Spring training has begun, and youth baseball players all over the country are starting to practice and prepare for their upcoming seasons. My very own 14 y/o son has started his 8th grade season, while having been working with his travel team on the weekends since mid December.


As a physical therapist, former player, father, and assistant coach on his 14U team, my first concern is always the health of a player. I see several baseball players in my sports medicine practice ranging in age from 9 year olds to MLB platers. Diagnoses include internal impingement, SLAP tears, little league elbow/shoulder, OCD, UCL sprains, rotator cuff tendinitis, instability, fractures and scapular dyskinesia.

One of the hardest things to do in my profession is get inside the head of a young athlete. Many will refrain from mentioning pain for fear of letting down a parent or coach, or out of concern for losing playing time. Society has become too focused on early specialization and winning from an early age. In addition, “travel baseball” has been somewhat diluted and water down by lots of dads who want their sons to play year-round. I often see kids being abused on terms of too little rest or improper recovery after they pitch and catch.

The biggest, most athletic and hardest throwing kids undergo the most strain as they are asked to shoulder the load at pitcher, catcher and shortstop early on. Many coaches are counting innings in tourneys and not pitches based on tournament guidelines. Too many kids are pitching on consecutive days without proper rest all in an attempt to win meaning less tournaments at a young age. Fortunately, we are making progress in the sports medicine world thanks to the efforts of Dr. James Andrews and others.

High schools are adopting pitch count regulations this year, and MLB along with Dr. Andrews has developed their site, www.pitchsmart.org, to spread education about injury prevention in youth pitchers. Dr. Christopher Ahmad is on the advisory committee for PitchSmart.org, and he is also the lead author on a new paper detailing an injury assessment tool for young baseball players, The Youth Throwing Score.

The Youth Throwing Score (YTS) was put together by an interdisciplinary team of providers and coaches as a way to assess upper extremity injury in youth and adolescent baseball players ranging in age from 10-18 years old.  Their paper was just published in the February 2017 edition of the American Journal of Sports Medicine. They developed a survey for players to self-assess their injury status.


  • 223 players completed the survey (recruited from local baseball leagues and 2 major training centers, in addition o those seen in the orthopedic clinic by senior author’s institution)
  • Mean age was 14.3 +/- 2.7 years
  • Players self-assigned injury status
  • 148 players were playing without pain (means core of 59.7 +/- 8.4)
  • 60 players were playing with pain (mean score of 42 +/- 11.5)
  • 15 players not playing due to pain (mean score of 40.4 +/- 10.5)

Conclusion: the YTS is the first valid and reliable instrument for assessing a young baseball player’s upper extremity health

Clearly this survey can aid health care professionals in identifying/assessing pain in youth baseball players, as well as potentially classifying this pain with specific injuries. In addition, it may help providers, coaches and parents identify strategies to reduce injury risk moving forward and curb serious overuse injuries.  More research nd follow-up is needed, but this another positive step in the right direction for reducing youth baseball injuries.

ReferenceAhmad CS, Padaki AS, Noticewala MS, Makhni EC, Popkin CA. The Youth Throwing Score. Am J Sports Med. 2017 Feb;45(2):317-324.