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New baseball rules aim to protect high school pitchers' arms

Baseball pitcher

The Kansas State High School Activities Association recently revised their pitching restriction policy for high school baseball pitchers.

I am one of several sports medicine physicians who serves on KSHSAA’s sports medicine advisory committee, where physicians, school nurses, and athletic trainers continually evaluate current research and make recommendations to the organization.

When it came to changing the pitching restrictions, we looked at changing the pitch count to protect the pitcher. It’s not meant to give another team the upper hand or to penalize teams who only have one or two pitchers. It’s meant to protect the student athlete.

There has been a move across the country to focus on “arm care” especially in young baseball players. A lot of them are pitching too much and injuring their elbow in such a way that they will need reconstructive surgery on the ligaments of the elbow because they’ve used it too much.

New concern

These types of injuries didn’t used to be as prevalent as they are now, and so when we began to see that these were happening more frequently, and younger and younger players were having reconstructive surgery, we started looking at the issue.

The physical risks of this type of overuse injury are significant. If a player needs to have reconstructive surgery on the ulnar collateral ligament in the elbow, this is a major surgery that has a year-plus-long recovery period and the elbow is really never the same.

There are also risks to the shoulder. As the body sees stresses in certain areas, other areas of the body have to compensate. If there’s extra stress on the elbow ligament, the shoulder mechanics will change and a player could potentially injure their shoulder, labrum and rotator cuff. This can set them up for several types of injuries. 

We know from objective evidence that people were injuring their elbows at a significant rate because they were pitching too much. This pitch count restriction protects young athletes because we want them to enjoy sports, but in a way that doesn’t do permanent damage to their bodies.

The rules

The new restrictions focus on the amount of rest a pitcher should have after throwing a certain number of pitches. 

Pitches Required rest
76-105 4 days
61-75 3 days
46-60 2 days
31-45 1 day
1-30 0 days

For example, if a player throws 105 pitches in a game on Monday, that player will have to rest four days (Tuesday-Friday), before being able to pitch again. 

Among the other important points of the restrictions:

  • There is a maximum pitch count of 105 pitches per day. If there’s a double-header, it counts for both those games. 
  • Only competitive pitches are counted. Warm-up or bullpen pitches don’t count. 
  • A pitcher will be allowed to finish a batter if their pitch count reaches 105.
  • If the pitcher is ambidextrous (pitches with both the left and right hand), the pitch count can only be a total of 105, not 105 for each arm.
  • The game in which a pitch count violation occurs will result in a forfeiture.
About Andrew Porter DO

I am associate director of the Via Christi Family Medicine Program and assistant director of the Via Christi Sports Medicine Fellowship. I am a team doctor for Wichita State University and Newman University in Wichita, Kan.