Houston Methodist. Leading Medicine

Elbow News

Which Pitch? And How Many?

Young children who pitch for baseball teams are at risk for elbow and shoulder problems. Physical trauma and stress over time add up from season to season. For this reason, parents and coaches are very interested in what guidelines to use for pitch type, count, and form.

A study of 467 baseball pitchers ages nine to 14 looked at pitch types. The curveball requires a snapping motion with a downward twist of the wrist to spin the ball so it curves away from the batter just as the batter starts to swing. The slider is similar to a curve ball, but requires a snapping motion in the opposite direction. This curves the ball over the plate toward the batter. The change-up pitch uses the same motion as a fastball but changes the speed. Usually, the pitcher is throwing the same pitch for quite a few pitches and then changes the speed of the pitch.

Both the curveball and the slider are "breaking" pitches. This means the ball travels two-thirds of the way to the plate and then "breaks" or changes. It either curves or drops down. The batter is already swinging to hit the ball when it breaks.

Shoulder or elbow pain in a young pitcher is a sign of an overuse injury. Muscle soreness is normal and expected. Joint pain is not. The curveball and slider are more likely to cause joint pain in young pitchers. These breaking pitches can cause injury to the growth plate, an area of cartilage near the end of long bones that eventually turns to bone. The change-up is a safe pitch for this age group. It works well because the key to its success is changing the speed of the pitch. This upsets the batter's timing.

Pitch types are important, but so are pitch counts. Pitchers should be limited to 75 pitches in a game and 600 in a season. These young pitchers should not play in more than one league at a time. Pitching on a regular basis without exceeding the limits helps build strength, coordination, and endurance.


Stephen Lyman, PhD, et al. Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball Pitchers. In The American Journal of Sports Medicine. July/August 2002. Vol. 30. No. 4. Pp. 463-468.

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*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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