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Pitch Counts in Youth Baseball and Softball: A Historical Review

Feeley, Brian T., MD*; Schisel, Jessica, BA; Agel, Julie, MA, ATC

Clinical Journal of Sport Medicine: July 2018 - Volume 28 - Issue 4 - p 401–405
doi: 10.1097/JSM.0000000000000446
General Review

Objective: Pitching injuries are getting increased attention in the mass media. Many references are made to pitch counts and the role they play in injury prevention. The original purpose of regulating the pitch count in youth baseball was to reduce injury and fatigue to pitchers. This article reviews the history and development of the pitch count limit in baseball, the effect it has had on injury, and the evidence regarding injury rates on softball windmill pitching.

Data Source: Literature search through PubMed, mass media, and organizational Web sites through June 2015.

Results: Pitch count limits and rest recommendations were introduced in 1996 after a survey of 28 orthopedic surgeons and baseball coaches showed injuries to baseball pitchers' arms were believed to be from the number of pitches thrown. Follow-up research led to revised recommendations with more detailed guidelines in 2006. Since that time, data show a relationship between innings pitched and upper extremity injury, but pitch type has not clearly been shown to affect injury rates. Current surveys of coaches and players show that coaches, parents, and athletes often do not adhere to these guidelines. There are no pitch count guidelines currently available in softball.

Conclusions: The increase in participation in youth baseball and softball with an emphasis on early sport specialization in youth sports activities suggests that there will continue to be a rise in injury rates to young throwers. The published pitch counts are likely to positively affect injury rates but must be adhered to by athletes, coaches, and parents.

*Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California; and

Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, Washington.

Corresponding Author: Julie Agel, MA, ATC, Department of Orthopaedics, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104 (

The authors report no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received August 18, 2016

Accepted February 21, 2017

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