Preventing Shoulder and Elbow Injuries in Little League Baseball: A Guide for Parents and Young Athletes

Posted on: May 27th, 2025 by Our Team

Baseball is a beloved American pastime, and for many young athletes, Little League represents their first exposure to competitive sports. While the game promotes teamwork, discipline, and physical activity, it also brings with it the risk of overuse injuries—particularly to the shoulder and elbow in young pitchers and throwers.

As a sports medicine specialist, I often see children and teens suffering from preventable throwing-related injuries. The growing bones and soft tissues of youth athletes are especially susceptible to stress, and without the right precautions, their passion for the game can lead to long-term problems.

Common Shoulder and Elbow Injuries in Youth Baseball

1. Little Leaguer’s Shoulder (Proximal Humeral Epiphysitis): This overuse injury involves irritation or widening of the growth plate at the top of the upper arm bone (humerus). It typically presents with shoulder pain in young throwers, especially after pitching.
2. Little Leaguer’s Elbow (Medial Epicondyle Apophysitis): This occurs when repetitive throwing places stress on the growth plate on the inside of the elbow. Pain is usually localized to the inner elbow and may worsen with continued throwing.
3. UCL Sprains or Tears (Ulnar Collateral Ligament): Though more common in older athletes, the rise of year-round play and early specialization has led to UCL injuries in adolescents. This ligament stabilizes the inner elbow during throwing, and repeated stress can lead to partial or full tears.
4. Labral Injuries: Repetitive overhead throwing can also damage the labrum, the cartilage rim of the shoulder socket, leading to pain, decreased velocity, and instability.

Why Overuse Injuries Happen

Overuse injuries are caused by repetitive microtrauma without adequate rest and recovery. In youth baseball, several factors increase the risk:

• Pitching too frequently or with improper mechanics
• Year-round participation without off-seasons
• Playing on multiple teams simultaneously
• Ignoring pain or early signs of fatigue
• Poor strength and flexibility, especially in the shoulder girdle and core

Prevention Strategies for Youth Baseball Players

1. Follow Pitch Count Guidelines: Adhere to Little League Baseball’s official pitch count rules based on age. For example, athletes aged 11–12 should not exceed 85 pitches per game and should have appropriate rest between outings.
2. Limit Pitching and Throwing Volume: Young athletes should not pitch more than one game per day and should avoid pitching on consecutive days. Also, consider limiting overall throwing—including practice and warm-ups.
3. Take Time Off: Encourage athletes to take at least 2–3 months off from overhead throwing each year to allow the body to recover and develop properly.
4. Avoid Year-Round Specialization: Diversify athletic participation. Playing different sports reduces repetitive stress on the same joints and fosters balanced development.
5. Emphasize Proper Mechanics: Working with a qualified coach or sports medicine specialist can help identify and correct poor throwing mechanics early on.
6. Strengthen Supporting Muscles: Conditioning programs that include shoulder stabilizers, rotator cuff strengthening, scapular control, and core stability can reduce the risk of injury.
7. Monitor for Pain or Fatigue: Pain is never “normal.” Any complaints of shoulder or elbow discomfort should be taken seriously, with rest and medical evaluation as needed.

When to See a Specialist

If a young athlete complains of persistent shoulder or elbow pain, decreased throwing performance, or swelling, it’s time to consult a sports medicine physician. Early diagnosis and intervention can often prevent long-term damage and allow a safe return to play.

Trusted by Athletes and Families

As a Double Board-Certified Orthopaedic surgeon and sports medicine specialist, I’ve helped countless youth athletes safely return to the sports they love. I take a comprehensive approach that focuses not only on treatment but on education, injury prevention, and long-term health.

If your child is experiencing shoulder or elbow pain, or if you’re concerned about overuse injuries, schedule an evaluation today. Let’s keep young athletes healthy, strong, and in the game.