While data collection in youth sports isn't as standardized as in the pros, multiple studies and national databases have flagged troubling trends:
UCL (Tommy John) surgeries in youth players doubled in frequency at some centers between 2010 and 2020 — and remained elevated through 2025.
Overuse injuries account for nearly 50% of injuries in youth baseball, with the elbow and shoulder most commonly affected.
Pitching-related injuries increased by over 30% post-pandemic, with many athletes returning to full competition without adequate ramp-up.
Athletes aged 12–16 have been particularly vulnerable due to growth plate sensitivity and poor mechanical habits.
1. Year-Round Play
Young athletes are no longer getting the offseasons their bodies need to recover. Many now play in spring leagues, travel ball in summer, fall showcases, and winter velocity camps.
2. Early Specialization
More kids are quitting other sports by age 12 to focus solely on baseball. This limits neuromuscular development and leads to overuse of specific joints and muscle groups.
3. Ignoring Pitch Counts and Rest Guidelines
Despite the widespread availability of recommendations (like those from Pitch Smart), many youth leagues and teams either don’t enforce them or lack awareness altogether.
4. Pandemic Deconditioning
After the disruptions of 2020, many young athletes returned to competition without the appropriate ramp-up in strength and conditioning — leading to a surge in acute and chronic injuries between 2021 and 2023.
Medial epicondyle apophysitis (“Little Leaguer’s elbow”)
UCL sprains and tears
Shoulder impingement and labral irritation
Growth plate stress injuries
Back and trunk overuse from poor mechanics
As physicians, coaches, and parents, we must be proactive:
Follow Pitch Smart guidelines for pitch counts, rest days, and innings per season.
Emphasize multi-sport participation to promote balanced physical development.
Delay breaking balls (like sliders and curves) until skeletal maturity.
Prioritize mechanics over velocity — speed isn’t useful if it’s unsafe.
Educate parents and coaches about the signs of early overuse injuries.
The game of baseball isn’t inherently more dangerous than it was 20 years ago — but the way we’re playing it is. A focus on early success and performance metrics has overshadowed the long-term health of our young athletes.
It’s time to step back and prioritize what really matters: healthy, happy kids who get to enjoy the game for the long haul.
Call or click to book a session with our professionals at Fuse Sports Performance, associates of Princeton Sports and Family Medicine, P.C. In addition to problem-focused visits, we offer sports performance evaluations to stop problems before they start. Plan your visit today!
At Fuse Sports Performance and Princeton Sports and Family Medicine, P.C., our professionals specialize in sports medicine services, including baseball evaluations to assess your risk for injury and assist in your performance goals.
