It’s not unusual for a major-league pitcher to need rehabilitation or even surgery on an injured throwing arm. But such injuries are an increasing problem for another group of athletes: youth players.
young arms

Over-the-top pitching throws off young arms
Many boys' baseball arms are where many girls' soccer knees were a decade ago: in need of protection.

Case studies
Here are some cases that Reds medical director Tim Kremchek has handled over the last three springs and two summers. They are typical of the injuries being suffered by young pitchers.

Every player under count
When the Madeira Hurricanes host their annual gala of a youth baseball tournament next weekend, parent Keith Neu will be there watching the pitchers.

Decision protects son's arm
Dr. Tim Kremchek's son, Teddy, just turned 10 in March and wanted to play select baseball this spring and summer. His old man wouldn't let him.

Knuckle curve easier on the wrist
Proper grip for the "knuckle curve," a pitch that can be thrown without snapping the wrist.

Coach K's 10 tips
Jack Kuzniczci's recommendations for young pitchers and their parents.
Kuzniczci has been varsity baseball coach at Madeira High for 14 years.

Fast facts
A rundown of current research on young pitchers.

The injured list

A sampling of Tristate youth athletes, ages 10 to 18, who are rehabilitating from arm injuries:

Name Age Residence Injured Treatment
Philip Santoro 15 Madeira Elbow (stress), shoulder (weakness) Shut down, physical therapy
Jim Schmidt 11 Western Hills Elbow (overuse) Shut down, physical therapy
Kevin Eckert 14 Anderson Elbow Shut down, physical therapy, exercise
Lynzi Engel 14 Loveland Shoulder (weakness) Shut down, physical therapy, exercise
Kyle Lonkard 14 Union Elbow (stress fracture) Surgery, physical therapy
Devon Rickert 12 Sidney Elbow (chipped bone) Removal of fragments, surgery
Ian Clark 13 West Chester Elbow (strain), shoulder (weakness) Physical therapy, exercise
Cramer Dethy 14 Loveland Elbow (stress fracture) Surgery
Andrew Lattocha 12 Mason Elbow (stress) First base only, physical therapy
Ethan Furlong 18 Vandalia Elbow (stress fracture) Surgery
Noah Buettgen 12 Middletown Elbow (overuse) Shut down, rest
Josh Ingram 10 Withamsville Elbow (stress reaction) Exercise, interval throwing
James Perry 13 Milford Elbow (stress-reaction fracture) Shut down, physical therapy

Dr. Timothy Kremchek
Larry Redwine
Ted Power
Ages 8-10
Pitches thrown Days' rest
21-39 1
34-50 2
43-59 3
51-70 4
Ages 11-12
Pitches thrown Days' rest
27-47 1
35-55 2
55-70 3
67-76 4
Ages 13-14
Pitches thrown Days' rest
30-52 1
36-57 2
56-76 3
70-90 4
Ages 15-16
Pitches thrown Days' rest
25-45 1
38-61 2
62-85 3
77-97 4
Ages 17-18
Pitches thrown Days' rest
27-49 1
45-70 2
62-83 3
89-101 4
Source: Beacon Orthopedics
Type pitch Appropriate age
Fastball Any age
Changeup 10
Curveball 14
Knuckleball 15
Slider 16*
Forkball 16*
Screwball 16*
*Depends on the physical maturity of the 16-year-old. If still maturing, hold off. Even if the pitcher is physically mature, limit the combined use of these pitches to one per inning.