Baseball season is back – and so are the injuries. Elbow injuries, once seen as a problem for professional athletes, are becoming more prevalent among high school and middle school athletes due to increased play and competition at the youth level. Repetitive stress to a pitcher’s ulnar collateral ligament (UCL) – an important stabilizing ligament of the elbow joint – can lead to pain and eventually to the inability to pitch and throw.
According to a literature review in the May 2014 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), overuse is the main cause of UCL injury. Year-round play – with the addition of numerous leagues, travel teams, showcase events and other opportunities for youth to participate in baseball outside of school – has contributed to a 10-fold increase of UCL reconstruction in the last decade.
The USA Baseball Medical and Safety Advisory Committee discourages young athletes from participating in multiple teams, especially during the same season, to help prevent overuse injuries.
Throwing with fatigue is the main risk factor for overuse injury, whether it is event fatigue (too many pitches in a game), season fatigue (too many pitches in one season), or year-round fatigue (not taking the appropriate 3-4 months off from throwing). In fact, throwing athletes with fatigue are 36 times more likely to suffer shoulder and elbow injuries.
Understanding the risk factors with fatigue and overuse can help prevent UCL injuries. Proper throwing mechanics are vital, as well as the encouragement to play a variety of sports instead of focusing on one sport year-round. The throwing athlete needs at least three months of rest a year, which can occur by playing other non-throwing sports such as soccer.
Recognize early symptoms and begin a therapy program to help prevent unnecessary surgery.