13 Ways To Prevent Pitching Arm Injuries, According To Research

  • Last updated Dec. 30, 2017

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Tommy John image If you're looking for the latest information on helping pitchers avoid injuries, you're going to love this article on preventing pitching injuries following a scientific approach.

Did you know that nearly 49% of youth baseball pitchers will suffer an elbow or shoulder injury in 2018?


And at the high school level, pitching injuries are happening at an even greater rate.

Doctors are now performing five times more "Tommy John" elbow surgeries than they were just a decade ago, according to the American Journal of Sports Medicine.

And Dr. James Andrews, one of the most acclaimed orthopedic surgeons in the world for the treatment of pitching arm injuries, has said his clinic has seen a tenfold increase in visits from high school and youth pitchers in the past 10 years.

10 times.

A dramatic rise in baseball pitching injuries

Look, it's no secret that injuries among baseball pitchers at all levels are on the rise, but elbow and shoulder injuries in Little League and throughout other youth baseball organizations are on the verge of becoming an epidemic.

Thousands of pitchers are seen each year complaining of elbow or shoulder pain. Your son or a youth pitcher you know may be one of them.

Tommy John elbow image Damage or tear to the ulnar collateral ligament (UCL) is the most common injury suffered.

This ligament is the main stabilizer of the elbow during a pitcher's release of the baseball.

Check out this slow-motion video of Clayton Kershaw's arm action as he throws a four-seam fastball.

Take a look at Kershaw's elbow:

Clayton Kershaw elbow animated
Clayton Kershaw's elbow bears a significant amount of force during a pitch. It's the same for all baseball pitchers.

Wow. Just plain wow, right?

Now keep in mind that at normal speed, this movement produces enough force to propel a baseball up to 95 MPH—and it's repeated as many as 120 times per game, over 30 games per year.

After seeing that, it's no wonder 25% of active MLB pitchers and 16% of current minor league pitchers have had UCL procedures, which reconstructs a pitcher’s torn ulnar collateral ligament.

Last season was particularly distressing: More pitchers had the surgery in 2014 than in the entirety of the 1990s.

Helping young pitchers stay healthy

The good news is there's a lot we parents and coaches can do to help our kids pitch safe and stay healthy this season.

As a former pro pitcher and now parent and coach of young pitchers, I know firsthand how important it is to help our kids pitch safe and stay healthy on the mound.

Youth pitcher image
Preventing pitching arm injuries is so important to help our kids have long, healthy baseball careers. (Photo by Rob Hurlbut)

13 injury prevention techniques for youth pitchers

Here are 13 ways to prevent pitching arm injuries to point you and your son in the direction of success:

  1. Make certain pitchers are properly conditioned before throwing full velocity or pitching competitively.

  2. Make certain pitchers have and use a proper stretching and warm up program before throwing.

  3. Develop a year round throwing program to maintain arm strength and stamina, flexibility, and normal range of motion.

    I personally recommend 1-2 month rest period at end of a long season, and then begin a limited and modified off season throwing program.

  4. Teach and supervise a proper weight and resistance program.

    I recommend the TUFFCUFF Jr training program; coaches or medical personnel should be responsible for implementing this program.

    Many pitchers restrict their flexibility and range of motion by improper use of weights. Other pitchers have actually weakened themselves by over stretching the shoulder joint, causing too much laxity.

  5. Have the pitcher throw at reduced velocity and shorter distance when learning new techniques or new pitches.

  6. Limit the amount of throwing a pitcher does during drills and practices if he plays another position. The positions which would cause the least amount of stress on the arm are first base or outfield.

  7. Make certain the pitcher dressed properly for warmth during cold temps, or to prevent early heat exhaustion during very hot weather.

    Also, be aware of proper intake of fluids to prevent early dehydration and muscle fatigue.

  8. Don't use a radar gun; emphasize the development of proper pitching mechanics, control and accuracy in young pitchers before pitching velocity. Learn the fundamentals now, and the velocity will come later as the pitcher grows and matures.

  9. Adhere to the following pitch count guidelines established by MLB, USA Baseball and Little League Baseball here:

  10. Recommended pitch count limits

    Age Pitches/Game
    7-8 50
    9-10 75
    11-12 85
    13-16 95
    17-18 105

    Source: MLB "Pitch Smart", USA Baseball, Little League Baseball

  11. Make sure the pitcher gets proper rest following pitching appearances in games (and even in practices and/or scrimmages) by adhering to the following rest period guidelines here:

  12. Recommended rest periods

    AGES 7-16
    Number of Pitches Rest Period
    61+ 3 days
    41-60 2 days
    21-40 1 day
    1-20 None
    AGES 17-18
    Number of Pitches Rest Period
    76+ 3 days
    61-75 2 days
    26-50 1 day
    1-25 None

    Source: Little League Baseball

  13. Concentrate on age-appropriate pitching skills.

    Nolan Ryan didn't start pitching until he was in high school.

