Overview
Baseball is considered America’s greatest past time and many kids have fun playing every year. More than 500,000 people are treated every year for baseball related injuries and more than 300,000 of those are kids. Injuries can occur in kids who play on multiple teams throughout the entire year or in kids who only play for fun with their friends. Most of these injuries are preventable.
Common Injuries
Soft tissue injuries are the most frequent including muscle pulls (strains), ligament sprains, contusions (bruises) and cuts. Other serious injuries can occur from contact with a ball, bat, or another player, especially if they are not wearing protective gear such as helmets. Throwing players (most frequently pitchers) are also at risk for overuse injuries to the shoulder and elbow.
- Head: Concussions most commonly occur when a player is hit in the head by a ball. Wearing a helmet is the best way to prevent concussion. A helmet should be fit properly and worn correctly. It should be worn beginning when a player arrives to the “on deck” circle then continuously worn while at bat, and during base running. Catchers should also always use a helmet and facemask. A concussion does not always involve loss of consciousness or blacking out. A concussion may just be a headache, confusion, dizziness, nausea/vomiting, or blurry vision. Any player with concussion symptoms should be evaluated by a medical professional and cleared before return to play.
- Shoulder/Elbow: Throwing athletes are at the highest risk for overuse injuries of the shoulder or elbow. “Little League Shoulder” involves an injury to the growth plate in the upper arm bone (humerus). A similar type of injury called “Little Leaguer’s Elbow” can occur with repetitive throwing. This is caused by a strong pull on the tendons and ligaments of the elbow. A player may feel pain on the inside of their elbow. If untreated, repeated throwing can hurt the ligaments or tendons at the bone or cause damage to bone or growth plate. Injury to the bone on the outside of the elbow can also happen as a result of excessive throwing.
- Leg/Ankle/Foot: Foot and ankle injuries are especially common when players are sliding into a base, so players should learn to slide only if they are 10 years or older. Injuries can include contusions (bruises), fractures, and serious ligament injuries. The injuries can occur to both the player that is running and the player in the field. Children should wear well-fitted shoes with appropriate cleats. Catchers should wear protective equipment including shin guards.
Prevention
Before You Play
Stretching and warming up is very important for preventing injuries. Prepare for the season by gradually increasing activity, such as running, agility training, and strength training. This is very important if you are coming off of a rest period. Throwing players should condition their arms. This should involve a gradual increase in activity. Warm-up should also be done before every practice or game.
Equipment
- Helmets: A helmet should be worn beginning when a player arrives to the “on deck” circle then continuously worn while at bat, and during base running.
- Cleats: Baseball players usually wear cleats. Pick a cleat type that is right for the playing surface. For example, screw-in cleats provide good traction in very wet conditions, but they may be more likely to cause injury than molded or multi-studded cleats. Be sure that the shoes fit well. Cleats should be plastic in youth leagues.
- Catchers: Catchers should wear well-fitting shin guards as well as a catcher’s mitt, helmet, facemask, throat guard, a long-model chest protector, and protective support.
- Baseballs: Using a softer type of baseball in a youth league can decrease the risk of injury from being hit by a ball.
Base Running
Players under the age of 10 years should not learn to slide into a base. Players should be taught proper technique and practice with a sliding bag. Only breakaway bases should be used during games. Base players must be out of the way of runners and should not block the base. First base should have a double bag to prevent foot and ankle injuries between the runner and fielder.
Pitching and Throwing
The USA Baseball Medical and Safety Advisory Committee provides guidelines for youth baseball including number and type of pitches thrown based on age.
Pitch Count Limits:
| Age |
Max Pitches per game |
Max Pitches per week |
| 8-10 |
50 |
75 |
| 11-12 |
75 |
100 |
| 13-14 |
75 |
125 |
| 15-16 |
90 |
2 games/week |
| 17-18 |
1-5 |
2 games/week |
Types of Pitches:
| Fastball |
8 |
| Change-up |
10 |
| Curve ball |
14 |
| Knuckle ball |
15 |
| Slider |
16 |
| Forkball |
16 |
| Splitter |
16 |
| Screw ball |
17 |
Injury Prevention Tips
- Have a pre-season physical to identify any conditions, injuries, or deficits that may lead to in-season injuries.
- Prepare for the season by gradually increasing activity, such as running, agility training, and strength training. This is very important if you are coming off of a rest period.
- Avoid overtraining and overuse injuries by taking rest periods throughout the year. Do not play on more than one team at a time. Cross-training or playing a different sport for a season is an excellent way to prevent overuse injuries and burnout.
- Be aware of field conditions. Fields should be maintained properly to avoid injuries, such as filling in holes and removing litter. Playing in very wet conditions can increase injuries. Basket stands should be padded.
- Use breakaway bases. This will decrease the risk of sliding injuries.
- Prepare for the weather. Hydrate well before playing, especially on very hot days, and take water breaks. Take cover during thunderstorms.
- Wear well-fitting cleats and shin guards. Take time to stretch before practice or games. Growing athletes are at risk for injuries because of lack of flexibility.
- Discuss injury prevention with your health care professional and coach.
Safe Return to Play
An injured player should have no symptoms when returning to play. They should have no pain, no swelling, a normal range of motion, and returned to their previous strength. Any player who has a concussion should have no symptoms at rest or with exercise and should be cleared by a physician before returning to play.
Other References:
POSNA.org
