Guidelines to Prevent Injuries in Young Pitchers

Concerned parents and coaches often ask about what pitches are OK to throw, at what age they can safely be thrown, and how many pitches should be thrown in a game. The medical issues involved with pitching involve protecting the fragile growth plates, the cartilaginous lining of the bone, and the sometimes underdeveloped muscles in the young pitcher. 

The chart below illustrates the type of pitch and the age that is appropriate to start throwing a given pitch. Generally, breaking balls should not be thrown until there is solid evidence that the growth plate of the elbow is nearly closed or strong enough to withstand the torsional forced placed upon the elbow and shoulder when throwing a curve, slider, screwball, forkball, or knuckler. Age is a very good indicator, but athletes mature at different rates. When the young pitcher starts to shave on a regular basis, this is a very reliable indicator of growth plate at the elbow having become nearly closed.

Fastball - Any age
Change up - 10 y.o.
Curveball - 14 y.o.
Knuckleball -15 y.o.
Slider -16 y.o.
Forkball -16 y.o.
Screwball -17 y.o.

A knuckle curve is permitted at any age after the pitcher has mastered a good change and is taught the proper mechanics and grip to throw this pitch. It is really not a curve in the sense that it does NOT involve any torque or rotational force on the arm or wrist as do other breaking balls. 

Remember that these are guidelines and once the pitcher has gone through puberty, throwing some of the more advanced pitches is also a function of the skill and ability of the individual athlete. 

Each team should have a pitching routine that includes pitch selection and count, days rest, working on mechanics on off days, as well as an in-season running and conditioning program, pre-game routine and off-season strength and conditioning. 

What you do for in-season conditioning and running depends on the level that the athlete is participating in. A knothole team will not do the same things that a high school team would, but the principles are same; get the legs and arms warmed up and develop a routine that fits around the age and experience of the players.

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The Curve Ball Debate Continues

On August 14, 2011, Dr. Timothy Kremchek appeared on WFAN-New York radio show "The Sports Edge" to discuss the ongoing debate of curve balls in little league. Despite recent studies that show curve balls do not harm young athletes, Dr. Kremchek was very adamant during the interview saying that kids, especially those under 13 years old, should not be pitching curve balls. To listen to his interview, see below. To follow ongoing developments on this story, visit "The Sports Edge" blog by clicking here.

Part 1



Part 2



Part 3