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This article originally appeared in the May 20, 2010 edition of the St. Louis Post-Dispatch.

As summer draws near and the St. Louis Cardinals expand their lead in the NL Central, baseball and softball are definitely hot topics.  These are by no means dangerous sports. But they can present a very real risk of injuries from things like wild pitches, batted balls, and collisions in the field.

“Participation in baseball and softball is possible at younger ages than many other sports and is strongly encouraged for exercise, mastery of basic skills in order to prevent injuries, and learning the value of teamwork,” says Jay Noffsinger, M.D., Director of Pediatric Sports Medicine at SSM Cardinal Glennon Children’s Medical Center.

At the high-school level, some pitchers can throw fastballs that reach 80-plus miles per hour, speedy enough to cause painful welts, broken bones, even concussions. Excessive pitching and improper throwing mechanics can lead to major league arm problems, and base runners and fielders frequently collide while running at top speed.

As with all sports, wearing and using the right gear can go a long way toward preventing injuries. The amount of equipment required for baseball isn't on par with football or hockey, but it is every bit as important. Players need to be sure they always have all the gear required by their league. Most leagues will insist on the following:

  • Batting helmets must be worn whenever a player is at bat, waiting to bat, or running the bases. Helmets should always fit properly and be worn correctly.
  • A catcher should always wear a helmet, facemask, throat guard, full-length chest protector, athletic supporter with a cup, shin guards and a catcher's mitt whenever they are catching pitches, whether it's in the game, in the bullpen or during warm-ups.
  • Shoes should have molded plastic cleats rather than metal ones. Most youth leagues don't allow spikes with metal cleats.
  • Some leagues have guidelines dictating what kind of bat a player can use. Some aluminum bats may be banned for hitting batted balls too hard. Be sure to check the league's policy before choosing a bat.
  • Boys should wear athletic supporters; most, particularly pitchers and infielders, should wear protective cups. Rules regarding which players must wear cups vary from league to league.

Just as with any other sport, warming up and stretching before a baseball game is very important. However, remember that in baseball and softball, kids should pay particular attention to their throwing arm. Most will require plenty of warming up before they can safely attempt a long, hard throw.

Overhand pitching, particularly for adolescent arms that are still growing, puts an enormous amount of strain on joints and tendons. Injuries to wrists, elbows, rotator cuffs, ligaments, and tendons can result from excessive pitching but can be largely avoided if players and coaches follow a few simple guidelines:

Make sure pitchers adhere to league rules regarding the maximum number of innings they're allowed to throw. This will generally range from four to 10 innings per week. If a kid plays for more than one team, include all innings pitched each week, not just the ones for each team.

Most leagues follow rules regarding the number of pitches kids can throw in a game. Keep in mind that even major league pitchers have strict pitch counts to keep their arms healthy.

Pitchers under 14 should limit total pitches to less than 1,000 per season and 3,000 per year.  If pitchers feel persistent pain in their throwing arm, they should not be allowed to pitch again until the pain goes away.

            Dr. Bob Wilmott is Chief of Pediatrics at SSM Cardinal Glennon Children’s Medical Center and is a Professor of Pediatric Medicine at Saint Louis University School of Medicine. If you have a question about your child’s health, go to the “Ask Dr. Bob” section of the Cardinal Glennon Web site at


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