Sports Injury Prevention | Baseball

The most common injuries in young baseball players are overuse injuries of the elbow and shoulder.

Most of these injuries are preventable, and playing through pain can turn a minor injury into a serious one. Your child should see a doctor if they have pain, swelling, or loss of range of motion in their shoulder or elbow.

Overuse injuries in baseball

Overuse injuries develop over time, often when players make too many pitches or overhead throws without giving their bodies a chance to recover.

• "Little League elbow" and "Little League shoulder" are usually caused by too much throwing and not enough rest between games and practices.
• Pitchers and catchers are particularly susceptible.

Shoulder and elbow injuries don’t usually end a player’s career. And while surgery is rarely necessary, effective treatment may require weeks or months of rest, physical therapy, and home exercises, followed by a gradual return to throwing. 

Acute injuries in baseball

Acute injuries are the result of a single event or an accident. Common acute injuries in baseball include sprains and strains, concussions, and fractures.

The most common baseball injuries depend in part on a player’s position:

• Defensive players can get injured if a base runner runs into them or if two players collide while going after the same ball.
• Fielders can get injured by batted balls, for instance, a ball that takes a bad hop and strikes the player in the face.
• Base runners may get injured by sliding into base headfirst or slamming into a stationary base with high force.
• Hitters can be injured by pitched baseballs.

• Playing in multiple baseball leagues in a single season. Playing on more than one team makes it less likely a player will have time to rest their arm fully before the next game or practice.
• Playing baseball year-round. Young athletes should play baseball no more than eight months a year. Playing other sports between baseball seasons can help the athlete develop a broad range of athletic abilities.
• Lack of cross-training. Like any sport, baseball uses certain muscles intensively and others barely at all. Cross-training reduces the risk of injury by balancing out an athlete’s overall strength and fitness.
• Overtraining. Training too much or too intensely without a solid foundation of fitness can lead to injury. This is of particular concern at the start of the season.

Parents, coaches, and athletes can all play a role in reducing the risk of baseball injuries by maintaining a safe environment and encouraging safe training practices.

Environmental safety

• Make sure that the field is in good condition and that the ground is free of holes, mounds, or ruts.
• Ensure players wear proper safety equipment at all times, including a helmet while batting or catching.
• Use break-away bases that move when the runner hits or slides into them.
• Minimize collisions in the field through proper coaching and player communication.
• Adhere to USA Baseball guidelines about bats and other safety equipment.

Conditioning and flexibility

• Make sure athletes warm up before every game or practice and stretch afterward to reduce soreness and strengthen the areas around the shoulder and elbow.
• For shoulders, “sleeper stretches” help maintain motion and prevent ligament or tendon problems. These stretches should be done regularly, rather than in response to pain.
• For elbows, injury prevention includes stretching and strengthening the biceps, triceps, and muscles inside the forearm.
• Cross-training with strength training and playing other sports diversifies muscle strength and gives overused muscles some time off.

Proper throwing mechanics

Athletes should keep the following things in mind while pitching and throwing:

• maintaining appropriate pelvic tilt in early windup
• keeping the hand strong and on top of the ball
• having the elbow high when the forward foot hits the ground
• ensuring the stride foot moves toward the target, not off to the side
• not throwing curveballs or sliders (or limiting the number they throw) until a player is the recommended age: 14 for curveballs and 16 for sliders

USA Baseball has provided guidelines for youth and adolescent pitchers by age group to protect young athletes’ shoulders and elbows. These guidelines should be observed for all practices and games. 

Whether injury prevention or recovery is your goal, we have the skills and dedication to help your child remain active in the sports they love.

As the largest and most experienced pediatric and young adult sports medicine practice in the country, the Sports Medicine Division at Boston Children's combines personalized care with innovative treatment for each athlete we treat.

Our Sports Medicine team consists of sports medicine physicians, orthopedic surgeons, physical therapists, podiatrists, athletic trainers, sports psychologists, dietitians, and many others who collaborate in every aspect of our patients’ care and their recovery.

The Throwers Clinic and The Micheli Center for Sports Injury Prevention (part of the Sports Medicine Division) offer practical strategies that help young athletes reduce their risk of injury while enhancing their sports performance. With high-speed cameras and computerized analysis, our throwing analysis services help baseball pitchers and their coaches identify aspects of their strength, flexibility, and throwing mechanics that could increase the risk of injury. Our rehabilitation and strength training programs help injured athletes return to play stronger and healthier.