safest sports available for today's youth. However, many of the serious injuries suffered by adult baseball pitchers may have begun to develop at the youth level. One of the missions of the USA Baseball Medical & Safety Advisory Committee is to provide scientifically based information to its youth baseball members to reduce the risk of injury and maximize the younger player's ability to perform and advance to higher levels.

Multiple Appearances
Because a youth pitcher usually stays in the game at another position after pitching, the player is eligible to return to the mound later in the game, according to the rules of baseball. While it may be good strategy to have a starting pitcher come back in and finish a game, it is not a good idea from a health and safety perspective. Muscles, tendons, and ligaments need time to "cool down" after physical activity, just like they need to "warm up" before activity.

Multiple Leagues
In order to get more opportunity to develop skills, many young players play in multiple leagues. Although the amount of pitching in a league is often limited by league rules or the judgment of its coaches, individual pitchers sometimes exceed such limitations by pitching in more than one league at a time. The strength and skills needed to be a successful pitcher are developed by repetition; however, a pitcher must also give his body time to rest and recover in order to optimize his development.

Year-Round Baseball
In certain parts of warm-weather states (Florida, Texas, California, etc.) baseball leagues are available in all seasons. However, the principle of periodization states that an athlete should have different periods and activities in his annual conditioning schedule. Specifically, baseball pitchers need a period of "active rest" after their season ends and before the next preseason begins. During active rest a pitcher is encouraged to participate in physical activities that do not include a great amount of overhand throwing.

Recommendations
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 and maximizing his chance of success

· Coaches and parents should listen and react appropriately to a youth pitcher when he/she complains about arm pain. A pitcher who complains or shows signs of arm pain during a game should be removed immediately from pitching. Parents should seek medical attention if pain is not relieved within four days or if the pain recurs immediately the next time the player pitches. League officials should inform parents about this consideration.

· Pitch counts should be monitored and regulated in youth baseball. Recommended limits for youth pitchers are as follows: