How do we get our 13-year-old son to stop pitching when he's tired? It's clear to us when he needs to take a rest, but he doesn't want to lose face or let his team down. It's a real dilemma.

Physiotherapy in North America for Baseball

Q: How do we get our 13-year-old son to stop pitching when he's tired? It's clear to us when he needs to take a rest, but he doesn't want to lose face or let his team down. It's a real dilemma.

A: It's clear now to sports professionals that pitching every inning of every game is no longer a good idea. But that's how it was done in the early days of baseball and for many years after. Fatigue (no matter how strong the athlete is) can lead to injury. Researchers have studied this problem trying to determine a formula whereby a pitcher would be able to calculate exactly how many pitches would be safe.

Younger, less developed pitchers are especially at risk for pain and injury from over-pitching. High-pitch counts (more than 75 per game or more than 600 per season) are to be avoided. Pitching when the arm is fatigued is also a no-no. Children must be trained from early on to let the coach know when he or she is tired. They must be taught that a fatigue-related injury can be prevented. They may think one more pitch is going to win the game, but in the long-run, they are not helping the team out if they end up injured. This can be a difficult concept for any athlete, especially young ones.

The coaches must also take it upon themselves to monitor their pitchers. Loss of pitch speed and pitching inaccuracies are clear signals of fatigue. Counting pitches and staying under the evidence-based guidelines determined by research is an easy and effective way to prevent injuries. And pitchers don't just injure their elbows and shoulders. Pitchers are also at increased risk for groin injuries, abdominal muscle strain, and knee and back soreness.

One useful tool in helping the young pitcher practice without overdoing it is the use of a lightweight (instead of standard-weight) baseball. As the pitcher trains and develops, he or she will advance from one type of pitch to another. There are many pitch types to learn such as fastballs, cutters, curves, sliders, sinkers, changeups, and knuckleballs. But it's always advised that young pitchers learn the fundamentals of fastballs first, then changeups and third, curveballs. Each pitch type requires its own unique combination of movements to achieve speed and accuracy.

Talk to the coach about his or her philosophy and thoughts on developing young pitchers. Don't hesitate to express your concerns and ask what can be done to help with this situation. It's likely this is a concern for other parents and players. Your questions may help develop some team strategies and foster player education that will benefit the entire team.

Reference: Dave Fortenbaugh, MS, et al. Baseball Pitching Biomechanics in Relation to Injury Risk and Performance. In Sports Health. July/August 2009. Vol. 1. No. 4. Pp. 314-320.