High School Pitchers Who Also Play Catcher are Nearly Three Times More Likely to Sustain an Injury

Thursday, May 24, 2018

The summer baseball season will soon be in “full swing” and new research published by the National Athletic Trainers’ Association (NATA) shows that high school pitchers who also play catcher, a common practice in the game, suffer more injuries than pitchers who play other secondary positions. “Rate of Upper Extremity Injury in High School Baseball Pitchers Who Play Catcher as a Secondary Position” is published online in NATA’s scientific publication, the Journal of Athletic Training.


There are already high rates of shoulder and elbow injuries in young pitchers because of the significant mechanical demand pitching places on the upper extremity. Pitchers account for 73 percent of injuries in high school baseball players, and approximately 10 percent require surgery.


“Clinicians, coaches and parents can use this information to determine secondary positions for pitchers to decrease injury risk,” says NATA member and lead author Elizabeth E. Hibberd, PhD, ATC, assistant professor, the University of Alabama Department of Health Science. “Our findings suggest that pitchers should consider not playing catcher as their secondary position in order to allow adequate time for recovery and to decrease their overall throwing load.”


Although pitch limits are well established in baseball, the results of this new study indicate that a 2.9 times greater injury risk may result from cumulative throwing load from both pitching and non-pitching activities, and that monitoring pitch counts is not sufficient. Catchers throw significantly more than other fielding positions.


The objective of the study was to compare the rate of throwing-related upper extremity injuries between high school baseball pitchers who also play catcher as a secondary position (pitcher/catcher) and those who do not play catcher (pitcher/other). The researchers studied 384 male high school baseball pitchers from 51 high school teams over three years. Of those athletes, 352 (97 percent) played a position in addition to pitcher, and 32 (8.3 percent) of them played catcher as their secondary position.  


The researchers reported 24 throwing-related shoulder or elbow injuries among pitchers during the study period. Five injuries occurred in the pitcher/catcher group, resulting in an injury rate of 15.6 percent, and 19 injuries occurred in the pitcher/other group spread among seven other positions, resulting in an injury rate of 5.4 percent. The proportion of pitchers who developed a throwing-related shoulder or elbow injury during the three-year study period was 2.9 times greater in pitchers who also served as catchers versus those who did not.  


The results of this study support previous research:

  1. Playing catcher when not pitching is a risk factor for severe shoulder and/or elbow injuries requiring surgery.3
  2. Pitch Smart (an initiative of USA Baseball and Major League Baseball) recommends not playing catcher as a secondary position.4
  3. Little League baseball prevents pitchers who throw more than 41 pitches in a game from entering as catchers.5


“Players and adults monitoring their play should use the results of our study and previous research and work with athletic trainers to determine the injury prevention techniques to keep athletes in the game,” Hibberd said.


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1. Krajnik S, Fogarty KJ, Yard EE, Comstock RD. Shoulder injuries in US high school baseball and softball athletes, 2005‒2008. Pediatrics. 2010;125(3):497–501.

2. 2014–15 high school athletics participation survey. The National Federation of State High School Associations Web site. http://www.nfhs.org/ParticipationStatics/PDF/2014-15_Participation_Surve.... Accessed January 3, 2018.

3. Fleisig GS, Andrews JR, Cutter GR, et al. Risk of serious injury for young baseball pitchers: a 10-year prospective study. Am J Sports Med. 2011;39(2):253–257.

4. Guidelines for youth and adolescent pitchers. Pitch Smart—USA Baseball Web site. http://m.mlb.com/pitchsmart/pitching-guidelines. Accessed January 3, 2018.

5. Regular season pitching rules—baseball and softball. Little League Web site. http://www.littleleague.org/learn/rules/pitch-count.htm. Accessed January 3, 2018.