The Risk and Rise of Throwing Injuries (Part 1)

The Risk and Rise of Throwing Injuries (Part 1)

This is part one of three part series on throwing injuries.

Risk is part of sports. Some injuries can happen in sports no matter what precautions are taken; however, most throwing injuries to the elbow are preventable. As a sports medicine physician, I hate seeing these injuries because in many cases they can be avoided by following well established guidelines.

Throwing injuries in athletes have been on the rise and are particularly common in baseball players. They are strongly associated with overuse; therefore, the way to avoid an injury from throwing is to not “overuse” the shoulder and elbow. The two biggest contributors to this type of injury are 1) single sport specialization and 2) year round playing of one sport (baseball) combined with travel teams and multiple leagues.

For years, Little League has recognized the importance of limiting the number of pitches that pitchers throw each week and has put pitch counts in place. Major league baseball also recognizes this and closely follows pitch counts. However, we have not had pitch counts at the high school or college level in the state of Michigan.

In the Lakeshore area we put together a group of experts that include area baseball coaches, athletic trainers, athletic directors and physicians to try to address these injuries. Our first focus was to try to get pitch counts implemented across the state at the high school level. We have had success with that and these changes will be happening. It is up to each athlete and parents of young athletes to be an advocate for themselves or their child. Pitch counts are one way to try to protect the throwing arm.

Maximum Pitch Count by Age*

Age Daily Maximum
7-8 50
9-10 75
11-12 85
13-16 95
17-18 105

Required Rest by Age and # of Pitches*

14 & under 15-18 # of Rest Days Required
66 + 76 + 4 calendar days
51–65 61–75 3 calendar days
36–50 46–60 2 calendar days
21–35 31–45 1 calendar day
1-20 1–30 None

Watch for “Throwing Injuries – Part 2” where I will discuss multiple sport athletes and feature documented opinions of well-known college coaches and professional athletes on that topic. Then in Part 3, I’ll talk about ways of preventing injury, what to do for specific throwing injuries and the importance of expert treatment and follow up care.

Keeping you in the game,
Bruce Stewart, MD

  • Bruce Stewart, MD, MBA

    Bruce Stewart, MD, MBA

    Dr. Stewart is an orthopaedic surgeon and a sports medicine specialist. He treats injuries to bones, joints, cartilage, tendons, ligaments and muscles and specializes in minimally invasive techniques and arthroscopy to treat complex injuries of the shoulder, elbow, knee, and ankle. Dr. Stewart's extensive training and experience includes caring for athletes and treating common orthopaedic problems ranging from pediatric injuries to fractures and other injuries of the musculoskeletal system.

    As a physician and sports medicine specialist, Dr. Stewart's experience with professional sports teams include: Houston Astros Major League Baseball team; Houston Texans NFL team; Houston Dynamo Major League Soccer team; University of Houston athletic teams, and several Houston area high school football teams. He trained with team doctors for the Chicago Bears, the Chicago Cubs, the Chicago Fire, and Northwestern University athletic teams while in residency at the prestigious Northwestern University in Chicago. Dr. Stewart is a member of the American Academy of Orthopaedic Surgeons, the Arthroscopy Association of North America, and the American Orthopaedic Society for Sports Medicine. He is in practice at Shoreline Orthopaedics in Holland, MI. Learn more about Dr. Stewart at

    Bruce Stewart, MD, MBA

Share this Post