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Young players told to ignore arm pain and keep throwing, study finds

Young players told to ignore arm pain and keep throwing, study finds


Nearly half of young baseball players have been encouraged to keep playing despite experiencing arm pain, according to a new study.

The study found that an alarming 47 percent of players had been encouraged to continue playing in a practice or game even though they were suffering arm pain. The study was led by Columbia University Medical Center (CUMC) researchers.

“It's alarming that so many young baseball players are encouraged to play with pain,” said Dr. Christopher S. Ahmad, study leader, professor of orthopedic surgery at New York-Presbyterian/Columbia and head team physician for the New York Yankees. “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.”

Ahmad and his colleagues designed a questionnaire to learn more about the frequency, severity and psychosocial effects of arm pain among active adolescent baseball players that was completed by 203 players from New York and New Jersey between the ages of 8 and 18.

“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,” Ahmad said. “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.”

Among the survey's findings was that 74 percent of players reported having arm pain while throwing while just 26 percent said they “never” had arm pain while throwing. The study also found that:

·         80 percent reported having arm pain the day after throwing.

·         82 percent reported arm fatigue during a game or practice.

·         54 percent reported that arm pain limited the number of innings they could play.

·         75 percent reported that arm pain limited how hard they could throw.


Pitchers, compared with infielders and outfielders, were especially likely to have played with pain. One-quarter of pitchers reported that they “often” or “always” had pain the day after throwing.

“These pitchers likely represent one of the higher-risk groups for incurring a future overuse injury and thus warrant particularly high monitoring,” Ahmad said.

One in eight players aged 17 to 18 reported that they “always” felt encouraged to continue playing despite having arm pain. A majority of players reported that arm pain caused them to experience less enjoyment while playing and that it was responsible for holding them back from being a better player.

Ahmad suspects that this phenomenon has contributed to the recent rise in “Tommy John” surgeries among college and professional baseball players.

According to Ahmad, current precautions and guidelines are inadequate for preventing injury.

“It's not enough to set pitch counts based on a player's age,” he said. “While some 14-year-olds are already quite mature, in terms of their skeletal structure, others haven't even started their growth spurt yet. We need to come up with more individualized throwing programs and better ways to detect which players are at risk for injury.”

Baseball Pitching Injury Study Arm pain

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