Arm Pain in Young Baseball Players

Young baseball players commonly have preventable arm pain, according to research published online in American Journal of Sports Medicine.

Researchers from Columbia University Medical Center conducted a survey in order to investigate frequency, quality, and effect of arm pain in healthy young baseball players. The questions were developed by a collaborative team including trainers, clinicians, and coaches. A total of 203 young baseball players, aged 8 to 18 years, from the New Jersey and New York areas were included in the cohort. The investigators theorized that arm pain would affect the majority of healthy baseball players and would furthermore be associated with adverse psychological effects.

Each of the surveys was completed by players without input from parents or coaches. Prior overuse injury was reported in 47 (23 percent) of players. A fifth of players (20 percent) their arm never hurt the day after throwing, while 26 percent reported pain when throwing the ball. Another 30 percent of players reported that arm pain sometimes caused them to have less fun while playing. Nearly half (46 percent) of players reported being encouraged at least once to keep playing despite experiencing arm pain.

Players who experienced prior overuse injury were more likely to have arm pain while throwing, to have arm fatigue during a game or practice, and to be encouraged to keep playing despite experiencing arm pain.

Pitchers, especially, were more likely to report arm pain while throwing and the day after throwing and indicate that arm pain hindered them from becoming a better player.

“Both nationally and internationally, we’re witnessing a troubling increase of elbow and shoulder injuries in young baseball players,” said study leader Christopher S. Ahmad, MD, chief of sports medicine and professor of orthopedic surgery at NewYork-Presbyterian/Columbia, explained in a press release. “The likely explanation is that they’re throwing too much, too early, putting increasing demands on their bodies that their bodies are not ready for. Despite current guidelines and precautions—for example, limiting pitch counts and emphasizing off-season rest—many players are still sustaining overuse injury to their throwing arm. Thus, it’s vital that we develop better ways for coaches, parents, and clinicians to identify players at risk so we can prevent irreversible injury and season-ending surgery.”

Ahmad believes arm pain has contributed to a recent rise in “Tommy John” surgery in young, college, and professional baseball players. The surgery is the colloquial name for reconstruction of the elbow’s ulnar collateral ligament first named after a Los Angeles Dodgers pitcher in 1974.

“It’s alarming that so many young baseball players are encouraged to play with pain,” Ahmad, who is also the head team physician for the New York Yankees, explained. “Years ago, prior to concussion protocols, we observed something similar in football, where players who suffered a concussion were routinely sent back into the game after ‘recovering’ for a few minutes. The initial concussion lowered the threshold for another concussion, and the repeated concussions put the player at risk for permanent damage. I think we’re seeing a similar problem in baseball, where playing with arm pain is setting the stage for more serious injury.”