Baseball!!! One of America's favorite pastimes has become increasingly popular with young athletes. Once played as a springtime sport, baseball is now played year-round in some locations by athletes of all ages. This increase in popularity and the amount of time spent throwing has caused the number of injuries related to the sport to rise at an alarming rate. For example, one study in an orthopaedic journal found that the number of elbow surgeries performed between 1998 and 2001 represented more than a 100% increase compared with the number of elbow surgeries performed between 1994 and1997. The reason is clear. More time is spent playing with less time spent on conditioning and controlling the number of pitches and types of pitches thrown.

The demands on young pitchers are increasing, and the types of pitches allowed are more difficult than in the past. Recently, Atlanta Braves orthopedic surgeon Joe Chandler polled more than 70 professional pitchers and 100 Little League coaches. The pitchers were asked about their own experiences as young players and what they would recommend if their child were a pitcher in youth baseball today. Although the coaches agreed on restricting a young pitcher's number of innings per week and number of pitches per game, only 63% of them actually counted pitches. With an increased number of injuries occurring in younger pitchers, it is clear that guidelines must be established and then followed by both coaches and parents with attention to the following risk factors:

1. Curveballs and sliders thrown at too early an age.
2. Abuse (too many innings/pitch counts too high).
3. Year-round baseball without enough rest.
4. Poor throwing mechanics.
5. Poor practice or conditioning habits.

Mark Baker, PT
Columbus, Georgia