    Madison Bumgarner wasn't allowed to throw a curve ball until he was 16 yrs old, according to an article in Sports Illustrated.

    In fact, most Big League pitchers didn't develop secondary pitches or breaking pitches before the age of 13 or 14 years old—they threw nothing but fastballs and change ups.

  14. Recommended ages for learning pitches

    Pitch Type Age
    Fastball 8 ± 2
    Change-up 10 ± 2
    Curve ball 14 ± 2
    Knuckle ball 15 ± 2
    Slider 16 ± 2
    Fork ball 16 ± 2
    Screwball 17 ± 2

    Source: American Orthopaedic Society for Sports Medicine

    → As for the relationship between certain pitch types and increased stress on the elbow, it has traditionally been believed that the curve ball is a more harmful pitch than the fastball or change up. This led to recommendations by the American Orthopaedic Society for Sports Medicine that youth pitchers refrain from beginning to throw curve balls until the age of 14.

  15. Make certain a pitcher pitches with proper mechanics.

    While each pitcher throws somewhat within his own style, through the critical phase of throwing, most successful injury free pitchers use very similar time-proven techniques.

    From what I've observed in working with hundreds of pitchers, is that from the hand break through the deceleration phase of the pitching motion, most successful pitchers use basically the same arm action.

    Other common traits of successful pitchers include:

    • Proper balance, flexibility and control of the body
    • Good body and arm alignment
    • Proper weight transfer
    • A long smooth arc of deceleration of the pitching arm

    When analyzing the pitching motion of a pitcher who is experiencing arm problems, be on the lookout for the following pitching faults, which may potentially be the root cause for the soreness or pain.

  16. Recommendations for sore arms

    Pain Why it might be happening What to look for (mechanics)
    Biceps or Triceps A result of not having enough functional strength in the arm as the demands of throwing increase, especially early in the season. Failing to utilize legs, hips and trunk to throw, making the arm carry a majority of the workload.
    Shoulder A result of poor throwing mechanics and not strengthening the small muscles in the rotator cuff (particularly, the decelerators) and scap with a weekly arm care program. Releasing the baseball when the elbow is behind the chin and dragging the arm. Postural inefficiencies.
    Elbow A result of poor throwing mechanics and weak functional strength in the wrist and forearms. Snapping the wrist when throwing a breaking pitch; releasing the baseball when the elbow is behind the chin; and dragging the arm.

    On a mobile device? Swipe to view more.

  17. Take care of the arm before and after a pitcher throws.

    Obviously, having a clean arm action, as previously mentioned, will eliminate a lot of problems, but if you don't prepare and recover you can still potentially run into injuries.

    There are also other ways to improve your arm action with arm care activities such as the following examples:

    • Resistance tubing or Jobes exercises;
    • Scap holds and waiter walks (shoulder stability);
    • Wrist weight exercises (forearm stability);
    • Rice bucket exercises (finger and forearm strengthening);
    • 2-lbs. mini med ball throws (reverse and pivot pick off);
    • Some kind of rhythmic stabilization (mini med ball ball throws against rebounder, kneeling stabilizations, or the "shoulder tube"); and
    • Foam roll with lacrosse ball (roll the lax ball over arm to find tender spots, increase pressure to release built up knots).

    And remember, arm care shouldn't stop only with the arm, either.

    Mobility and flexibility of the hips and thoratic extension of the back is just as important. The hip flexors, internal and external rotators, hamstrings and groin all need active and static care.

Protecting youth pitching arms

Finally, even though I recommend light weight, full range-of-motion conditioning and strength work, I sincerely believe the single best method to build throwing arm strength and stamina—and to prevent pitching arm injuries in little league age youth pitchers—is to throw a baseball…

...and throw it mechanically correctly all the time.

It's a constant process; never stop improving, never stop learning, and never stop working hard.


One of the big misconceptions in baseball is that playing the game keeps you in shape to pitch. I wish that was true. It's not.

To get to the next level, preparation matters. Big League pitchers spend far more time preparing to pitch than actually pitching.

If you believe adding velocity could be critical to your success, check out my pitching workouts for baseball pitchers.

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