Olsen SJ, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. The American Journal of Sports Medicine 34:905-912, 2006.

Olsen et al. examined 95 adolescent pitchers who had shoulder and elbow surgery, and 45 adolescent pitchers who never had a significant pitching-related injury. The adolescent pitchers ranged anywhere from 14 to 20 years of age. The study compared their responses to a survey to determine risk factors associated with pitching injuries and surgery. When a pitcher regularly threw with arm fatigue, he was 36 times more likely to be in the surgery group as opposed to the non-surgery group. When a pitcher engaged in more than 8 months of competitive pitching during a year, he was 5 times more likely to be in the surgery group. When a pitcher threw more than 80 pitches in a game/appearance, he was 4 times more likely to be in the surgery group. When a pitcher self-reported that he threw more than 85 mph, he was 2.5 times more likely to be in the surgery group. There were no significant differences regarding private pitching instruction, coach's chief concern, pitcher's self-rating, exercise programs, stretching practices, relieving frequency, or age at which pitch types were first thrown. In conclusion, the factors with the strongest association with injury were overuse and fatigue.

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August 30, 2006